A 'growing number of concerns' about the way Labour supporters dominate non-executive appointments in the health service has led the woman charged with overseeing jobs on quangos to launch a 'scrutiny' of the hiring system.
Dame Rennie Fritchie, the commissioner for public appointments, says she is looking at 'whether Labour nominees or councillors are getting some sort of preferential treatment'.
The number of complaints about individual appointments and about the system generally has snowballed since Dame Rennie first picked up the issue.
Official figures released last month appeared to support allegations that non-executive directors are appointed more for their allegiance to the Labour Party than for their skills in holding boards of directors to account.
Trusts have more than five times as many Labour-supporting non-executive directors as Conservatives. In HAs the difference is three-fold. The Liberal Democrats trail behind in both institutions.
Dame Rennie, herself a former regional HA chair in the south west, is responsible for making sure recruitment to quangos is fair and above board.
Her own£70,000 job was created in 1995 in response to allegations of cronyism when posts were awarded. The Nolan committee report on standards in public life had uncovered a serious lack of monitoring of who, how and why people got these jobs.
Dame Rennie oversees some 14,000 public sector appointments, including roughly 7,000 in the NHS.
She describes the figures for political alignment as 'interesting'. The Department of Health's annual report on public appointments shows that in HAs, 126 non-executives who declared support backed Labour, while only 30 were aligned with the Conservatives and 20 with the Liberal Democrats.
'There is a lot of smoke. We need to know how big the fire is,' says Dame Rennie.
While the statistics may surprise people outside the system, she says it would be 'unusual' to find non-executives who did not support the government's direction of travel. 'You want to make sure that a non-executive is going to implement government policy and make sure it works in their area.'
But the number of complaints made to Dame Rennie suggests that there is a widespread perception of bias.
First there were 'a number of direct complaints' about individual appointments. 'People didn't believe the process we had laid down had been followed,' Dame Rennie says.
She is still investigating these. But then other people heard about those complaints and began to contact her with more general problems.
Dame Rennie had already started practising what her office preaches by looking at the independent assessors who monitor and advise on each appointment. As part of this investigation into her own backyard, she sent a questionnaire to each of the 300 assessors across all government departments. 'Within two weeks I had about 200 replies, which is a very fast response.' As a result, she began to get calls from assessors who were themselves unhappy with the system.
Dame Rennie is keen to point out that the comments are not one-sided: 'There are some people who have concerns, but others say we have some very good Labour councillors who do a very good job.'
But there has been a growing worry about apparent bias in appointments, particularly in the NHS. 'A number of people privately raised their concerns, and Labour councillors themselves began to say we have a concern that some of the people coming forward may not be the most suitable for the job.'
Dame Rennie is looking, in particular, at North West and Northern and Yorkshire regions, the two which generated most complaints.
It will 'follow the paper trail' for previous appointments and look at the current round. It will 'seek the views' of the independent assessors who observe and advise on quango recruitment and interview the regional chairs. Dame Rennie says both regions are providing 'every support'. The scrutiny group, which includes human resources and management consultants as well as independent assessors from both the NHS and other government agencies, is due to report to Dame Rennie 'at the end of December'.
The commissioner 'expects to report to the public early in the new year'. But, she insists, this is not a formal inquiry. 'I have asked people to go in and scrutinise what is there.' An inquiry would be 'premature'.
She is adamant that what she is doing 'is not a witch-hunt. I am trying to see what the truth is and what impact it has had and what lessons can be learned for the future'.
But an audit is timely when the government is restructuring the NHS. Non-executives will have an important role to play in the new primary care trusts. The DoH has already begun advertising for PCT lay members, despite not yet knowing how many trusts there will be in the first wave that starts next April.
The members will be charged with ensuring that the clinicians, who will decide where money is invested locally, are acting in the interests of the public, not lining their own pockets. Critics of the system must hope that Dame Rennie's review comes in time to ensure the new wave of non- executives are beyond reproach.