NHS managers and administrators in the North East have become the latest victims of the government's public spending blitz.
More than 500 positions have been put in the firing line at NHS trusts in Tyneside, Wearside, County Durham and Teesside, sparking concern from senior managers and unions who argue that despite being targeted en masse by the government, health service managers still carry out "important NHS functions".
David Stout, executive director of finance and communications at NHS North East, said savings targets of £27m a year left trusts with no choice but to identify those at the upper end of the NHS pay scale.
"Like all public sector organisations, the NHS in the region must deliver substantial savings in order to meet the challenges of a difficult economic environment," he said.
"The management cost reductions we have outlined will inevitably impact on many people and we are of course committed to keeping staff fully informed throughout this difficult process.
"The savings made will be reinvested directly in frontline NHS services so that we can meet the future challenges of coping with an ageing population, the introduction of new treatments and technologies and increasing our focus on prevention."
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"I feel that NHS top directors should have their salaries reduced, including the MP's who claim expenses, and further more that all the banks who had to be bailed out with taxpayers money should be reimbursing the taxpayers" – Liz Clarke, Cheshire