Mr Milburn's analysis of the 376 chairs named shows that trust boards are dominated by men - only 97 are led by women - and by the business community. A total of 152 chairs are past or present company directors, or have their own businesses; 22 have backgrounds in finance while only 13 come from medical careers.
A spokesman for the Department of Health said that candidates from commerce were often selected, regardless of whether they had any health service experience, as they could inject 'fresh thinking and business acumen' into the NHS. He added: 'Political affiliations do not play a part in the appointments.' However, opponents argue that because of the selection process, a background in local politics is unlikely to go unnoticed.
Trust chairs are paid up to pounds 19,285 a year, plus expenses, and are appointed by the Secretary of State for Health from candidates suggested by the regional health authority and the NHS appointments unit in Leeds. Crucially, a place on the short list often depends on being proposed by existing trust executives or health authority members.
Unlike the old-style health authorities whose members included elected local councillors, trust boards have been criticised for their lack of public accountability. A Labour Party survey of 156 first- and second-wave trusts found that of the 122 that responded, fewer than half held board meetings open to the press and public apart from the statutory annual general meeting. …