Making major changes to any organisation is bound to lead to upheaval and expense.

So in a sense it is no surprise to learn that the re-organisation of the NHS is costing £363 million in the West Midlands alone.

After all, the NHS is a huge organisation. This sum, massive as it is, represents a small proportion of total expenditure.

And as the changes include the abolition of existing health trusts, there have inevitably been significant redundancy costs. It remains to be seen whether Labour’s claims that the same people will end up being-rehired by new commissioning consortia prove to be correct.

In the longer run, the result of the changes may be to save money, and allow more cash to be ploughed directly into health care. That’s certainly the intention of the Government, which argues that £1.5 billion a year will be saved in administration costs which, coupled with a pledge to maintain and increase total NHS funding, will mean more money is spent on actually treating patients.

Maybe so. But it has to be said that the medical establishment doesn’t seem to be convinced.

And while there is, sometimes, something to be said for imposing change on an organisation, it’s hard to see why the Government believes this is the right time to make radical changes to the NHS.

As the latest economic figures show, the economy is still fragile. At the same time, most public services have been forced to cope with significant spending cuts, even though health has been spared.