PCTs have been shedding managers in an ‘uncontrolled’ way, Sir David Nicholson told the House of Commons health select committee.
The mass exodus risks opening up a management hiatus until commissioning consortia form in 2013/4.
More than 2,000 staff took the redundancy package, and in total as many as one manager in 12 has left the health service in the past eight months, Sir David told MPs last week.
The ‘mutually agreed resignation scheme’ for PCT staff cost over £40 million and has now been halted.
The deal was a financially attractive redundancy package that forbids managers to return for six months.
GP and Conservative MP for Totnes Dr Sarah Wollaston told health secretary Andrew Lansley that PCTs are ‘haemorrhaging’ staff.
‘How are you going to stop them losing the best people?’ she asked.
Dr Wollaston voiced doubts that PCTs could deliver efficiency savings when ‘in very many areas we are seeing PCT managers disappearing and PCTs effectively in meltdown’.
But Mr Lansley denied that PCTs are ‘in meltdown’.
Fellow Tory MP Nadine Dorries said the PCT walk-outs will create a management hiatus next year as consortia seek to configure themselves.
Sir David admitted that the devolution from PCTs to consortia is ‘unlike any reorganisation I have ever managed before’, stressing that for the first time it is a ‘bottom-up’ shift.
He said that PCTs will adopt the London ‘cluster model’ with a single management team until handover to consortia in 2013/4.
He added that ‘a local presence’ will be needed after consortia take over.
Mr Lansley ducked Dr Wollaston’s question on whether the commissioning consortia will inherit PCTs’ debt until the operating framework is published in December.
‘It’s a bit early to answer that,’ he told her.