'The fundamental objective must be to make some positive difference to patients. If Andover and others can do this, they will serve as a beacon for much of the rest of the NHS'

Evidence that not everyone was idle over the holiday period emerges from Hampshire this week, where a community trust has seized on the opportunities offered by The New NHS to propose itself and its local GP fundholders as the basis of the first primary care trust (see News, page 5).

In many ways, Andover and District Comunity Health Care trust is already some way down the road towards the model of an open and accountable body with consumer and community representation which health secretary Frank Dobson and his team have advocated since they took office.

The trust's managers and local fundholders are lucky, perhaps, that their own preferences coincide so neatly with the opportunities set out in the white paper, and that both existing links between statutory and voluntary agencies and the civic culture of the town make further progress possible so easily.

Many others will find the going far tougher. They will endure more disruptive organisational upheavals, have to confront deeply entrenched historical differences, and face suspicion of change. It will not be easy - though it may well be easier in areas where one model of general practice has held sway. Where fundholding has been particularly weak, as in Scotland and some big English cities, or strong (as is the case in Andover), the problems may be less than in areas with competing systems.

Of course, the fundamental objective must be to make some positive difference to patients. If Andover and others can do this, they will serve as a beacon for much of the rest of the NHS. We wish them well.