Whether it is local economic development, health or local government we see all governments look to reorganise services as a solution to delivery. Too often we see organisations established with too little thought about what they are trying to achieve. This year we have seen the ending of contracts for Community Rehabilitation Companies and changes to Local Enterprise Partnerships. Both could have been established better at the beginning. We have also seen changes to delivery bodies in the NHS with a serious lack of local accountability. If MPs are confused about which body is responsible for different parts of the NHS no wonder citizens are confused.