Private managers could be brought in to run failing hospitals under measures to tackle poor performance in the health service.

Alan Johnson, the Health Secretary, is to announce rigorous standards of quality, safety, cleanliness and financial management for all hospital trusts, making it easier for inadequate managers or chairmen to be dismissed without large payoffs, The Times has learnt.

Under the controversial plan, which has strong backing from Gordon Brown, managers could be brought in from the private sector or from elsewhere in the NHS.

Ben Bradshaw, the Health Minister, told Channel 4 News last night: “What we’ve never done before is to allow the private sector to take over the running of a whole hospital in the form of a franchise, which is one of the options that would be included in this performance regime. What we know from our experience of involvement in other parts of the health service is that the private sector can bring different skills, different management skills, different techniques.”

Doctors, politicians and unions gave warning last night that the measures risked undermining the fundamental principles of the NHS.

Ian Gibson, Labour MP for Norwich North and former chairman of the Commons’ Science committee, said: “The privatisation of the NHS is becoming less than subtle. This is a blatant snub to the health service.”

A spokesman for the British Medical Association, the doctors’ union, said it would have “grave concerns if the private sector took over [NHS] management”.

“There is already an immense amount of talent within the NHS – in leadership and management – and this should be nurtured to ensure NHS trusts do not find themselves in a position of failure in the first place.”

A key new performance measure will be levels of Clostridium difficile or MRSA infections. There are 20 trusts that are classified as “weak” in the Government’s ratings and they will come under early and tough scrutiny.

The plan has been adopted enthusiastically by the Prime Minister, who hopes to show that he will be as radical on public service reform as Tony Blair. During the Blair years Mr Brown was often accused of being an obstacle to change, and prevented Alan Milburn giving independence on borrowing to foundation hospitals.

Government sources said last night that Mr Johnson’s move would be the first of a series from Cabinet ministers aimed at improving public services. They promised stringent minimum standards “and real consequences for those who fail to meet them”. Managers and trust chairmen will have their contracts drawn to relate to their performance against the new standards. They face dismissal – without payoffs – if they are placed on a performance improvement plan and then fail to meet the deadlines set within it.

At the moment 30 trusts, out of 290, including mental health trusts, are responsible for 46 per cent of the cases of MRSA infection and 57 per cent of patients having to wait more than 18 weeks for their operation.

A total of 20 trusts were rated as “weak” for both quality of services and use of resources in October, while there are also 16 trusts that are considered “financially challenged” because of long-term budget deficits.

A government source said last night: “We can proceed with the next stage of public sector reform only if we have tackled the failing hospitals and eliminated unfair variations in local services. But we can only do that if we have a stringent set of minimum standards and enforce them.”

The following trusts scored as weak in the Healthcare Commission's assessment for both quality of services and use of resources (October 2007)

Great Western Ambulance Service NHS Trust

Yorkshire Ambulance Service NHS Trust

Northern Devon Healthcare NHS Trust

Maidstone and Tunbridge Wells NHS Trust

Royal Cornwall Hospitals NHS Trust

Royal United Hospital Bath NHS Trust

Scarborough and North East Yorkshire Healthcare NHS Trust

Surrey and Sussex Healthcare NHS Trust

West Hertfordshire Hospitals NHS Trust

Worcestershire Acute Hospitals NHS Trust

Cumbria Primary Care Trust

Devon Primary Care Trust

East And North Hertfordshire Primary Care Trust

Leicestershire County And Rutland Primary Care Trust

Luton Teaching Primary Care Trust

Mid Essex Primary Care Trust

Sheffield Primary Care Trust

Surrey Primary Care Trust

West Hertfordshire Primary Care Trust

Wiltshire Primary Care Trust

The following trusts scored as weak for two years running:

Northern Devon Healthcare NHS Trust

Royal Cornwall Hospitals NHS Trust

Surrey and Sussex Healthcare NHS Trust

West Hertfordshire Hospitals NHS Trust

Additional trusts considered to be "financially challenged" include:

Barking, Havering and Redbridge Hospitals NHS Trust

Bromley Hospitals NHS Trust

Hinchingbrooke Healthcare NHS Trust

Mid Yorkshire Hospitals NHS Trust

North Bristol NHS Trust

Queen Elizabeth Hospital NHS Trust

Queen Mary's Sidcup NHS Trust

Surrey and Sussex Healthcare NHS Trust

The Lewisham Hospital NHS Trust

The Royal West Sussex NHS Trust

University Hospitals Coventry & Warwickshire NHS Trust

West Middlesex University NHS Trust

Weston Area Health NHS Trust

Whipps Cross University Hospitals NHS Trust

Source: Department of Health

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