It is an organisation so cherished and considered so uniquely British that it won a starring role in the London 2012 Olympics opening ceremony.
The National Health Service – known to all affectionately as simply the NHS – was born in 1946 and promised care for everyone "from the cradle to the grave".
But after decades of what now appears like mere tinkering round the edges, seismic reforms have at last come into effect.
Many warn that it is the beginning of the end of the NHS, and that the "free at point of entry" health system, which is the envy of the world, will break up.
But supporters of change argue that the NHS is a lumbering dinosaur doomed to extinction without a cure.
Moreover, they say that wholesale changes in the backroom – costing an estimated £1.5-£3 billion – will have absolutely no effect at all front of house.
Colin Philip, the St Ives GP who chairs the new Kernow Clinical Commissioning Group (CCG), which has taken over purchasing health services for people in Cornwall, is convinced of the matter.
"People won't notice a difference," he said.
"Why would there be a difference? This is not a revolution and it would be wrong for it to be a revolution because that is not the idea at all."
The new CCG groups have been one of the most contentious parts of the reforms.
But many GPs argue that they live and work in their community, coming face to face with the patients every day, and are therefore best placed to understand their needs.
Dr Philip said he was "optimistic" for the future and believed that the changes would pave the way for a better, more integrated healthcare system.
Across the Tamar, the Northern, Eastern and Western (New) Devon CCG is the biggest in the country and caters for the needs of patients in the catchment areas of the three large acute hospitals – Derriford Hospital in Plymouth, North Devon District Hospital in Barnstaple and the Royal Devon and Exeter Hospital in Exeter.
The CCG has taken on responsibilities from the former primary care trusts of NHS Devon, Plymouth and Torbay.
GP Tim Burke, chairman of Devon CCG, said they had some ambitious plans, including boosting support for people with dementia and developing a hospital-at-home initiative.
"Our vision is healthy people living healthy lives in healthy communities, and we will only achieve this if we put the patient at the heart of everything we do, working with people to deliver the right NHS services locally," he said.
But despite the optimistic words from those at the helm, the NHS reforms have yet to win over a substantial number of doubters.
Some fear increasing competition in the NHS will lead the private sector cherry-picking easy, profitable procedures which effectively snatch income from already-hard- pressed NHS hospitals.
Graham Webster, vice-chairman of the campaign group Health Initiative Cornwall, said he remained gravely concerned about the breakneck speed of fundamental changes which were carried out at a time when health funding was being cut.
"Too much has happened too quickly and sadly I think there are real problems around the corner because some organisation are just not ready.
"That is bad enough but what makes it worse is that this has been done at a time when the NHS is expected to deliver huge savings and improvements to patient care. That is just an impossible ask."
Mr Webster's voice offers a passionate local perspective, but academics have also been lining up to pick apart the reforms.
Professor Kieran Walshe, an expert in health policy at Manchester Business School, said the reorganisation was a tragic waste of money.
"If you break a leg you will still get the same service as a patient," he said. "So you have to ask, what was the point of spending £3 billion reorganising something if it is not going to change?"
Prof Walshe said the money spent on the NHS reforms would have been better spent elsewhere, such as improving adult social care services.
"It's a tragedy," he said. "The health service has been wrapped up in this change for three years and all the time and effort that has been spent could have been used much more productively elsewhere."
The three-year passage of the Bill into reality has failed to convince Andrew George, the St Ives MP who is a member of the powerful Health Select Committee.
"I voted against it, I argued against it and I strained every sinew every step of the way to fight against it," he said. "If there was another chance to vote on the bill tomorrow, I would vote against it again."
