Historians of local government (and there are a few among The MJ readership) will remember one of the reasons for the creation of the London CC and the London boroughs in the late 19th century was the sheer incompetence and nepotism of the ‘vestry councils' and boards that preceded them.

Now we see modern day government is following the dictum that ‘history repeats itself first as tragedy and then as farce'. It was reported that Clinical Commissioning Groups have awarded over 400 contracts worth more than £2bn to companies, clinics and hospitals in which their board members have declared direct personal interests. Given the current government interest in governance arrangements in Birmingham City Council it is interesting to note that GP leaders in that city have awarded contracts worth more than £1.7m to a company in which three of them were shareholders.