On Tuesday I suggested that sooner or later GP organisations would recognise that they have a great deal of power over the way in which the Government could carry out its policy of GP led commissioning.

It is clear that the leadership of organisations such as the NHS Alliance and NAPC really want to make GP led commissioning work. But if they were to decide that the conditions that the National Commissioning Board are now constructing for that commissioning to take place would reduce the possibility of it working they could suggest that, unless those conditions change, they would walk away.