I am a bit concerned with the accounts of the new NHS bill coming before Parliament. We will have to see the detail, but it seems to include a lot of powers for the minister to override local health decisions, which I find problematical.

A quick recap: go back far enough and the NHS was wholly under the responsibility of the Department of Health. This made the minister ultimately responsible for the decisions taken. This was then re-organised into "arm's length" bodies, which had strengths and weaknesses. The minister was less accountable, but it opened the way for more specialist and dedicated management.

It appears the new proposal combines the worst of those features. The accountability remains with the arm's length groups but the new powers will allow a minister to swoop in, override a decision about contracts, or opening and closing hospitals and so on, then fly out again.

I think we can take it as read the minister is unlikely to demand the closure of a hospital against the local advice. Why would they court such flak?   On the other hand, if a local authority has a budget problem and decides the only choices are to cut services everywhere or close a local hospital, there will – as always – be a local protest and the minister can turn up, declare the hospital stays, collect all the popularity and disappear again, forcing the local health bodies to cut the services as their only other way of balancing the books.

It looks as if the minister can act with no knowledge of the local circumstances, then leave without suffering any of the consequences, leaving others to sort any mess arising.

Again, the minister can force through contracts, overriding local decisions. If that is not another PPE jobs-for-chums scandal in the making, I don’t know what is.

I also mentioned that the current structure was introduced to enable management by highly skilled and dedicated people as one of its strengths. Dido Harding? She still seems to be in the running.

All in all, the proposals as reported so far sound potentially quite damaging for the NHS.   But we will see shortly.