A highly critical report on political appointments must spell out the roles and responsibilities of councillors who sit on trust, health authority and primary care group boards, NHS leaders have demanded.

An investigation by commissioner for public appointments Dame Rennie Fritchie is understood to have uncovered 'damning' evidence of cronyism in the way former health secretary Frank Dobson appointed Labour supporters to NHS boards.

The report - due to be published next week - was sparked by what Dame Rennie called a 'growing number of concerns' about the way non-executive directors were replaced after the last election. Launching the 'scrutiny' last year, Dame Rennie said she was looking at 'whether Labour nominees or councillors are getting some sort of preferential treatment'. NHS sources say the report will make 'devastating' reading for the government.

Graham Brady, Conservative MP for Altrincham and Sale, said he hoped the report would tackle 'systematic abuses of the appointments process'. Mr Brady, who gave evidence to the inquiry, said: 'It is clear the report will be a very serious document with significant findings.'

The government was putting party politics ahead of financial and managerial competence in the selection process, he added.

Appointments in North West and Northern and Yorkshire regions sparked most complaints to Dame Rennie.

Ministerial delays in choosing nonexecutive directors meant that at one point last year, five trust chairs and 15 lay board member posts were vacant in North West region, leaving trusts and HAs unable to take major decisions.

A further scandal in the same region developed when Mr Dobson removed the whole non-executive board of Preston's Guild Community Health Care trust following wrangles over the suspension of chief executive Les Howell.

Mr Howell was later sacked and is now appealing against the decision. At the time, some departing directors criticised 'political' intervention when Labour MP Audrey Wise supported Mr Howel l.

Dame Rennie's inquiry has considered official figures showing that Labour has more than five times as many declared supporters on trust boards as the Conservatives, and three times as many supporters in HAs.

Statistics for 1998 show that 288 nonexecutive directors and chairs declared an affiliation to Labour, while there were 49 Conservatives and 28 Liberal Democrats.

The report comes just weeks before a handbook for non-executive directors is set to be published. The NHS Confederation, which is drawing up the guidance with the NHS Executive, wants the exact duties of lay board members to be defined.

Human resources chair Andrew Foster said: 'We would like a much clearer view of what ministers want from non-executives.'

Mr Foster said the confederation had told Dame Rennie there were 'some elements of the process which don't work'.

Chairs were not kept fully informed, he said. 'Some candidates have been appointed who have not met the chair.'

Shadow health secretary Dr Liam Fox attacked the 'politicisation of appointments to boards under this government'. While many non-executive directors were dedicated people, 'there is no doubt that some people appear to have come with a very clear political agenda'.

But Dr Fox denied that his party would remove Labour appointees if it won the next general election.

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