The health service has been in an apparently permanent state of revolution for years, so the changes were met with weary resignation rather than anger.
Of the 37 quangos which come under the remit of the Department of Health, 28 are to be abolished as independent entities. It does not mean they will disappear, rather they will be subsumed back into other parts of the NHS. Thus the Human Genetics Commission, which advises ministers on the scientific and moral implications of genetic advances, re-emerges phoenix-like as a Department of Health Committee of Experts.
Likewise, the Human Fertilisation and Embryology Authority, which regulates IVF treatment, will seen its functions and staff split across three or other bodies.
For many workers the shake-up had more than touch of déjà vu. One body earmarked for closure is the Health Protection Agency, which has existed for only seven years since its predecessor, the Public Health Laboratory Service, was abolished in a similar bonfire.