Two Yorkshire hospitals will start 2005 with a greater degree of independence.
The trusts which run Barnsley Hospital and Harrogate District Hospital have both been given foundation status.
It means the hospitals will be able to borrow and spend money as they wish, making them, it is claimed, more responsive to local needs.
Health chiefs in Barnsley plan to spend £7m on a new children's and women's wing, something they have been waiting the NHS to fund for three years.
The hospital's chief executive Jan Sobieraj said: "Investing the money from our own income growth means we will be able to pay for it ourselves, speeding up the development considerably."
Members of the public have a chance to sign up to become members of the hospital trust and put forward views on how the organisation should be run.
In Barnsley, 12,500 people have joined, one of the highest membership figures for any foundation hospital in England.
The figure for Harrogate is 10,000 and more are still wanted, according to trust chairman Albert Day.
"I should like to encourage everyone across the district to sign up and become a member of the new organisation, said Dr Day.
"It's the views of local people that will help develop hospital services for the future so we want to ensure that we listen to as many people as possible."
Both hospitals will be regulated by Monitor, the organisation which grants foundation status.