When the Business Secretary described Government reforms to public services as “Maoist and chaotic”, his comments struck a note with unsettled backbench Tory and Liberal Democrat MPs.

Vince Cable was referring to the abolition of regional development agencies, but he might as well have been talking about plans to cut National Health Service administration by 45 per cent and changing yet again the way that hospitals and GPs work on behalf of patients.

No-one can be quite sure how the new system will work in practice. If the Government is correct in believing that the NHS is top-heavy with bureaucracy, then the disappearance of thousands of officials will save money and lead to an improved service.

Certainly, here in the West Midlands, highly-paid administrators are voting with their feet by getting out while they can to take other jobs in the public sector. There are fears that this exodus could cause major problems at a time when the Government’s changes are beginning to feed through.

This radical shake-up, the latest in a long line concerning the NHS, involves GPs taking direct control of budgets on behalf of patients. It is a bold venture by the coalition, but history tells us that the health service does not usually take kindly to rushed change.