A greater role for frontline staff

The 23 trusts would be merged with their 15 local health boards in an effort to cut bureaucracy.

The reorganisation is part of a series of planned reforms contained in a Scottish Executive White Paper published on Thursday.

However, in practice nothing can happen until after the Holyrood elections in May.

Confused accountability

Launching the White Paper on Health in the Scottish Parliament, Mr Chisholm told MSPs there would also be a greater emphasis on integration and decentralisation.

He announced plans for more local health care, in order to deliver a wider range of services locally.

Mr Chisholm said: "The existence of separate NHS trusts covering the same areas as NHS boards has not yielded clear benefits, but has confused accountability and obstructed the integration of services.

"We shall require NHS boards to submit plans to dissolve trusts and to establish decentralised operating units with a strong role for frontline staff.

Key points in White Paper More local health care Abolition of NHS trusts Treatment time guarantees to be extended Independent monitoring of services Patients to be involved in decision making A £26m fund to build a new model NHS More staff training and professional development A new Scottish Health Council

"By bringing together the boards and trusts, we will reduce bureaucracy and produce efficiency savings for frontline services."

He said a new Scottish health council would promote the involvement of patients and the planning and delivery of better services.

He added that improving waiting times would be a priority.

The latest quarterly report, published on Thursday, showed that waiting times for NHS treatment have barely moved.

In the last three months of 2002 the median wait was 35 days and to see a specialist 57 days.

At the turn of the year, almost 2,000 patients had spent more than nine months in the queue for an operation.

Nicola Sturgeon: More needs to be done

Scottish National Party health spokeswoman Nicola Sturgeon said that many of the proposals had already been promoted by her party.

Ms Sturgeon said the White Paper did nothing to help tackle under-capacity in the health service.

She called on the executive to carry out a national bed review to ensure the health service had the correct number of acute beds to meet demand.

She also urged it to pay nurses 11% more than the UK settlement to give Scotland a "competitive edge" in recruitment.

Tory health spokeswoman Mary Scanlon suggested the White Paper seemed "very familiar" to the executive's health plan, published when Susan Deacon was health minister.

Lib Dem health spokeswoman Margaret Smith said there was "quite a lot to welcome" in the minister's statement.

But she said concerns remained over the provision of local healthcare co-operatives, suggesting that they were non-existent in some parts of the country.