Such a decision would be seen as a partial retreat from a full application of the internal market to the NHS. A spokesman for the department said that a decision was imminent. It was 'absolute nonsense' to suggest that Virginia Bottomley, the Secretary of State for Health, was retreating in any way on the NHS reforms.
Many hospital trusts, which are free of the control of district health authorities, want to see the dissolution of the regional health authorities to which they are still accountable. The regions are regarded as overly-bureaucratic and interventionist. Many trusts want to deal directly with Whitehall.
But it is becoming clear that Mrs Bottomley is determined to retain a tier of administration that will act as a buffer between her department and the trusts. The intermediate tier would also assume responsibility for implementing national health care strategy.
The spokesman said a new type of intermediate tier 'which I would hesitate to call a region' was the most likely prospect. 'The secretary of state is aware that public accountability for the NHS, which employs one million people and spends pounds 36bn, must be safeguarded,' he added.
Mrs Bottomley is expected to make public her decision on the future of the health regions by 23 February at a conference in London on 'managing the market'.
The conference is organised by the National Association of Health Authorities and Trusts. Its director, Philip Hunt, said yesterday a new type of region would emerge, one that employed fewer people and had fewer functions. 'It will focus on the market and managing that market.'
A London teaching hospital that is battling to save itself from closure after the recommendations of the Tomlinson inquiry into health care in the capital is being accused of a 'massive disinformation' campaign that has misled the public into thinking that it is losing a national asset.
Senior consultants at the Royal London hospital NHS trust say they are sickened by the campaign initiated by St Bartholomew's hospital.
One consultant from the Royal London, who asked not to be named, said: 'Barts is putting out a certain amount of disinformation in their struggle to survive. They are exaggerating their clinical role and intimating that they are one of the world's unparalleled research centres. This is not the case.'
Professor Michael Besser, chief executive of Barts, last night described the comments as 'rather sad.' He said the Royal London had been hoping to 'pick off' the outstanding research departments from Barts but he said these departments would be much less effective if they were absorbed into a high volume accident and emergency driven service such as the Royal London Hospital.