This adjournment debate in the Commons last night is of interest. Firstly, it shows that dwarf-baiting Health Minister Simon Burns MP is going to prove an effective performer on the defensive. That will prove a useful skill.

Secondly, it is a reminder that service changes are going to have significant effects on local politics. And that ministers will be held to account by MPs and media, until commissioning is much further down the track and has much higher public visibility and responsibility for driving change.