Published: 20/03/2003, Volume II3, No. 5847 Page 7

'At least one-third' of Department of Health jobs are to go as the department is restructured into a slimmed-down organisation.

The new-look DoH will consist of three divisions plus a chief executive's office.More than 1,000 central jobs will be lost in the shake-up.

NHS chief executive Sir Nigel Crisp told HSJ the DoH would become a more strategic organisation that would 'steer, not row'.

He said the department, which has 3,500 staff, 'will reduce in size by at least a third'. But he said compulsory redundancies would be avoided, although there will be some voluntary ones. The DoH said most staff were likely to go to other agencies like the Commission for Healthcare Audit and Inspection or the Social Services Inspectorate.

The department's reorganisation is part of changes which will shortly see the abolition of the four regional directorates, which went live just nine months ago.

Sir Nigel stressed that the DoH would move from 'managing an institution to managing a health and social care system'.

He likened the new relationship between the DoH and the NHS to that between central and local government, and he said the department would concern itself with 'standards, capacity, capability and a diversity of providers'.

The three new DoH divisions will be:

Health and social care standards and quality group, headed by chief medical officer for England Professor Sir Liam Donaldson.

nCorporate management and development group, under Hugh Taylor, currently DoH director of external and corporate affairs.

nHealth and social care delivery group, whose director has yet to be appointed. John Bacon, chief executive of the London directorate of health and social care, is widely tipped for the post but declined to comment.

Under the shake-up, the Modernisation Agency will be given a new status as an executive agency. This will distance it from the DoH, which will no longer fund it, and give the agency greater freedoms. The DoH will have a new management board, chaired by Sir Nigel and made up of the new divisional directors as well as directors of policy, communication and finance. Chief nursing officer Sarah Mullally will also sit on this board, following speculation that she could be demoted in the shake up.

There will also be a health and social care delivery board, with 11 members, that will manage the DoH's relationship with strategic health authorities and the NHS.

NHS Confederation policy director Nigel Edwards broadly welcomed the changes as 'moving in the right direction', but warned that the new delivery division must not try to 'second guess' SHAs. He said: 'It will bring delivery into sharper focus for the department and it looks positive. But there is a hazard that it could turn into the big delivery unit looking over the shoulders of SHAs and holding them to account.'

However, one SHA chief executive said they were confident SHAs would be robust enough to continue with their work without fear of hindrance.

But one HSJ source warned there was a 'lot of doom of gloom' around the DoH following the announcement of a 'culling season'. Communications about the change got off to a bad start when 400 senior DoH civil servants were summoned to London to hear the news, but half were left outside because the room booked was not big enough.

A change management team has been appointed to see through the transition, led by Ruth Carnall, current director of health and social care for the south of England.Her team will be in place for 18 months.