A FORMER North-East health boss has criticised the "control and command" culture of the NHS.
Penelope Young, who stepped down as chairwoman of Easington Primary Care Trust (PCT), in east Durham, last year, delivered her stinging criticism in the influential Health Service Journal.
She believes local NHS organisations should be given more freedom to tackle local problems.
"The point of establishing PCTs was to devolve decision-making to frontline staff, clinicians and patients.
"The reality is that PCTs are led by their noses from the centre, through the delegated power of strategic health authorities," she writes.
While much was achieved in the two-and-a-half years she chaired Easington PCT, including the recruitment of more nurses and the setting up of a counselling service, Ms Young said more ambitious plans were stalled.
She said: "The board wanted to make huge leaps in expanding primary care services and to invest heavily in services for children and their families. But, as the months rolled by, the board became bogged down and frustrated by demands from the centre."
Ms Young said it became clear that if the investment was not a national priority, it would be approved.
She also said she was not convinced the control and command culture of the NHS had loosened the reins sufficiently to allow the rhetoric to become reality.
Dr Roger Bolas, chief Executive of Easington PCT, said: "The reality of spending taxpayers money is that public organisations, including PCTs, are accountable through Parliament for their stewardship."
Ken Jarrrold, chief executive of County Durham and Tees Valley Strategic Health, said: "Easington PCT has achieved a great deal in difficult circumstances. We strongly support their drive for health improvement on behalf of some of the most deprived people in England."
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