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 The BBC's Nick Robinson reports"NHS boards are appointed by the Health Secretary"  real 28k  |
The report accused the government of filling health bodies with Labour Party supporters and calls for a fundamental review of the system of health appointments.
The independent report - by Public Appointments Commissioner Dame Rennie Fritchie - says people have been appointed not on merit, but on political allegiances.
Responding to the report, Health Minister John Denham said the government needed to ensure that the range of people being appointed was broadened.
He also told the BBC that the issues raised by the report could be addressed by "allowing more decisions to be taken on the advice of health authorities at the local level" rather than leaving all appointments to the secretary of the state.
 The management of hospitals is under scrutiny
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Her report, published on Wednesday, said the system of consulting MPs and councillors over appointments should be scrapped in favour of a system of head-hunters.
In 1995-6, under the Conservative government, 81% of appointees were not politically active. Of those who were, 7.6% voted Labour and 9% voted Tory.
But in the first two years after Labour won the election, of 343 councillors appointed, 36 were Liberal Democrats, 23 Tories and 284 Labour.
Dobson accused
Labour's London mayoral candidate Frank Dobson was Secretary of State for Health for most of that time and will be seen as a major target for the criticism.
He accused the Conservatives of "cronyism" when they were in office.
But he has defended many of the appointments made saying they boosted the numbers of women and ethnic minorities serving on health trusts.
Labour hits back
Speaking earlier, David Hinchliffe, Labour chairman of the Commons Health Select Committee, said he did not believe in a system of appointments whichever party was in power - a system the government inherited.
He told the BBC the government had had to take action on the number of health body chiefs who were not committed to the NHS, but who favoured private medical treatment.
Speaking on Radio 4's Today programme, he said Dame Rennie's report contained some fundamental errors. It favoured "tampering" with the appointments system rather than ditching it in favour of a more democratic procedure, he said.
The NHS Confederation, which represents health authorities and trusts, welcomed the Fritchie report.
Andrew Foster, human resources director, said: "The overriding consideration should be the appointee's merit based on an agreed job description and understanding of the overall needs of Boards."
Mr Foster said the appointment system had been coloured by the government's rejection of the internal market in the NHS.
He said: "It is only in the last six months that the contribution of local NHS Boards has been more fully understood and recognised.
"Unfortunately the result was the neglect of the appointments process and lack of clarity about what candidates were being appointed to deliver."
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