A meeting of senior health, local government and business representatives in the West Midlands last week reached a consensus that the planned configuration of strategic health authorities and regions will be too large and diffuse to engage effectively with trusts, primary care trusts and local authorities.Participants at the meeting of the Lunar Society, a body concerned with social, economic and cultural issues in the West Midlands, agreed that three SHAs are too few and do not match the political and social map of the region.Members, including senior NHS figures, felt the SHAs will be too remote and lack the resources, manpower and relevance to make a real difference to the implementation of the NHS plan.

At worst, they concluded that the proposed restructuring might destabilise the modernisation programme, at best the changes would slow things down.