In recent years notions of self-help and voluntarism have emerged as key elements in the delivery of services in rural England. This paper explores these themes by reference to 'Rural Wheels', a voluntary medical transport scheme in rural Northamptonshire, introduced to overcome the closure of branch surgeries and to provide access to a new medical centre. By focusing upon the organisation and operations of the scheme, the paper highlights the important role it plays in the welfare of rural residents, particularly elderly women. Yet, because effectively it is run by a small core group, the paper raises questions not just about the viability of this scheme but also about the increasing commitment of central government to the voluntary sector as a means of delivering health care to rural people.