Sack 12,000 'Luddite' NHS bosses, Blair is told

Thousands of "Luddite" hospital managers who oppose radical reforms to the health service should be sacked, Tony Blair has been told by leading businessmen.

The Prime Minister appeared to agree with bosses who told him at a Downing Street seminar yesterday that he should not allow management "whingers" in the NHS to slow down his reforms and should dismiss a third of them.

The move would mean sacking 12,000 of the 36,000 managers employed in the NHS, according to the Government's own figures. Such a cull would be politically unacceptable, but the call for those resisting change to be sacked underlines the risks facing Mr Blair in driving forward his programme.

Today doctors' leaders will call for a halt to the reforms. Dr Paul Miller, chairman of the British Medical Association's consultants committee, will accuse the Government of wasting NHS money on costly private finance deals, independent sector treatment centres and needless management consultants.

In a speech to the consultants' annual conference, Dr Miller will say: "Care is suffering, jobs are disappearing, patients and staff are paying the price. If a patient gets worse instead of better with treatment, then it's time to figure out whether the diagnosis or the treatment is wrong. Something is going very badly wrong with these health policies. It is time to call a halt. Examine what is not working and why."

The businessmen's call for job cuts came when Mr Blair called senior managers of FTSE 100 companies to Downing Street to discuss ways in which NHS foundation hospitals can learn from the marketing and cost-cutting techniques of private firms. He was told that companies including BMW, Tesco, Sainsbury's and Jaguar Cars have already exchanged managers with NHS foundation trust hospitals and both sides have benefited.

Richard Lapthorne, chairman and non-executive director of Cable & Wireless, told Mr Blair he should not allow anybody on the board of the independently run trust hospitals who was "sympathetic to the whingers" who never want to change.

Mr Lapthorne said a third of managers were opposed to the changes and a third were "role playing and have not made up their minds". He added: "You need a programme that might be difficult in these areas where you are going to have to choose who you get rid of." He said in the past the public sector had "pulled back from taking on that issue". Asked later how managers who opposed the changes should be got rid of, he said: "You sack them. That is what we did at British Aerospace."

Mr Blair said: "I think that is absolutely right." The most difficult thing about change in any organisation of the services was that initially you could not prove what the outcome was going to be, he added. "They resist on the basis that it is not going to work; it is colliding with this or that principle. There is a huge culture change that is going to be necessary. It is going to break the myth that public services and the notions of proper business management operate in two separate spheres, with contradictory value systems."

Mark Britnell, chief executive of the University Hospital, Birmingham, an advocate of NHS reforms, said later that he found the estimate of one third of managers resisting change was exaggerated. "Fifteen per cent are Luddites," he said. "You must stop them being too cynical which makes the organisation cynical."

Patricia Hewitt, the Health Secretary, will announce today that NHS hospitals have a net deficit of below £600m.