Around 21,000 NHS staff will be made redundant at a cost of £1bn under plans to scrap primary care trusts and hand more power to GPs, the government has admitted.
The figures were revealed as the Health and Social Care Bill was published last week, providing details on the huge NHS shake-up.
It shows that the average redundancy payout will be £48,000, which suggests that the average person affected would be on a £32,000 salary.
Documents released alongside the bill also suggest that the NHS pension scheme may be watered down to help the private sector.
They say the relatively generous scheme means the independent sector “cannot compete on a fair playing field” with NHS trusts.
Monitor “will need to consider” issues such as this, the bill’s impact assessment says.
Launching the bill, health secretary Andrew Lansley said the plans would remove “a large tier of management” and support clinical leadership.
He told journalists last week: “Our intention is to produce health outcomes that are at least as good as anything found elsewhere in the world.”
Under the bill, care will be commissioned by groups of GPs, led by GPs, who will be accountable to the NHS Commissioning Board.
Foundation trusts will receive greater freedoms - including being allowed to treat as many private patients as they wish - and their watchdog Monitor will be turned into an economic regulator overseeing competition issues.
Royal College of Nursing chief executive and general secretary Peter Carter said the plans could result in “unexplained variations in service, a reduction in collaboration and less sharing of good practice - all of which impact on quality care.”