MORE than 4,500 NHS staff across the Merseyside area will lose their jobs in the biggest shake-up since the health service was born, it was announced yesterday.

All primary care trusts (PCTs) will be abolished when £70bn of work “commissioning” care is transferred to groups of family doctors, from 2013. Town halls will be responsible for public health work.

Yesterday, Health Secretary Andrew Lansley refused to give any guarantee that PCT staff – who include clinicians, managers and administrators – would find similar jobs in the new set-up.

Much of the commissioning work is instead expected to be contracted out by GPs to private health firms, such as Bupa, Capita and a clutch of US-owned giants. Meanwhile, the Department of Health is expected to try to water down redundancy terms for NHS staff, a process already under way for local council workers losing their jobs. Asked if attempts would be made to cut an otherwise enormous redundancy bill, NHS chief executive Sir David Nicholson, said: “We will wait for the negotiations to take place.”

In the Commons, Mr Lansley insisted the changes involved “shifting power decisively towards patients and clinicians” by getting rid of Labour’s “top-down management hierarchy”.

He told MPs: “We will re-balance the NHS, reducing management costs by 45% over the next four years, abolishing quangos that do not need to exist.”

But Shadow Health Secretary Andy Burnham attacked a “gamble with the great success story that is our NHS”, adding: “The handing of the public budget to independent contractors is tantamount to privatisation.”

The shake-up also poses difficult questions for the Lib-Dems, because the coalition agreement proposed directly-elected PCTs, that would be “champions for patients”. Two months later, they are being axed.

Southport MP John Pugh, a Liberal Democrat, immediately challenged Mr Lansley to explain how “local citizens, not doctors, will be making any decisions”.