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  BUT: it is an opportunity to reduce some of the complexity and re-target resources and, truth be told, an opportunity to downsize the number of ineffectual managers. A significant proportion of the public sector PCT and SHA managers/directors have either never worked at the sharp end or have lost touch with it and acquired a new and less helpful set of priorities and in addition lack the ability to manage effectively. Many of those public sector managers are now wondering why the GP consortia are not beating a path to their doors - I can tell them why!

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