The decision to create a single ambulance trust for Wales was not the most popular ever taken by the then Welsh health minister, Win Griffiths.
The Welsh Association of Community Health Councils condemned the consultation process as 'tokenistic' and Unison warned that the deficit bequeathed by South East Wales Ambulance trust would be a 'millstone' around the new trust's neck.
Campaigners who fought to retain the unique integrated ambulance and acute service run by Pembrokeshire and Derwen trust were appalled.
Fifteen months on, chief ambulance officer John Bottell says provisional figures show that the new trust has met all its financial targets and broken even.
Management posts have been reduced by 35, taking the trust '75 per cent of the way' towards meeting its target of transferring£1m a year from 'red tape' to frontline services.
Mr Bottell says Orcon standards are better than for the five services amalgamated into the new body, and the trust is 4 per cent above its target of meeting 50 per cent of urgent calls in eight minutes.
To round off 'a very good year', health and social services minister Jane Hutt is due to open the Welsh Ambulance National Training College this week, the trust has won£350,000 for research and development and it is about to take delivery of 65 new vehicles.
But there have been teething troubles. Last week, the trust agreed to pay more than£200,000 to John Beecher, former chief ambulance officer of Mid-Glamorgan Ambulance trust.
Mr Beecher claims he was sacked when he refused to accept an inferior post involving a round trip of 94 miles from home, and had his bank account frozen when the trust decided he was not entitled to a redundancy payment that had already been made.
At least one similar case, involving a senior ambulance officer from the same area, is still hanging over the trust, according to the First Division Association.
The trust has also to agree new rotas in south Wales, where staff formerly employed by the South East Wales Ambulance trust took industrial action last month.
Unison regional officer Brian Evans says the dispute was sparked by a disparity in pay between these staff and those formerly employed by MidGlamorgan trust of up to£1,200 a year.
Conditions were 'more or less equalised' at the end of the dispute, but work on new rotas is 'going slowly'.
Mr Evans says the disparity dated back to South East Wales Ambulance trust's financial problems and 'was an issue from day one' that might have been dealt with faster. But he accepts that 'all amalgamations involve new cultures' and take time to 'bed down'.
Roger Coakham, chief officer of South Gwent CHC, also feels that the jury is 'still out' on the new trust, and its first year 'has not told us whether it will work permanently or not'.
'It is not what people wanted in the first place, its headquarters is in the wrong place (in north Wales) and we still think it was set up in too much of a rush, ' he says. 'Plenty of issues are still simmering away under the surface.'
One simmering issue is ambulance cover in rural areas, particularly Powys and parts of north Wales. The 12 ambulance stations in Powys provide night-time cover on a 'stand-by' basis, a situation that Brecon and Radnorshire MP Richard Livsey describes as 'totally unacceptable'.
John Howard, chief officer of Montgomery CHC, also wants change.
He accuses Dyfed Powys health authority, which has well-known financial problems, of purchasing ambulance services at below national standards.
The HA denies this, and says that 'in overall terms, 51 per cent of calls are being responded to in eight minutes'.
Mr Howard responds that the overall figures hide night-time problems, when only about 11 per cent of category A calls are reached in eight minutes.
And standards have just been introduced in Wales requiring 75 per cent of category A calls to be reached in eight minutes.
Dyfed Powys HA says it is 'working closely' with the ambulance trust and other groups to 'examine the guidelines and develop ways in which they will be met'.
Mr Bottell links the situation with resolving pay and conditions issues.
'We inherited five sets of pay rates and conditions and it has been very difficult to reconcile them, ' he says. 'We believe we have now got one of the best packages in the UK, and we will be taking it out to staff on an all-Wales basis, although we have always said staff can remain on their old terms and conditions if they want.
'That has an impact on Powys and North Wales because we will be looking at rotas and how we can manage services.
'Historically, the HA (in Powys) has not purchased full cover. But there are only four calls a night on average, so it is not clear where that cover should be provided.
'We have a commitment to reducing stand-by and we are looking at providing some 24-hour cover. If we can do it while bringing in the new salary structure , we will do so.'
One way of improving response times, at first glance, would be to introduce an air ambulance service.
And there has been an offer of support from the Automobile Association, as part of its plan for a national air ambulance fleet.
But Mr Howard argues that the ambulance service would have to find£200,000 to support an AA-provided helicopter - enough money to staff six ambulance stations around the clock, and money that would have to come from somewhere else in the service.
'My CHC would rather improve our basic, core service, than have a highprofile service that could potentially further erode it.'
Mr Bottell says the trust has 'very good' relationships with the police and Ministry of Defence and uses its ambulances. In April, it agreed that further air cover would be 'beneficial', but it would not be appropriate to use NHS money because it was not essential.
He says: 'In reality we are not going to bring many more eight-minute response times because ambulances have to take off and find somewhere to set down.'
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