IS IT just a coincidence the latest changes to the NHS came in on April 1, and if not, who’s the fool? Branded the biggest shake-up to the system since it began, it comes in the wake of a whole host of other changes to management.

Not that the NHS isn’t used to change, the difference here is no-one has a clue how the new system will work. Even supporters of clinical commissioning groups (CCGs) openly admit they haven’t got a clue how the process will work.

If it allows health professionals to better understand the needs of their patients and provide better choice it has to be good, but this is far from certain. Doctors are the first to admit they are as confused as anyone about the changes but one thing those I’ve spoken to do agree on is managing the service can only become more complicated and expensive. Whether the extra cost can be justified by better care for us all will only be seen in time.

Meanwhile there are a significant number of doctors and other healthcare staff seriously worried about their personal involvement in a number of different organisations. Will the news system, for example, require them to declare their interest in private health organisations, care homes etc?

Many, many doctors have, over the years, spotted opportunities and bought into lucrative private concerns to supplement their incomes. To be viewed as truly independent, surely such interests will need to be declared at the outset and not just when they become relevant to the decision making process?