David Cameron promised yesterday to cut the cost of running the NHS by a third while handing day-to-day management of the health service over to an independent body.

The Tory leader guaranteed that up to £1.5 billion of savings on bureaucracy would be reinvested elsewhere in the health service. He also pledged to extend “patient power” and to create a rebranded Department of Public Health if his party won the next election.

Experts said that the plans to make the NHS more independent under a new executive board lacked detail, risked the health service becoming an unaccountable quango and could mean that decisions to award NHS contracts were distorted by commercial interests.

In a speech setting out his priorities for the health service Mr Cameron promised “real-terms growth” in health spending every year but insisted that money could be better spent.

The £4.5 billion annual bill for administering the health service was “astonishing”, he said, adding that the NHS needed “top to bottom reform”. This would involve cutting the administration budget by a third over four years.

Under the Tories patients would also have the right to much more information about their local hospitals, which the party says will make doctors accountable to patients rather than to ministers. Hospitals would publish online the success rates of everything from heart transplants to cancer survival rates.

“When patients not only have the power to choose where they get treated, but also the information to make an informed choice, then hospitals and GPs who don’t provide good care will have to raise their game,” Mr Cameron said.

The Tory decision to replace heath targets with “outcomes” is set to become a key dividing line at the general election.

Last week The Times revealed that ministers intend to entrench performance targets on maximum waiting times in legislation before the next election. Mr Cameron yesterday insisted that scrapping the targets would not increase waiting times.

Private companies would be able to compete with existing hospitals or GPs to win contracts to provide services for the NHS. Andy Burnham, the Health Secretary, has stressed that NHS organisations would remain Labour’s “preferred provider” for health service contracts.

The Tories say that their proposed NHS board, which Labour has labelled a giant quango, will control how the health service is organised and spends money. The party has not said who will sit on it, although members of the public, not doctors, will make up the majority.

Niall Dickson, chief executive of the King’s Fund, the health think-tank, said that the £100 billion budget of the NHS meant that ministers would always, ultimately, remain in charge. “We need more detail on how [an independent board] would operate and we need to be realistic about what it can and can’t achieve.”

Mr Dickson added that the present Government had already asked the NHS to deliver up to £20 billion of efficiency savings over the next four years and that additional spending on management, rather than cuts, might be necessary to maintain solvency.

Patients groups questioned whether the Tories’ proposals would improve the health service. Katherine Murphy, director of the Patients Association, said: “It is difficult to say at this stage how effective an independent board would be at running the NHS. We would like to see more detail on hospital trusts, down to staff-patient ratios, infection rates and complaints about specific wards or departments.

“We are concerned not to see more detail on how the Conservatives will ensure rigorous regulation and scrutiny to address problems when hospitals fail or let patients down. Nothing can replace the accountability of the ballot box.”

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