Irwin Brown of the Socialist Health Association suggests that NHS healthcare commissioning and market Stalinism are inimical bedfellows.

The enthusiasm amongst some GPs for the 'liberation' proposals has now been replaced by scepticism as the contents of the Bill reveal the actual proposals.

The Bill is designed to achieve a full market in health; a proper market with price competition, and most services subject to the any willing provider model. This is not what most GPs want.

Oh dear. Previously, DH has fared not-so-well in Cabinet Office capacity and capability reviews.

Their latest staff survey, dated Autumn 2010 and with a 67% response rate, is scarcely designed to inspire great confidence.

Which, on the face of it, is not surprising. The DH will be shedding significant staff over coming years, if it is to keep in line with SOS Lansley's intention to cut management costs by 1/3.

However, the process has not really started yet.

Earlier today, I was asked on Twitter (where I'm @HPIAndyCowper; do say hello if you tweet) to explain something pertaining to 'the Big Society'.

You've probably heard the Big Society joke, but just in case:

Q: What's the difference between the Big Society and the Big Issue?

A: Some people buy the Big Issue.

(Big Society czar Lord Wei has certainly heard it.)

The recent session of the Public Accounts Committee with NHS Supreme Soviet Chair Sir David Nicholson and DH permanent secretary Una O'Brien was an inadvertent masterpiece of political satire.

Its quality was sufficient to rival even a speech by the magnificent Health Minister Simon 'Dale Winton on Valium' Burns.

I don't want to be unkind to whoever wrote the DH's PCT cluster implementation guidance.

Or at least, not more unkind than is strictly necessary.

They did not write this dog of a policy; they are merely having to try to operationalise it.

You'll already know that the second reading of the Health and Social Care Bill passed last night.

The brilliant folks at Hansard have the transcript online now.

Some key extracts follow below; first, a few thoughts.

It's going to be a busy day.

The Government has published its response to the health select committee's recent and critical report on commissioning.

The Government's response is to "welcome the Committee’s conclusion that more effective commissioning is the key to delivery of efficiency gains".

Prime Minister David Cameron spends more of his political capital on SOS Lansley's reforms and continues his unctuous self-anointing as the 'heir to Blair' by seeking to advance his political agenda with an appearance on BBC Breakfast to outline his desire to "cut bureaucracy and waste" and this article for Rupert Murdoch's Times on NHS reform myths.

I'm grateful to a reader of Health Policy Insight for giving me sight of the House Of Commons library document on the Health And Social Care Bill.

We have previously raised the issue of the statutory status of consortia, and again here.

"What I tell you three times is true" - Lewis Carroll, 'The Hunting Of the Snark'

The political case for NHS reforms has become serious news, and last week's NHS week is still nto played out. Ministers are parrotting party lines about myths, which we shall analyse shortly.