Welsh Secretary Alun Michael told the Commons on Thursday that 10 new trusts will be created in Wales by April next year.

Four of the Welsh trusts, including the Welsh ambulance services trust, will be left untouched.

This means the number of trusts will fall from 26 to 16.

Eventually this figure may be reduced to 15 as two of the new trusts, covering Cardiff and the Vale of Glamorgan, might eventually merge.

Mr Michael said no hospital would close as a result of the reorganisation, but he added: "Standing still is not an option."

"A new coherent pattern of trusts is needed to replace a situation in which many act as if they are medieval city states, each competing with the other," he said.

The aim of the mergers is to bring neighbouring hospital trusts together to avoid duplication and promote better collaboration; to combine community and acute trusts to provide "a seamless service" for patients and to make sure NHS trusts share the same boundaries, where possible, as local authorities and the proposed primary care groups.

The new trusts, which mostly cover mental health, acute and community services, are:

• the North West Wales NHS Trust, covering Ynys Mon and Gwynedd
• Conwy and Denbighshire NHS trust, covering Conwy and Denbighshire
• North East Wales NHS Trust, covering Flintshire and Wrexham
• Carmarthershire NHS Trust, covering Carmarthenshire
• Swansea NHS Trust, covering Swansea
• Bro Morgannwg NHS Trust, covering Neath Port Talbot and Bridgend
• Pontypridd and Rhondda NHS Trust, covering the Taff Ely and Rhondda areas
• Gwent Healthcare NHS Trust, covering the Gwent area
• two trusts covering Cardiff and the Vale of Glamorgan.

The statement on mergers has been delayed by five weeks because of former Welsh Secretary Ron Davies' resignation.

Collaboration

Fiona Peel, chairman of the Welsh NHS Confederation, said she welcomed the fact that a decision had been made.

"If we look back on the reason for planting the idea of reducing the number of trusts and making them bigger it was to improve collaboration, remove barriers between trusts and create sub-specialities in care," she said.

"If the government is going for large-scale integration of trusts it is a very good idea, especially when put in the context of creating local health care groups which will commission care from the trusts," she added.

However, she said a lot of work would have to be done in the next three months to merge the trusts and she anticipated some resistance from some trusts.

Nigel Evans: there could be cuts in frontline services

The government has asked trusts to keep down the costs of the mergers, but Mrs Peel hoped any job losses would be kept to a minimum.

The Conservatives said the government was looking to make major savings from the mergers, but Welsh spokesman Nigel Evans commented: "There is a grave suspicion that these cannot be made from reconfiguration. They will be made from frontline services."

Fiona Peel, however, dismissed this speculation. Her only comment was: "There are no Tory MPs in Wales."