Who should commission maternity care? Health secretary Andrew Lansley has decided it should not be part of the “great majority” of services that GPs will eventually be responsible for.

The story of how this came to pass and the debate it is sparking has much to tell us about how responsibility for commissioning will develop.

There was little GP reaction to begin with, but now unrest is growing. The NHS Alliance reports members declaring the decision “outrageous”, while Royal College of GPs chair Steve Field called it “stupid” and British Medical Association GPs committee deputy chair Richard Vautrey said it was “illogical”.

This reaction is interesting, given the recent trend has been for GPs to highlight the support they will need to grasp the commissioning nettle. Surely a lightening of the load would have been welcome. Could it be damaged pride that is heating up the debate?

The truth is that the various royal colleges associated with maternity care lobbied for GPs not to have anything to do with commissioning in their sector, and won the day. The government might want the approval of GPs, but - in this context - it fears the wrath of midwives more.

Once this knowledge becomes more widespread might interest groups associated with other types of care start to apply pressure? There are a number of powerful medical lobbies with a relatively low opinion of GPs’ knowledge of their discipline. The BMA, whose reaction to the reforms is influenced heavily by its specialist members, will perch on the fence.

But might, ironically, this questioning of GPs’ ability be just the kick the profession needs to get involved en masse?

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GPs stung by maternity services rebuff