The words both Doctors and Nurses dread to hear are, review, reform, overhaul, change, and shake-up. I've had similar experience of change during my service in the Royal Navy - and it was all bad. Poor managers refuse to accept responsibility if something is not working as well as it should be. It must be the system - the system needs changing - we must hold a review - blah, blah, blah... In the majority of cases the system in place works perfectly well when it is being run by a competent manager. Sadly, most government run organisations are lacking that vital ingredient.
I found (and I'm sure health staff are experiencing the same thing) that just when I got to grips with how the Engineering branch in the Navy worked, we would get a new Admiral and everything would change again. This change also tends to be driven by the Admirals need to be seen to be doing something, and I'm sure the same goes for Health Ministers. What people at the coal face want, is for those people on the surface who have no idea what is going on down below, to leave them the hell alone.
Doctors and Nurses must dream of the day when the instructions to change this or that stop coming down from the government. The NHS is a fantastic organisation lead by the wrong people. Doctors know where improvements need to be made (that's improvements - not changes) to the system and the government should leave them to get on with it for at least a couple of years. The fact that Doctors have already delivered a petition to Downing Street signed by a million patients rejecting the new polyclinics, shows how popular this review will be with those having to make yet more changes.
Gordon Brown is very pleased with the changes, he claims that they are a "once-in-a-generation opportunity" and will have "an even more profound effect" than previous shake-ups. I'm sure they will, and I'm sure that health staff are dreading them.