The change from five to one primary care trust for the whole of Oxfordshire is a sensible one. The body, that effectively commissions health care on behalf of all of us in the county, will be more cost-efficient and effective for having one chief executive, one chairman and one senior management team.

The only question is why we ever went to five PCTs in the first place with the obvious duplication and increase in bureaucracy.

Common sense has eventually prevailed and the main cost has been in anxiety for the many employees of this important service.

The truth is, most of us will not notice any day-to-day difference. We will still be served by the same GPs who will refer us to the same hospital services if we need them.

Behind it all, however, there are some big decisions to be taken by this new trust that will have an impact on all of us.

While it is more cost-efficient than its predecessors, the savings are nothing like enough to deal with the hole at the heart of NHS finances in Oxfordshire.

The new PCT has to deliver savings of £18m. Top of its list is likely to be community hospitals - facilities that are rightly prized and fiercely guarded in their localities.

The chief executive of the Oxfordshire Primary Care Trust, Andrea Young, is making the right noises. She says a key part of planned reforms will be to bring health decisions closer to the public. She may find that that is harder to achieve in practice.