The Labour leader warned yesterday that the Secretary of State for Health in a Blair administration "will have the power to replace trust boards", and promised pounds 100m would be saved to enable an extra 100,000 patients to be treated.
All health trusts and health authorities will be required to reduce their management costs to the level of the most efficient 25 per cent.
League tables of efficiency will be published, and Labour would appoint a "bureaucracy buster" to go into trusts and authorities to force economies.
At his adoption meeting in County Durham, Mr Blair said: "A Tory fifth term would put the very existence of the NHS at risk. We will raise spending on the NHS in real terms every year."
The internal market is "killing our health service" he argued. Government figures show managers are up by 3,400 and midwives down by a further 3,300.
"Last year buying and selling treatment ... produced over two million invoices. This year it will be 150,000 more ... laid end to end the invoices would stretch from London to Paris - and back again."
A Labour Party survey has found huge variations in the level of red tape. One trust had 70,000 invoices in a year. Another, only 600. GP fund holders treated only 22 per cent of patients, but generated 83 per cent of the paperwork.
"Enough is enough," said Mr Blair. "The waste must stop."