Who elected the government? Who pays the bankers? Who decides when you will retire? Who decides which drugs you prescribe? Who decides which hours you’re open?  Who decides how much money it costs to run the practice? Who decides if you’re any good as a GP? Who decides which operations are “low priority”? Who closes the local AED? Who needs to spend more on British Pharmaceuticals to save UK PLC? Who commissions for Quality in General Practice? Who writes prescriptions for food supplements? Who stops patients from getting DLA? Who is responsible for all those benefits scroungers? Who supplies addicts with their gear? Who protects nurses from making decisions? Who runs the CCG?

By now you will have realised that the answer to the question is that you are the person responsible for all of the above. I suspect it is not the job description of General Practice that made you enter the speciality. I suspect that most of us for reasons of sanity, choose only to recognise some parts of the above, but sadly, with the exception of electing the government, we are all responsible in the eyes of our patients, colleagues and press for everything else.

Our problem is that, unlike Fred Goodwin, our influence is dispersed across thousands of practices. Since we never seem to be capable of supporting any GP leader since the 1970s our influence will always remain dispersed, but our accountability will be personal. Unless the profession decides to unite change will ripple through the NHS until that too no longer resembles the organisation we thought we’d joined and hoped would care for us and our families in need.