HSJ sources have attacked the process by which 'the second most important job in the NHS' went to a regional director without the job being advertised.

Barbara Stocking, director of South East regional office, will take up post next month as director of the NHS Modernisation Agency. She will take the job 'for an initial period of six months'.

On Monday a Department of Health spokesman said this meant 'she has got the job for six months to let her get a feel for it, then if it is going well she can stay on - if it doesn't, it will be advertised'. He said the job would only be advertised if Ms Stocking left the post.

HSJ sources said the suggestion that Ms Stocking would get 'first refusal' on a substantive appointment 'made a mockery' of open recruitment processes.

But on Tuesday, the DoH reacted to the criticism by saying that Ms Stocking's new role was a secondment to set up the agency, and that 'permanent arrangements will be put in place in due course'. The spokesman would not say whether this would mean advertising the post.

David Hunter, professor of health policy and management at Durham University, said that in the light of Nolan rules on public appointments, the way the appointment had been made was 'just not very clever'.

'Perception is all - this will handicap Barbara and weaken the whole enterprise, ' he said.

NHS Confederation chief executive Stephen Thornton said he was 'pleased' that Ms Stocking had been given the short-term post, which he described as 'one of the most important jobs in the NHS, probably second only to the chief executive's'.

But he added: 'I would presume that at some time in the future a post as critical as this would have to go to open competition.'

But some senior managers defended the use of short-term appointments as 'a lot more honest' than 'artificial recruitment processes which put a lot of people through a lot of angst when the outcome is a foregone conclusion'.