THERE is a temptation to dismiss the relegation of Morecambe Bay primary care and hospitals NHS trusts in the Government-inspired star system as meaningless. Who cares how many stars their local health service has, as long as their treatment is satisfactory?

There are very good reasons why the adjudication does matter, however. The whole way that the health service moves forward in the area has been dealt a severe blow.

The hospitals trust last year achieved the maximum three-star rating, which opened up the way for it to apply for foundation trust status. The board which runs the trust enthusiastically set off down this road.

They spent £175,000 of Department of Health money (that means taxpayers') to try to recruit several thousand members who would be involved in the running of the trust. Ironically this very week bulky packs of glossy leaflets and posters arrived on the doorsteps of local employers, asking them to distribute them to their own staff. The advice now is to bin them.

Trust staff put a huge effort into pursuing the foundation holy grail. The application was detailed and complex. Goodness knows how many senior management man hours were devoted to the cause.

The team were excited by the prospect and the application had a positive effect on morale. They craved the financial freedom to borrow money themselves. They believed this would significantly speed up projects like the replacement of the Ulverston hospital, which has taken years to get off the ground under the present cumbersome, centrally-controlled route. Shaking off the shackles of the Department of Health has obvious attractions.

Now all those hopes, if not exactly dashed, have to be shelved for a year at least. Senior managers' main task now is to overcome despondency and make sure morale is not torpedoed by the enforced delay.

The hospital trust should take some comfort from the feeling that they missed out on the third star by a whisker, and that the criteria which tripped them up had nothing to do with clinical care. For example the trust missed a target for capturing ethnic origin data. It was hardly surprising that, in an area where more than 95% of patients are British whites, this was not seen as a priority. This was a new target this year, and one of the valid criticisms of the star-system is that moving targets are the hardest to hit.

The good news for patients is that the Bay's hospitals are no worse today than they were yesterday. The bad news is that the hospital trust has undoubtedly suffered a set back, although an easily recoverable one.

The situation at the primary care trust is more worrying. Although the trust as a whole maintained its two-star status, for mental health services, which are assessed separately, they have slipped from two stars to none. They are yet to hear whether they will be put into "special measures" which will mean heavy interference from professionals appointed from outside the trust.

Again some of the areas where they failed were fairly bureaucratic, but to score nil has obvious impact on not only staff morale, but also on staff recruitment.

Not many primary care trusts took on mental health when the current system of managing the National Health Service was implemented. In most parts of the country a separate trust looks after this specialised aspect of community health care. The Bay PCT will now review that decision.

In the meantime local health service managers need to pick themselves up, have the sort of robust and honest self-assessment that will ensure their performance improves, and hope that the Healthcare Commission, which awards the stars for the Government, stops moving the goalposts.