THE proposed new North Yorkshire-wide primary care health trust (PCT) needs to work with local people to help them take greater care of themselves said Michael Whitworth, chief executive of Scarborough, Whitby and Ryedale PCT.
Mr Whitworth told community leaders at a public meeting in Scarborough's Stephen Joseph Theatre: "People need to take better care of themselves and the NHS needs to engage with patients earlier, so they can look after themselves".
He said the new PCT, which will also cover York, will replace four existing PCTs.
He forecast that management costs would be reduced, which would result in more investment in cancer treatment and palliative care.
Mr Whitworth said attempts had been made to designate the new county PCT as officially covering a rural area, which would have benefited it financially. But there was no such arrangement in England.
He said hospitals in Scarborough, Malton and Whitby had high rates of elderly patients. "The problems we have in York and North Yorkshire are as big as anywhere in the country," said Mr Whitworth.
He said the existing PCT, which is wrestling with major debts, would continue to struggle in the future if it continued in existence.
On volunteers, Mr Whitworth said: "We are very much in favour of supporting voluntary services and I can see a growing role for the voluntary sector in the next few years."
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