There are "major risks" to radical plans to shake up Wales' health service - according to the senior civil servant managing the project.

By April 2003, Health Minister Jane Hutt intends to replace Wales' five health authorities with 22 health boards - based local health authority boundaries - as part of her aim to improve healthcare by streamline NHS bureaucracy.

But a leaked confidential memo sent to ministers warned the plan may be off-course and suggests a big question mark hangs over whether the reforms will work at all.

Jane Hutt was given a warning over the shake-up

Uncovered by BBC Wales' politics programme Dragon's Eye, the news is likely to heap pressure on to the minister as the changes are timetabled to be operating fully in the run-up to next May's Assembly elections.

First Minister Rhodri Morgan has already vowed his administration will be judged on its public services record in May.

But with just four months to the planned shake-up - and five months to the assembly vote - the memo by Bryan Mitchell - charged with overseeing the structural changes - is likely set alarm bells ring in the Labour/Lib Dem coalition:-

• Costs for the changeover and its operation once are still unknown.

• Whether the reformed service will work properly at all is unclear.

• It is not clear whether the changeover can take place on time.

• Many senior staff will be housed in temporary accommodation for an indefinite period.

• Key directorate appointments are still unfilled and some have attracted little interest - the original expectation was to appoint by August 2002.

• The government has not yet decided on how to widen the field of applicants - perhaps using headhunters - while the director of finance post will be re-advertised from 4 November.

• The deadline for appointing chief executives for the local health boards was missed by two months.

The e-mail - sent to Rhodri Morgan, Jane Hutt and Peter Hain amongst others - challenges the health minister's repeated public assurances her project is on-track and on-budget.

The reform is part of a 10-year modernisation strategy designed to boost local power health management, putting cash for healthcare closer to patients.

But the move was widely criticised by opposition parties when presented in November 2001.

The minister consultated 345 parties in arriving at the policy proposal - the most ambitious set of reforms proposed by the Welsh Assembly Government.

Members at Cardiff Bay voted through a revised version of the plan despite fierce criticism from many AMs, healthcare professionals and unions about their complexity, bureaucracy and cost.

Opponents angry

Currently, the five health authorities filter money through to Wales' 16 NHS trusts.

Opposition AMs have now rounded on Jane Hutt, calling for her to explain the warning.

Conservative health spokesman David Melding said: "She will be called to account. Our most fearful expectations have now been fulfilled."

Plaid Cymru counterpart Dr Dai Lloyd said: "[We wanted] a simpler structure, something that saves money and something that improves patient care - Labour's restructuring fails all three criteria.

He said the health service needed another process of restructuring "like a hole in the head" and promised the minister would face severe scrutiny.

Not policy

Mr Morgan, Ms Hutt and Welsh Assembly Government colleagues declined invitation for interview, saying it was not policy to comment on leaked documents.

A spokeswoman for the Welsh Assembly Government said a progress report by Jane Hutt on the NHS restructuring and risk management was available on the assembly's website.

A full progress report was published as part of Jane Hutt's monthly report for the Health and Social Services Committee on Wednesday. It has been on the internet for everyone to see.

A spokeswoman for the Welsh Assembly Government said a progress report by Jane Hutt on the NHS restructuring and risk management was available on the assembly's website.

"On time"

The spokeswoman said: "All the possible obstacles and difficulties that might happen unless they are closely managed that were mentioned in the progress report are completely in the open and regularly discussed in all parts of the programme.

"The Minister and Director NHS Wales were advised last week by Bryan Mitchell, the change programme director, that the programme is on time and that all the issues mentioned are being managed and are under control.

"The Minister scrutinises progress on a regular basis."