The report that recommended call centres (and would have meant tens of thousands of redundancies) was written by the Foundation Trust Network, made up of NHS managers, and welcomed by the Department of Health. When the proposals were made public in Pulse magazine at the end of last week, the outcry was instantaneous; the report was trashed by the British Medical Association. Suddenly, the Department of Health changed tack and claimed it was only one of "several options" it was considering, but it definitely would not be going ahead with plans to use call centres.

Lansley says his plan to hand GPs the right to handle their own budgets and directly commission services will cut out layers of NHS bureaucracy. That will only work if they have a dedicated support staff. Not managers, but front-office people. Patients aren't interested in the spurious concept of "choice". They expect to be seen as quickly as possible, and they want a welcoming face at the front desk, not a disembodied voice at the end of a phone line.

I'm still not convinced Mr Lansley understands what providing a service really means.