The former Chief Medical Officer - now a North-East academic - has accused the Department of Health of ignoring warnings about reforms for reforms' sake.

The Government's plans for modernising are "at risk of failing" because of the constant changes to the structure of the NHS, according to a new report from Durham University called Make or Break Time?

The authors are Professor Sir Kenneth Calman, Vice-Chancellor of Durham University, Professor David Hunter, professor of health policy and management and researcher Annabelle May.

Sir Kenneth's criticism carries particular weight because until a few years ago he was the principal medical advisor to the Department of Health.

The authors are also critical of the "highly centralised system of management control" in place in the Health Service.

They maintain that the traditional command-and-control approach will no longer work "in a world that has become more complex, more interconnected and less predictable."

Two years into the NHS Plan launched by Health Secretary Alan Milburn the "obsession" with targets has resulted in what the authors describe as "a serious lack of trust among those upon whom the Government is reliant if its NHS reforms are to succeed."

The report is a follow-up to an earlier report published in May 2001 called Things Can Only Get Better.

"We concluded than that the health service did not need more structural fixes but a change of mindset. We urged the centre to relax its iron grip," the authors said.

"Sadly, the conclusions from the earlier study have been ignored. The NHS is in the midst of the most profound restructuring in its history," they add.

Among the wide-ranging report's key messages are: *A punitive inspection system will demotivate the workforce and will not achieve the desired aim of raising quality. The Government should adopt a developmental approach instead. *An innovations unit set up by the Department of Trade and Industry should be duplicated within the NHS to make the most of shared learning. *In order to retain scarce skills in the NHS, more flexible career paths should be allowed. *A commission should be set up to re-examine all health care professions and their training programmes to produce health workers fit for today's and tomorrow's needs. *The new structures for patient and public involvement in the NHS risk being undermined unless they are adequately funded and more independent. *There is a need to improve the important role played by public health and the public's understanding of it.