On Wednesday the cumbersome structure of health hierarchies will collapse into a single bureaucracy, while the government is yet to appoint a new chief executive and is having problems even with the interim appointment, and, Medicare Local will close.

As always the perennial quest to make health delivery more efficient and leaner goes on, against a background of spiralling costs and perennial protests from stakeholders.

For instance the cost of the Department of Health and Human Services has doubled over the past decade. It cost $824 million in 2004-05, but now it costs more than $1.6 billion. Inflation over this period was about 30 per cent.

And, despite the bottomless pit of expenditure there seems to be an endless procession of increasing surgery waiting lists, job losses and angry health workers looking for a pay rise.

In politics they call health the graveyard shift. The portfolio where leaders usually park ambitious ministers who might cause trouble angling for your job.

Mr Ferguson is showing no such overt ambition, but someone had to do the thankless job.

This week he faces the major test of his ability and competence. The white paper is the biggest focus on health since the Richardson report into health services in 2004.

Mr Ferguson is presiding over a new structure and also a rationalising of services in the North West where the Liberals hold four House of Assembly seats and will be struggling to hold all of them in 2018.

He appears to be a competent minister but he will be tested. If he can prevent health becoming an explosive issue he will have achieved the goals his boss set for him.