The NHS in England spent more than £300m on management consultants in the last year, figures show.
The cost is almost the same as the amount spent on skin and lung cancer services combined, the data for 2009-10 showed.
The government released the figures to show how much was spent on management consultants - as well as advice from architects, lawyers and surveyors - in the last year of the Labour government.
Overall, primary care trusts (PCTs) and strategic health authorities (SHAs) spent £313.9m on consultancy services.
London spent £114m, the South East spent £22.5m and the South Central part of the country spent £23.3m.
Health secretary Andrew Lansley said: “I am staggered by the scale of the expenditure on management consultants in the NHS.
“I have asked PCTs and SHAs to reduce their management costs by 46% over the next four years. This will root out unnecessary bureaucracy and any expensive duplication of functions.
“Every penny saved will be reinvested in improving patient care, meeting demand and driving up quality.”
Dr Peter Carter, chief executive of the Royal College of Nursing (RCN), said: “Spending this amount of money at the same time we have identified NHS trusts cutting thousands of NHS jobs is outrageous.”
Nigel Edwards, acting chief executive of the NHS Confederation, which represents NHS organisations, said: “Any spending of taxpayers’ money has to be justified, and the NHS has been asked by successive governments to perform tasks for which internal expertise was not present or needed to be developed.
“Dismissing all this spending as wasteful is unfounded.
“External advice will be necessary if NHS organisations are to deliver change and, with the financial challenges and the size of the current reform programme, it is probable that NHS organisations, especially new GP consortia, will require external help to deliver what the Government wants.”
Alan Leaman, chief executive of the Management Consultancies Association, said: “Research by the association has shown that on average, for every £1 spent on management consultancy, benefits worth the equivalent of £6 are returned to the client.
“An organisation as complex and fast-changing as the NHS is entitled to benefit from the high quality advice and delivery that is offered by MCA member companies.”