A leading cancer expert has warned that the NHS is on the point of implosion.

Dr Maurice Slevin says that bureaucracy and bad management is rife in the health service.

However, there are not enough front line staff such as nurses and ancillary workers, and doctors are demoralised.

As a result, he says the quality of patient care is suffering.

In the NHS the vast numbers of managers are there to stop things happening Dr Maurice Slevin

Dr Slevin's grim diagnosis is set out in a pamphlet published by the right-leaning Centre for Policy Studies.

His views have been supported by 16 other leading doctors.

Dr Slevin, who works at Barts and the London NHS Trust, argues the problems of the NHS will not be solved purely by the vast amounts of new money that the government is pumping in.

Too much of this is being wasted on proliferating bureaucracy and is not reaching the patient, he says.

Cancer services

Dr Slevin cites the example of his own field of specialty - cancer services.

The government has increased spending in this area by �407m, but many units say they have not received all the allocated funds.

Meanwhile, there are eight managers for every 10 nurses in the NHS, compared with just under two for every 10 nurses in the private sector.

"In the NHS the vast numbers of managers are there to stop things happening. In the private sector, the small numbers of managers are there to make things happen."

Dr Slevin is calling for a voucher system to ensure money follows the patient - and good hospitals prosper.

He also proposes a dramatic reduction in the numbers of managers and administrators in the NHS, using the funds generated to substantially increase the number and pay of nurses and allied professions.

Government response

A spokesperson for the Department of Health said the amount of money spent on management as a proportion of the total NHS budget was falling

There was now only one manager for every 10,000 patients.

"The NHS, after decades of neglect, is moving forward.

"There are big problems of course but progress is well under way.

"The extra resources and the reforms in the ten-year NHS Plan are biting. Resources produce results. Nurse, doctor and bed numbers are all rising.

"Thanks to the hard work of NHS staff the number of patients waiting over twleve months for a hospital operation have fallen by almost two-thirds in the last year.

"By April, waiting times for a heart operation will have halved from 18 months when the government came to office to nine months.

"That is still too long, and there is a long way to go, but the NHS has turned the corner."

Nigel Edwards, policy director for the NHS Confederation also took issue with the idea that there were too many managers in the NHS.

He said: "Managers only make up 3% of all NHS Staff.

"There are just over 26,000 managers in the NHS, many of them doctors and nurses, each one providing vital support so that front-line staff can get on with focusing on patient care."

Specialists who back Dr Slevin's paper are:

• Dr Peter Clark, Consultant Medical Oncologist, Clatterbridge Centre for Oncolgy NHS Trust, Wirral.
• Professor Charles Coombes, Professor of Medical Oncology, Head Department of Cancer Medicine, Imperial College.
• Professor Gus Dalgleish, Professor of Oncology, St. George's Medical School, University of London
• Dr Rob Glynne-Jones, Consultant Clinical Oncologist, Mount Vernon Hospital, Northwood.
• Professor Martin Gore, Professor of Medical Oncology, Royal Marsden Hospital, London
• Dr Peter Harper, Consultant Medical Oncologist, Guys and St Thomas's Hospitals
• Professor Ian Jacobs, Professor of Gynaecological Oncology, Barts and the London NHS Trust, London
• Professor David Luesley, Professor of Gynaecological Oncology, Birmingham Women's Hospital, Birmingham
• Dr Richard Osborne, Consultant Medical Oncologist, Poole Hospital, Poole
• Dr Nicholas Plowman, Head of Clinical Oncology, St. Barts and the London NHS Trust, London
• Dr Anthony Rickards, Consultant Cardiologist, Royal Brompton Hospital, London
• Dr Matthew Seymour, Consultant Medical Oncologist, Cookridge Hospital, Leeds
• Professor John Shepherd, Professor of Surgical Gynaecology, Barts and the London NHS Trust, and the Royal Marsden Hospital, London
• Mr Roger Springall, Consultant Surgeon, Charing Cross Hospital, London
• Dr Andrew Thillainayagam, Consultant Gastroenterologist, Charing Cross and Hammersmith Hospitals, London
• Professor Jonathan Waxman, Professor of Medical Oncology, Charing Cross and Hammersmith Hospitals, London