About 6,000 jobs will be axed in a cull of NHS quangos in the next four years, releasing an extra £500m for frontline patient care, the health secretary promised yesterday.
John Reid said a reorganisation of NHS agencies operating at arm's length from the Department of Health would include the abolition of the Mental Health Act Commission , the Health Development Agency and the NHS Modernisation Agency.
A government report said 38 "arm's-length bodies" spent £4.8bn a year, including operating costs of £1.8bn. Half were created since Labour came to power in 1997. By 2007/8 they will be reduced to 20 organisations. Many will be merged or subsumed into other agencies and there were doubts in the service last night that the savings would be as large as ministers claimed.
NHS Direct, the nurse-led telephone and on-line advice service, and NHS Professionals, the staff recruitment agency, may be converted into non-profit trading companies.
The most controversial victim of the cull was the Commission for Patient and Public Involvement in Health (CPPIH), created last year to provide a voice for NHS customers.
Yesterday the government promised "more efficient arrangements to provide administrative support and advice to [local patient] forums", but made no mention of a national patients' voice.
Sharon Grant, the CPPIH chairwoman, said: "These proposals will be seen as betraying the government's promises to provide an independent voice for patients and the public in health."
The Consumer's Association said: "If the government is serious about promoting patient choice, it's contradictory to remove their voice."
Mr Reid said: "Reducing the cost of arm's-length bodies will generate resources that are the equivalent of four new hospitals, or 20,000 more nurses, by 2008. The arm's-length sector has done a lot of good work, but no longer meets current health and social care needs."
The changes include:
• The Healthcare Commission will take on responsibility for the regulation of care for people detained under the Mental Health Act after abolition of the Mental Health Act Commission.
• A new Regulatory Authority for Fertility and Tissue will be created to encompass the work of the Human Fertilisation and Embryology Authority and the proposed Human Tissue Authority.
• The National Institute for Clinical Excellence will take on the work of the Health Development Agency.
• The National Patient Safety Agency will take the lead on hospital food, cleanliness and safe hospital design. NHS Estates will be abolished.
• A new Blood and Transplant Authority will combine the services provided by the National Blood Authority and UK Transplant.
Niall Dickson, the chief executive of the King's Fund health thinktank, warned that abolition of the CPPIH left the question of patient involvement in disarray, but he otherwise welcomed the cull. "The NHS has been drowning in an alphabet soup of acronyms," he said.
