Health service managers have been given an assurance that there will be no redundancies and few early retirements as a result of a decision to cut the number of Scottish trusts from 46 to 28.
But there will be a significant clear-out of trust boards. Six of the chairs named last week to lead the new trusts are new to the post, and Scottish health minister Sam Galbraith hinted at sweeping change among non-executive directors. 'Many of the people involved have already left the system in anticipation of this move, so there will be no need for redundancies,' he said. 'Instead we will see people edging out through early retirement or by moving on.'
The Scottish Office has allocated 2m for early retirements, 'although we don't know if we will even need that much', said Mr Galbraith.
Five chief executives have retired and eight have left and not been replaced since shake-up proposals were announced last year.
The reconfiguration plans confirm proposals put forward over the summer by Scotland's health boards and will mean one acute and one primary care trust in most areas. Scotland has 15 health boards, but only 12 are affected by the plans. The others cover areas such as Shetland without a separate trust structure.
The two largest boards - Lothian and Greater Glasgow - have been allowed to deviate from the template set out in the Designed to Care white paper. Each will have one combined trust covering part of its area.
Speaking at the launch of the new structure, Scottish secretary Donald Dewar said reconfiguration would mean '18m more to spend on doctors, nurses, equipment, new drugs and operations'.
Donald McNeil, secretary of the Institute of Health Services Management in Scotland, was delighted that ministers had confirmed the 'no redundancies' pledge given to managers informally by civil servants, but was suspicious of the 'awfully neat' savings target of 1m for each trust abolished.
The appointment of trust chairs means that chief executive posts can now be filled. All those wanting a job in the new structure have had to go through a 'competency assessment' before being approved by the Scottish Office.
The new shadow boards are due to take over from existing organisations on 1 April next year.
Scottish National Party health spokeswoman Kay Ullrich said: 'We welcome any reduction in NHS bureaucracy, but we must wait until October when health board appointments are made to see if there is to be a fundamental change in the appointments system
The plans were welcomed by Arthur Morris, chair of the British Medical Association in Scotland, who said they 'reversed previous NHS reorganisation, which split the Scottish health service into too many disparate units'.
The Royal College of Nursing welcomed the 'emphasis on co-operation' in the new structure, but the Scottish Conservatives claimed the mergers would lead to services being 'centralised'.
See News Focus, pages 9-10.
Saved by the burn: cardiologist Clifford Garratt discusses an innovative procedure to burn away damaged heart tissue with north Wales firefighter Gwyn Jones, the first UK patient to undergo the treatment at Manchester Royal Infirmary. Mr Jones faced retirement at 42 before Mr Garratt traced the source of his irregular heartbeat to an area at the top of his heart. A catheter was inserted to burn away damaged tissue. 'I am very hopeful that Mr Jones will now be able to lead a normal life,' said Dr Garratt.