Chris Ham, an architect of NHS reform who ran the Department of Health’s strategy unit until June, told The Times that the Government had unleashed a wave of “creative destruction” on the NHS. He added that while rapid reform was necessary, the Government risked the closure of a number of district general hospitals as they struggled with new competition from independent healthcare providers.

He said that while the radical programme of NHS reform had started out well, it had fallen “out of sync” over the past two years and was now veering into “incoherence”. His comments come after a series of alarming reports of financial deficits paralysing parts of the NHS. On Friday, the Queen Elizabeth Hospital NHS Trust in South East London said that it was facing a deficit of almost £30 million because of the cost of its annual Private Finance Initiative repayments. Overall, hospitals in England have a £620 million deficit, which could reach £1 billion by March.

Many of the problems have been sourced to the rapid introduction of competition and efficiency-inducing policies, such as payment by results, which rewards hospitals for the number of procedures carried out, and the use of independent sector treatment centres to increase capacity.

Professor Ham, the head of Birmingham University’s Health Services Management Centre, said that he approved of shaking up the health service, but he feared the unforeseen damage caused by the reforms. “The whole purpose of creative destruction is to say that unless you put a rocket under the NHS it will just absorb these reforms and things won’t change,” he said.

“I feel that the direction is the right one, but I am very anxious about the lack of synchronisation between the reforms.”

The net result would be hospitals forced to cut services that they cannot afford to keep running, with some closures.

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