This summer something extraordinary happened in the west Cornish town of Hayle.
By Branwen Jefferys
BBC News health correspondent
Around 27,000 people took to the streets to protest against changes in their local hospital services.
Faced with one of the largest overspends in England the Royal Cornwall Hospital Trust was suggesting closing one of its hospitals to help it get back into balance.
Those plans have been put on hold for the moment - but campaigners in Penzance say they still fear cuts.
They have heard Tony Blair explain NHS deficits are less than 1% of spending, but that is not an argument that means much here.
Terry Murray said: "I recognise what he's saying, but the problem we have here is that you have to look at it in terms of the locality, our cuts are much more serious than losing 1%."
They are concerned that the pressure to sort out the deficit this year will have long-term consequences.
Graham Webster said: "At the end of the day there is no confidence in health service.
"People unfortunately don't trust what the health service is doing because of situation."
It's no wonder they have little trust. A series of reports has slated the financial management of the Royal Cornwall Hospital Trust.
Its use of resources was recently officially rated as weak by the Healthcare Commission.
The deficit is at least £20m and rising. It seems almost inevitable that changes will have to be made in its services to control costs, but its initial plans have been put on hold.
A review of all NHS provision in Cornwall has begun, and will only complete in January 2007.
The hospital turned down a request from the BBC for an interview.
But Ann James, who is leading the review of health services in Cornwall and the chief executive of the newly formed Cornwall and Isles of Scilly Primary Care Trust, said: "I can understand some people do think it feels like changes are being made in a piecemeal or knee-jerk fashion.
"That's why I want to start again with a blank sheet of paper."
What has happened in West Cornwall is on a much larger scale than many of the campaigns elsewhere in England.
The local authority has backed the community, and has said it will insist on full consultation on any changes to NHS hospital services.
Chief executive Jim McKenna says the impact of any reduction in hospital services would be catastrophic, and he's appalled by the lack of transparency in the finances of the local NHS.
"We understand there is potential for the deficit to be as much as £50m by the end of the year.
"Like us, the trust provides publicly funded services - we have an obligation to explain."
But union official Stuart Roden is convinced more jobs will be lost at the local hospitals.
He says the relentless pace of change and reform has contributed to the problems and, as a Labour supporter, he is deeply disillusioned.
"I think it's going to be electoral suicide.
"They invested more than any other political party in history and yet they've ended up with the biggest political mess in history. How did it happen?"
How did it happen indeed - the NHS has traditionally been Labour's calling card to the electorate.
The government has invested a record amount and can point to tangible improvements such as the reduction in waiting times.
It says standing still isn't an option, and reforms will mean better care and value for money.
But many communities are bewildered about what that means for their NHS.