A major shake-up to NHS care is set to take affect in County Durham in a matter of months, a council meeting was told.
Councillors heard how health organisations could be transformed this summer, with some arrangements moving back to "pre-1974".
The Health and Care Bill going through Parliament proposes to abolish clinical commissioning groups (CCGs), which currently plan and buy health services for local communities.
From July, if the Bill is passed, new bodies called integrated care boards (ICBs) will take over the job.
Michael Laing, director of integrated community services at the County Durham Care Partnership, spoke about the reorganisation to Durham County Council's adults, wellbeing and health scrutiny committee on Monday (March 21).
Mr Laing said: "Integrated care boards will have responsibility for commissioning £5.8bn worth of healthcare in the North-east and Cumbria.
"In County Durham that's currently about £1.5bn worth of services across primary care in GPs, pharmacies, community services, district nurses, community hospitals, therapies, mental health and other associated services.
"So we're talking about the commissioning of a significant amount of money which has a major economic impact on the county."
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He said the area's new ICB was already operating as a "shadow board" under chief executive Sam Allen, chair Professor Sir Liam Donaldson and medical director Neil O'Brien.
He added: "It becomes the responsible organisation in July.
"And that's a very, very short timescale to create this new organisation."
He said under a Government White Paper the new system was intended to make sure children's services and adult care and health worked together.
He said: "You see your health and care needs as one.
"County Durham, the county council, and others should be working together so that the experience for patients is seamless, so that they don't have to tell their story more than once, so they're not being handed off between organisations."
He said County Durham would be grouped with South Tyneside and Sunderland in an area to work together to make recommendations, with the Tees Valley classed as a different area.
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He told the committee: "What the CCGs have done over many years is make strong links between out GPs and what happens in GP surgeries and what happens in hospital wards.
"So we are going to have to work really hard together to make sure that we keep those links and that connection between the GP and the hospital ward is maintained.
"So there are some dilemmas in the proposed operating structure."
He said the committee should scrutinise how the new arrangements affect the people of County Durham.
Councillor Craig Martin asked about the new structure, saying some people might go to Darlington or Middlesbrough hospitals.
He said: "County Durham almost needs a foot in Teesside and a foot in the town centre area."
Mr Laing said: "Patients do not stop at the boundary of County Durham.
"The trust covers two local authority areas. It covers Durham and Darlington. So the trust is having to engage that way with Tees Valley and this way with the County Durham arrangements.
"These are almost exactly the arrangements we had pre-1974.
"We had a region, an area and then district health authorities. That's what we're kind of going back to.
"That regional bit in the middle is the bit where it isn't certain exactly how that will play out."
Chair of the committee Cllr Patricia Jopling said: "Initially we were told... for some time you won't notice the difference.
"But I think in the long term things will definitely start changing and that's obviously what we've got to keep an eye on."
Cllr Olwyn Gunn said residents would have concerns: "When will we see any difference? What will change? How long will it take to change? Will it be piecemeal?
"They're key questions that we will be getting from residents.
"Changes always, always make people anxious."
Mr Laing said enquiries would be about GP surgery and outpatient appointments: "That is the point of these changes.
"The point of these changes is to make things better for the people in County Durham."
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