Imagine the scene, a young entrepreneur has a plan which will make millions, he goes to the dragons den.
The pitch is good, solid, his idea has been tested out on colleagues and friends, he knows it's good.
He finishes the pitch, silence descends and Theo speaks..
"That's nice, but we're the dragons and we decide what happens"
Our hero is confused.
Peter Jones clears his throat.
"Theo is right, you have to realise we are the new dragons, we decide what happens and we also come up with the ideas"
An uncomfortable pause, before Duncan moves on his chair.
"let me tell you where I am on this- I'm a dragon, we have the money" he says patting a large pile of notes, "and we will decide who gets the money, we also have the ideas"
This isn't working out as expected our heros idea seems to have missed its mark, the dragons seem intent only in enforcing the mantra of their power.
There is only one dragon left to take an interest in the idea.
She looks up from her papers.
"I'm sorry I'm far too busy ticking boxes proving I'm a dragon, have the money and ideas to take an interest in your scheme, come back to me in a few months."

Although this distorted den is clearly a fantasy, the reality is that across the country CCGs are playing those difficult dragons, whilst a diverse group of clinicians, managers and organisations are seeking support, not necessarily investment, for new ideas. Once our CCG dragons relax, secure in their positions things might improve for the entrepreneurs. Until then it's likes to be a frustrating experience in the dragons den.