A change in culture rather than a change in structure must be our immediate goal

Susan Deacon

Speaking during a parliamentaray debate on modernising the health service, she told MSPs that the NHS's governance and accountability was complex.

"If we are to provide a modern patient-centred NHS the last vestiges of the internal market must go.

"Patients, staff and the local communities all too often feel shut out from decisions which affect them.

"Too often additional investment trickles through the system and its impact is diluted as a result."

The NHS strategy will be published next month

Ms Deacon said the structure of the NHS would not change in the short term with 15 health boards and 28 trusts set to remain in place for now.

"A change in culture rather than a change in structure must be our immediate goal," she said.

Ms Deacon said an executive survey had found only 38% of people felt able to influence decisions about the NHS and said the service must be more responsive.

In June, she indicated that 10 senior health posts would be abolished in a radical shake-up of the NHS in Scotland.

She said she wanted to ensure that the "right people" were put in the right places to drive change forward.

Her proposals would mean reducing the number of health board chairmen and trust chief executive posts.