THE Redditch and Bromsgrove Primary Care Trust has now been consigned to history.

The people of both towns over the past decades have had their health services delivered by such a number of different organisations that they cannot be blamed for failing to keep up with the patterns of and rationales for organisational change, and no insider is left not reeling and confused by the shifts of explanation and justification designed to arrive apparently at a point we left many years before.

We now have the new Worcestershire Primary Care Trust and we must go forward believing in the ambition of change to improve.

The ultimate configuration of a locality structure will be the responsibility of the new trust. I believe that there is a large responsibility now on the practice commissioning groups to ensure that services are designed and determined according to the priority needs of their own populations, and that unwelcome changes are not forced upon the clinicians and patients in the name of cross-county rationalisation or symmetry, nor that resources hitherto allocated to localities are diverted into other areas to the detriment of the existing services.

The achievement of Redditch and Bromsgrove practices in arriving at early agreement over a single practice based commissioning cluster should be a very great asset in settling future service design. The triumph of existing PCTs has been the very involvement and supremacy of clinicians in determining strategy, but any loss of influence and ownership of the organisation would be a retrograde move.

The recent annual general meeting of this PCT celebrated the great success of this organisation over its four year life. The director of public health produced a detailed record of achievement in improving the health of our public. I also would highlight the changes and improvements at the Princess of Wales Community Hospital, particularly palliative care and the Minor Injuries Unit, new health centres at Church Hill and Catshill, with Wythall nearing completion, the introduction of the new GP and dentist contracts, improvements in podiatry, wheelchair and equipment services, breast screening, occupational therapy and others.

I can only express my recognition and gratitude to all colleagues in the trust for its contribution to delivering the difference in healthcare reached in the last four years by this organisation. The Strategic Health Authority has thanked us for delivering one of the best performances across the West Midlands South region. In Redditch and Bromsgrove, our partners, the local authorities, the public and patients in meeting after meeting, in the press and in our premises, have been positive in their support and praise for this trust because it has succeeded in its own terms: in quality and design of service, managerial efficiency, financial viability and local accountability.

I come to the end of my term of office as chairman with satisfaction that the organisation has done its job with distinction and to public acclaim. We will all feel implicated in the future of the county's health service because of the inheritance we pass on. We trust that our successors will share the commitment, dedication and ambition that this organisation has manifested throughout its existence.

Graham Vickery, Chairman, Redditch & Bromsgrove Primary Care Trust