Managers have reacted with anger and confusion to a threat by health minister Mike O’Brien to “name and shame” those who slash budgets and services in response to the public sector funding squeeze.

The threat, repeated in several speeches in recent days, was accompanied with a warning to managers not to “get fixated” on finances.

We will oppose any slash and burn cuts and will name and shame managers who carry them out for the sake of it

The comments are being called “contradictory” after NHS chief executive David Nicholson told the service earlier this year it needs to find £15bn-£20bn of savings by 2014.

Speaking at the NHS Employers conference last week, Mr O’Brien said: “We will oppose any slash and burn cuts and will name and shame managers who carry them out for the sake of it.”

He added: “We’re here not to slash budgets but to ensure that vision of better healthcare for all becomes a reality.”

Then at the Royal College of GPs annual conference on Thursday, the minister said: “We cannot allow the economic situation to be used as justification for destroying what we have all worked so hard to build.

“I will not hesitate to name and shame PCTs who view it otherwise - who cut services rather than improve quality, who slash budgets rather than finding creative ways of releasing funds for the front line.”

David Nicholson made clear in June that organisations needed to start planning for spending cuts immediately, saying it was vital the NHS started to transform itself before finances were tightened from 2011.

Managers told HSJ the fear of being publicly castigated may discourage trusts from sharing ideas to save money.

One acute trust chief executive said: “There will be some tough decisions ahead. What we don’t need is in an environment that means you’re always looking over your shoulder.”

Managers in Partnership chief executive Jon Restell called for clarity over which changes would be viewed as cuts and which would be deemed necessary.

He said: “The problem is managers have these contradictory messages about what they should be doing.”

Salford Royal Foundation Trust chief executive David Dalton called Mr O’Brien’s comments “inappropriate”, saying NHS leaders were required to make “brave and bold” decisions and should be trusted to make them. “No leaders are going to be running wildly through their organisations trying to cut services,” he said.

NHS Confederation policy director Nigel Edwards said he would be “very concerned” if the proposal led to ministers interfering in local decisions.

While he agreed slash and burn cuts would not meet the challenges of the funding squeeze, he said there was an “unhappy history of ministerial intervention”.

On naming and shaming, he added: “Managers should be expected to do the right thing and if they do not, there is a process for managing this which needs to be led by NHS boards.”

However, Cambridgeshire and Peterborough Mental Health Foundation Trust chief executive Karen Bell said she welcomed government interventions over spending decisions by PCTs.

This was because some commissioners were already planning to cut costs in a way that could force trusts to impose mass redundancies, she said.

Both Labour and the Conservatives have accused each other of failing to “come clean” on NHS spending, with the Conservatives calling on the government to match its commitment to real terms increases after 2011.

Healthcare Financial Management Association vice chair Paul Assinder said finance directors were already “acutely aware” of the need to make sensible spending reductions, adding: “We’re all realistic.”

The fact the recession was hitting the public sector after the private sector meant there was plenty of time to make the necessary preparations, he said.

In a statement for HSJ about his comments, Mr O’Brien said the government would only “intervene” in decisions over local services where it was clear “the sole motivation is to prejudge national decisions about NHS spending”.

“We will be clear with trusts that they must not make short term cuts that harm patient care. At the moment there is no evidence that trusts are making harmful cuts, but we would not hesitate to say so if they were.”

He hoped to be able to “name and fame” managers who led the way in quality and innovation, he said.

Managers’ anger at O'Brien's name and shame threat