Two-thirds of the new bodies charged with running health services under the Government's controversial reforms have hired a bureaucrat, not a doctor, as their boss.
Research by the Health Service Journal reveals that managers from the defunct primary care trusts are being rehired to lead the new clinical commissioning groups made up of GPs. Of 81 CCGs to have made appointments, 50 have chosen a manager.
Andrew Lansley, the Health Secretary, wrote to health workers last week, urging them to use their clinical expertise and their knowledge to ensure NHS services meet the needs of patients. "My ambition is for a clinically-led NHS that delivers the best possible care for patients. Politicians should not be able to tell clinicians how to do their jobs."
But emerging evidence suggests the reforms, hugely rewritten in the face of opposition from Lib Dem peers and medical bodies, will put in place new complex management structures. Liz Kendall, a Labour Health spokesperson, said the next year will be focused on "creating a huge new bureaucracy", including 240 CCGs, local education and training boards, a National Commissioning Board, an NHS Trust Development Agency and clinical senates across the country.
Responding to the HSJ research, the Department of Health insisted that "every single one of these organisations is clinically led", arguing that where the accounting officer is not a clinician, the chairman should be. "Clinical leadership always means exactly that; doctors and nurses setting the agenda for their local NHS... Our reform plans will slash bureaucracy by £4.5bn, which will be reinvested back into frontline NHS care."
But Andy Burnham, Labour's Shadow Health Secretary, said: "Andrew Lansley is spending billions of NHS cash on creating his new CCGs, but it turns out that many look suspiciously like PCTs, employing the same staff... It is yet more evidence that this vanity project is a damaging distraction and an unforgivable waste of money."
Redundancies in PCTs and health authorities will cost £56.5m, even though hundreds of staff are expected to join CCGs. The NHS must find £20bn in efficiency savings by 2015, equivalent to almost 5 per cent of its annual budget. Doubt has been cast on whether the cuts can be achieved at a time of major organisational upheaval.