The wheels on the bus go round and round, round and round, round and round, all day long. Those of you who have children know this song. It's great. At least, it is for the first 10 times of listening. In the same way, some have welcomed reorganisations of the National Health Service (NHS) as the way forward – but again, and again, and again, year in, year out?

My first experience of primary care management was the Family Health Services Authority. If my memory serves me correctly, next came the Health Commissioning Agency – in fact, there may have even been something in between these …