Plans to merge health services have been condemned by a Midland MP in a House of Commons report.
Health Secretary Patricia Hewitt has announced proposals to reduce the 30 West Midland health trusts responsible for commissioning NHS services to about 15 larger bodies.
The four existing trusts in Birmingham, known as primary care trusts, could be merged into just one, covering the entire city.
At the same time, the Government is proposing a merger of the region's three Strategic Health Authorities into a single body.
But the changes have been criticised by the Commons Health Select Committee, including Worcestershire MP Richard Taylor (Ind Wyre Forest).
He warned that every time health services were reformed, it took them 18 months to recover. But the trusts have already been through a series of changes.
Until 2002, Birmingham actually had a single trust, known as Birmingham Health Authority, but this was abolished and replaced by the four PCTs - which the Government is now considering merging back into a single body.
The trusts control 80 per cent of the local NHS budget and commission health care for their local populations from hospitals, GPs, ambulance trusts and other providers.
Some are also responsible for directly providing community health services, including district nursing and health visiting. The Health Select Committee described the plans as "ill thought out" as it published the findings of an inquiry into the latest reforms.
It also criticised a "clumsy and cavalier" approach to NHS staff caused by uncertainty over who their future employers would be. The MPs said there were well-founded concerns that patient care would suffer because of the proposed reforms.
Dr Taylor said: "It is important to note that PCTs were established only three years ago, at considerable cost to the taxpayer."
This meant that just as the benefits of establishing PCTs were about to be realised, the Government had decided to set about restructuring them again.
"The cycle of perpetual change is ill-judged and not conducive to the successful provision and improvement of health services. Major restructuring should only be undertaken if there is an overwhelming argument in its favour; in this case there is not."
But Health Secretary Patricia Hewitt defended the changes and insisted the mergers were "not change for change's sake".
She said: "We aim to create stronger and more effective PCTs which can secure the best possible health and healthcare, for all patients, in every local area.
"We are responding to local wishes in many parts of the country to merge Primary Care Trusts."
The reforms would save £250 million in administration costs annually, which could be spent on medical services instead, she said.