Published: 11/4/2002, Volume II2, No. 5800 Page 9

The Scottish Executive was this week accused of distracting managers from the task of implementing health service reform by announcing a team to lead another NHS shake-up.

Scottish health minister Malcolm Chisholm announced last week that he is to chair the Executive's new advisory panel for the review of management and decision-making in NHS Scotland.

Former chief executive of the NHS in England Sir Alan Langlands and Royal College of Nursing general secretary Dr Beverly Malone are on the panel, which is likely to bring about the abolition of trusts.

The advisory panel will 'inform the strategic direction' of the review, which is due to report in 2003, Mr Chisholm said.

Since the review was promised at the start of this year, speculation that it would lead to the end of the trust system has become increasingly confident.

This week, the Institute for Healthcare Management warned that the personal uncertainty generated by the setting up of the group could lead to managers 'taking their eye off the ball' because of anxiety over their jobs.

The Executive defended the move, saying it was part of an ongoing evolving process of reform.

It also defended the membership body (see below) set up to lead the process, though it does not include any current NHS manager representation. As well as Dr Malone and Sir Alan, who is now principal of Dundee University, the panel has representation from academic, social work, trade union, medical and non-executive director backgrounds. Following the announcement, Scottish IHM secretary Donald McNeill insisted that he was 'not unhappy' with the makeup of the panel.

But he added: 'The announcement heralds more change ...and I think this is unfortunate at a time when both the first minister and the health minister have been talking about delivery.This will detract from the focus on implementation and delivery.'

Mr McNeill said he hoped the group would not be overly influenced by the changes introduced in England on April 1: 'We need Scottish solutions for Scottish problems such as rurality, deprivation and high levels of illhealth.' He said he did not doubt that the review would mean the end of trusts and a knock-on effect on managers' jobs.

Mr McNeill said: 'The health service has a good track record in supporting displaced individuals, but if managers are anxious about their personal position there is a risk that they will take their eye off the main ball. This has ramifications throughout the service - for executive directors and others, not just for chief executives.'

An Executive spokesperson said: 'Part of continually improving services is reviewing the management and decision-making structure of the NHS.Current managers will be at the heart of this process.

The work will be driven by five project groups, four of which are to be led by experienced and highly respected NHS chief executives.

There will be opportunities for managers at all levels of the NHS to be involved in this review.'

Who's who: membership body Membership of the group includes Professor Frank Clark, chair of Forth Valley board until the end of last month, who has 30 years'experience in the NHS; Sheena Duncan, former director of social work with Renfrewshire council; Professor David Hamblen, chair of Greater Glasgow board and former professor of orthopaedic surgery at Glasgow University; Sue Llewellyn, professor of management control at Edinburgh University; Dr Bill Reith, chair of the Scottish council of the Royal College of General Practitioners; and Grahame Smith, deputy general secretary of the Scottish Trades Union Congress and a former NHS ambulance driver.