The Welsh Assembly has announced plans to slash the number of local health boards and strip them of their commissioning role.
A consultation published last week proposes cutting the number of boards from 22 to eight and funding trusts directly from the assembly or a new NHS board for Wales.
The paper outlines three options for establishing a new NHS board for Wales: a special health authority; a civil service board; or an advisory board supporting an assembly NHS chief executive.
Health minister Edwina Hart said the aim was to deliver a more effective administrative structure and improve care. "These [plans] are not driven by cost. These proposed changes will be contained within the current finances."
It is just five years since the 22 local boards were established, covering the same areas as local authorities and intended to bring decision making closer to local people.