Should we worry that some primary care trust chief executives who are offered more junior roles in PCT clusters, losing their accountable officer status in the process, cannot opt for redundancy instead?

After all, these are highly paid people who will get to keep a job on the same salary when colleagues face compulsory redundancy.

We should be concerned for two reasons, one practical and one professional.

The practical concern is that in a period when the accountability of those being given responsibility for commissioning is still unclear, treating accountable officer status as something which can be removed without any implication is likely to set the alarm bells ringing even louder.

The professional concern is related. Those who pursue a career in the management of health services see the accountable officer position as a summit to aim for.

Many managers thinking of becoming accountable officers of commissioning consortia - and most accountable officers will be managers - are going to look askance at such HR jiggery-pokery. They will not automatically assume things will be different for consortia.

If the government wishes accountable officer status to have the weight attached to it in the Health Bill, it must ensure it is respected and valued during the transition. The loss of something valuable requires compensation.

The fact this might end up with the NHS facing unbudgeted redundancy costs is unfortunate to say the least - especially in the current climate. These “golden goodbyes” would no doubt attract some fierce media and political criticism.

But strategic health authorities should not shrink from making the right decision. Some are taking on board these concerns and acting appropriately. The rest should follow suit and avoid leaving a question mark over the robustness of the accountable officer position at this crucial time.

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