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Published: 30/06/2005, Volume II5, No. 5962 Page 20

We asked the HSJ100 reader panel: NHS chief executive Sir Nigel Crisp has confirmed that the number of primary care trusts and strategic health authorities will decrease. Is yet more change inevitable, essential or an unnecessary bureaucratic

Hilda Harvey, chair, Bury primary care trust The NHS is like a whale - it must keep moving or it will die. Change is inevitable and essential, but many people question the pace of that change.

Euan McPherson, patient advice and liaison services and involving people manager, Herefordshire PCT I do not think anyone would argue with a reduction in the number of PCTs or strategic health authorities if the end result was improved efficiency. However, I am not sure that all PCTs have even had time to stabilise yet and therefore optimise their performance following their introduction, so is it really possible to forecast that reducing the number will lead to greater efficiency?

David Smith, director of performance, Surrey and Sussex SHA It is essential that we create SHAs and PCTs that are fit to drive forward the next stage of NHS reforms. It is inevitable that the number of organisations will reduce. However, we must avoid the temptation simply to merge existing organisations into larger ones - form must follow function.

Heather Maughan, head of nursing services, Easington PCT I am not sure that structural change is required to improve services. In my experience this sort of restructuring actually stalls all improvement and innovation while people worry about reapplying for jobs or finding new positions, new stationery is sorted and everyone gets used to working within the new structure.