David Cameron has been warned by one of his own MPs that he is in danger of creating a "Trojan horse" that could destroy the NHS from within.
Dr Sarah Wollaston, MP for Totnes in Devon, has issued a scathing reply to the Prime Minister's boast, made in the Commons last week, that "we are not reorganising the bureaucracy of the NHS. We are abolishing the bureaucracy of the NHS".
Dr Wollaston, who worked as a GP for 18 years, forecast that a more likely set of events is that the NHS will pay out huge sums in redundancy to bureaucrats whose jobs have disappeared, only to re-employ them when when they find that they cannot get by without managers.
The proposed changes drawn by the Health Secretary Andrew Lansley and backed by the Prime Minister will involve abolishing primary care trusts, which are the middle layer of NHS management and handing their budgets over to GP consortia, who will be responsible for paying hospitals for patient care, overseen by a new national regulator.
Dr Wollaston said that doctors should not have the final decision on which patients receive treatment without an input from patients and "the wider clinical community", and that GP consortia will need professional managers.
Writing in yesterday's Sunday Telegraph, she warned: "It is unrealistic to assume this vast organisation can be managed by a commissioning board in London with nothing between it and several hundred inexperienced consortia."
She added: "It is no use 'liberating' the NHS from top-down political control, only to shackle it to an unelected economic regulator."
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