Milton rejects claim that NHS reforms are 'weak link' in government policy

Independent NHS consultant and former trust chief executive Roy Lilley said there was no evidence to support white paper proposals such as GP led commissioning.

He said: “We’re going to hand over [to GPs] £80bn of tax payers’ money with no evidence base at all.”

However, Ms Milton argued that poor commissioning, carried out by “distant” and “unresponsive” primary care trusts, wasted money.

Rather than being a leap in the dark, GP led commissioning was simply an extension of practice based commissioning, which Labour had supported, she said.

KPMG head of healthcare Mark Britnell said there were “enormous studies” demonstrating that devolving power to clinicians led to effective patient care.

He expected that consortia, rather than the national commissioning board, would hold contracts with GPs and said he hoped they would use this for performance management purposes.

The panel of guests were answering questions, some of which were submitted by Health Hotel members and some posed from the floor.

Responding to a question about NHS management, Mr Britnell said the top 2 per cent of managers in the private sector were “no better or worse” than those in the public sector.

However, private sector management had more “depth” because salaries were higher. Rules around NHS managers’ pay needed to be “liberated”, he said.

However, he added the NHS was “probably over-bureaucratised”.

Mr Lilley also defended managers, highlighting that only 3 per cent of the total NHS budget was spent on managers, of which there were less than 50,000.

He said: “I would rather have a public sector manager who has produced more for less than lots of… private sector managers. Public sector managers are bloody good and [health secretary] Andrew Lansley should stop knocking them.”