You've got to laugh; they've made it a condition of becoming a pathfinder consortium.

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Click here for details of 'You say substantive and I say substantial', Issue 7 of subscription-based Health Policy Intelligence.

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Not content with launching a bogus listening exercise that doesn't receive incoming phone calls and won't let people know where its events are, the Lansley-loving fraternity has now tried to punt the contrived support by a Tory partisan GP as a groundswell of support. (This despite the fact that 43 GPs is not quite a groundswell.)

The interesting back-story behind the coalition-of-the-willing creation of this letter by Tory partisan GP Dr Jonathan Munday was first revealed by Randeep Ramesh, social affairs editor of The Guardian, and then followed up by us.

The letter itself airily asserts that "much of the criticism has sadly been noticeably misinformed" - and goes on not to outline which criticisms, and how they are misinformed.

It also blithely assumes that "if they (patients) are dissatisfied with the services provided, will have no difficulty in saying so", overturning at a stroke reams of research literature about whether patients tell medical professionals when they are not happy with those professionals' service.

It is unsurprising that some of the 43 signatories are wholly sensible people like Dr Shane Gordon who genuinely believe in the potential of the reforms. In some places, clinically-led commissioning is going to work brilliantly. In others, it is going to be a goat-love of epic proportions.

The IHP Tendency are all still there.