WAR is declared by health supremo Stephen Dorrell on the NHS's army of bureaucrats - as he promises to axe up to 5,000 administrative jobs over the next 12 months.

"More white coats and fewer grey suits" is his catchy slogan for purge on the pen-pushers.

Fine. We do not complain - not when the savings are promised to go to patient care.

But whatever benefits may ensue, it is impossible to overlook the political gimmickry behind this crackdown.

For the boom in bureaucracy is not really down to grey-suited empire building that, as part of the show, Mr Dorrell now waves a knife at, but to the government's own health service reforms built around the creation of an internal market in the NHS.

If you create a system involving the itemising and costing of treatment and the exchange of contracts and money between the service's providers and purchasers, you also need people to run it.

Lots of them.

As long as two years ago, it was revealed that the first three years of the reforms had seen 30,000 new managers and clerks recruited to the NHS - and 26,000 fewer nurses.

It may be, as some suggest, that the NHS is generally well-managed, with its administration costs comparing favourably with those of private sector business.

But this does not satisfactorily explain the four-to-five fold variations in how much health trusts spend on management.

Quite rightly, then, surgery is necessary where the increases in management have been evidently excessive.

Nonetheless, the impression remains that this sudden war on wastefulness needs to be qualified by the inescapable fact that much of the NHS's extra bureaucracy was created by the government itself - and in the name of greater efficiency.

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