IT was easy to be cynical and to see it as just one more re-organisation, said Mr Barlow, but he pointed out that health minister Alan Milburn had made it very clear it was the last re-organisation for the foreseeable future.

"We are a totally different animal to the former Primary Care Groups and the Worcestershire Health Authority," he stressed. "One of the things that makes us different is that we are the centre of a network and what makes us special is that for the first time we have local doctors, nurses, therapists and other local professionals right at the heart of decision making, helping health improvement and reducing inequalities."

South Worcestershire PCT is responsible for a population of 290,000 covering an area from Broadway 40 miles across to Tenbury Wells, with a £200 million budget, responsible for GPs, nurses, dentists, pharmacists and opticians, community and district nurses and special services such as palliative care and sexual health services.

"As well as being broad geographically, we are broad in terms of service," the chairman said.

Mr Ridley said the new trust could be more locally sensitive to the needs of the population and was able to make local decisions on where money was to be spent, enabling them to integrate care and make it more effective.

Mr Barlow explained: "We are now in a position to weld all our resources together and overall make a package of care for each individual patient which we believe will make it more effective."

So important were the trusts, he said, that in two years time it was anticipated they would be responsible for 75 to 80 per cent of all NHS expenditure.

Questioned about the future of Evesham Community and Pershore Cottage Hospitals, Mr Ridley said: "Nothing stands still. The two hospitals are assets for the local communities, heavily involved with local GPs. What we need to be absolutely sure of is that they are fully integrated into the whole system and barriers not built up around them.

"We need to ensure all the beds are fully used, to support the services appropriate to what is done in these hospitals and that it links in with the acute hospitals and in the overall services. I have got to say to the GPs in Evesham and Pershore that we need to continue to review what we are actually providing to the local community. We need to take account of all assets available to us."

Mr Barlow added: "We have to review, but that should not be taken to mean there is any panic about closure. We have no fixed ideas but nothing stands still. What we are about is breaking down barriers."

Mr Barlow said he saw his biggest issue being one of communication and forming closer links between GPs and all primary care services.

"I hope more patients will be treated within GP practices, that more community physiotherapists will be used to avoid people going into hospital, and that we shall concentrate on prevention and healthy living," he said.

"It is our intention to get much more closely involved with voluntary groups and use the enormous amount of goodwill the volunteers offer in terms of expertise, time and support of the bigger organisation. Only by working together will we achieve that."

Mr Barlow said it was not often that anyone had the opportunity to set up a brand new organisation but he was particularly pleased with the local people on the board as well as the professionals.

South Worcestershire Primary Care Trust is run by a Trust Board, and there is also a Professional Executive Committee which has representatives on the Trust Board.

SOUTH Warwickshire Primary Care Trust is responsible for the healthcare of about 250,000 people living in Stratford and Warwick districts.

It took over from four separate organisations - Stratford and Warwick Primary Care Groups, South Warwickshire Combined NHS Trust and some of the functions of Warwickshire Health Authority, on April 1.

The trust manages St Michael's Hospital, Warwick, Ellen Badger Hospital, Shipston and Alcester Hospital. It also manages a number of other community units including the Tiddington Fields mental health unit for the elderly.

The trust's total annual budget is £170 million, which it uses to provide services and commission services from other providers. Its major provider is Warwick General, which includes Stratford Hospital.

There are 38 GP practices working within the trust.

Trust lead nurse Viv Bennett said the trust's aim is to look at the health needs of the population and provide services to meet those needs.

The primary care trust in the Cotswolds area is the Cotswolds and Vale PCT. This trust administers the hospitals in Bourton and Moreton. The area it covers includes Stroud and the Berkeley Vale.