The chief executive of one of England’s most high profile trusts has said the government did not understand the NHS when it came to power, and that recent health service reforms have created ‘a bureaucratic monster’.

Sir Robert Naylor told a conference in London yesterday that he hoped future political leaders would “understand the health service in a way that clearly the cabinet didn’t, and the prime minister didn’t”.

“I think he very painfully learnt about the health service through a listening exercise,” the University College London Hospitals Foundation Trust chief executive added.

“I do think we need greatly enhanced political leadership. I think we’ve got ourselves into a mess.

“I’m not aligned to any political party but I did happen to meet the current prime minister and the then secretary of state six months before the last election with a group of peers. We said there are six things we think are important for the manifesto and they pretty much ignored all the six things.”

Speaking at a conference on NHS leadership, Sir Robert said the number of NHS managers was “often maligned” by politicians, but the average across the health service was “significantly less” than that across the UK economy overall.

He continued: “We are under-managed in my opinion. The trouble that we’ve got ourselves into - through the reforms of the NHS - is we’ve become over-administrated and over-regulated. The bureaucracy which has blown up is just truly mind boggling.”

He cited the example of a recently approved reorganisation of cancer and cardiac care in London, saying: “We counted 62 different organisations that had a power of veto over what we were trying to do so we had to go out and persuade all 62 of them to agree.

“I think what’s happened, particularly through the recent changes in the health service, is we’ve created a bureaucratic monster that we really need to do something about.”

Sir Robert, who is chairing HSJ’s inquiry into the future of NHS leadership, added: “In my opinion we have eight to 10 times more [clinical commissioning groups] than we need, and we’ve probably got three times as many hospital trusts in London [as] we need. We need to break through this bureaucracy and regulation.”

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