Despite all the previous reforms, no one could claim the National Health Service is not in need of another change to get it right. But surely doctors are the last people to whom we should be handing the NHS finances? Don’t expect anyone to benefit except the GPs themselves.

Doctors are trained as practitioners, not managers, and every hour spent on paperwork is an hour less servicing payments. Putting them in charge of the NHS’s massive budget will mean many doctors hanging up their stethoscopes permanently as they choose to become businessmen.

Medics are bright people and many will adapt to commerce easily. Just look how the consultants in hospitals run their organisations for their own financial benefit, or at the GPs who run multi-site surgeries and “earn” £250,000 or more. But for every doctor who wants to be a businessman there is at least one who merely wants to care for patients and forcing them to become accountants risks forcing them out of practice too.

But doctors do not earn money, they merely spend it, so they are not real businessmen. Their income is not generated but accrued by a formula for meeting targets and providing services – the same sort of formula that can pay a primary school headteacher £230,000.

And doctors have proved extremely able in beating their government employers in negotiating such formulae. Look at the new contracts won from the Blair government which gave them more money but saved them making out-of-hours visits: young doctors merely signed up with out-of-hours agencies to be paid extra to do the work they used to do anyway. Abolishing health authorities and primary care trusts may be a right reform – the PCTs’ 1,800 non-executive directors exceeds the whole FTSE 100 - but it will mean a massive redundancy bill.

This reform looks more like re-arranging deckchairs when what the NHS really needs is a reduction in the service it provides and a way of making patients – customers – appreciate the value of what they receive. Doctors who offer a service to suit customers – weekend and late opening, for instance – would be welcome, but the risk of commercialising GPs is that they go the same way as dentists and opticians and effectively operate outside the health service.

If we’re going to end up with a semi-private health service, we should not be paying for it through taxes as well. But expecting doctors to look after anyone themselves is a high hope.

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