Published: 06/02/2003, Volume II3, No. 5841 Page 4 5

Although the Department of Health says nobody will lose their job as a result of the reorganisation, there must now be question marks over the future of those working in the four directorates.

There are 435 people working at the four directorates of health and social care, according to the DoH, although the original intention of the Shifting the Balance reorganisation was to cap the numbers at 'around 40' for each directorate, plus staff in research and development undertaking a national function.

There are concerns that staff who had only recently relocated to work at the directorates in Leeds and London could be forced to move again if their jobs changed.

Some staff could move to the new Commission for Healthcare Audit and Inspection.

There is speculation that NHS director of operations Alan Doran - who currently has responsibility for the four health and social care directorates - could lead the new delivery unit within the department.

But given the tight reins London director John Bacon has held on performance in the capital, he is also a strong contender for the role. DoH director of external and corporate affairs Hugh Taylor could lead the corporate management and development function.

Modernisation Agency director David Fillingham is seen as likely to continue leading the modernisation function, while chief medical officer Professor Sir Liam Donaldson appears the natural candidate to take the lead on public health.

Mr Taylor and Mr Bacon are both on the change management team which is overseeing the reorganisation.