title: Lights out at region?
abstract: The hottest issue in the upper echelons of NHS management is not hospital closures or patient services, but the findings of the review headed by the Management Executive's Alan Langlands. For the next phase of changes to hit the health service will target now defunct management structures and lines of accountability that are at odds with the NHS reforms. By April next year, 90 per cent of hospitals and units will have achieved Trust status - all reporting directly to the Secretary of State through the ME. Under the old system, many sceptics questioned the need for regional health authorities: under the new there is an even bigger question mark over their survival.