Health secretary John Reid has said a third-term Labour government would not 'slash' the numbers of primary care trusts and strategic health authorities.
NHS chief executive Nigel Crisp has already indicated that PCT and SHA numbers will reduce. There has also been speculation that after the election a Labour government might announce a timetable to reduce the number of SHAs to nine, in line with regional government offices.
The Department of Health has already earmarked millions of pounds of efficiency savings in Whitehall and in arm's-length bodies under the Gershon review.
Labour's manifesto, launched last week, promised to release a further£250m to the front line via 'streamlining' and to 'ensure it is possible for the NHS to change the way in which it organises its services as quickly as possible'.
Asked about plans to rationalise SHAs and PCTs to this end, Mr Reid told Health Service Journal: 'I wouldn't be prescriptive about the number of PCTs or SHAs. I think we want to do things gradually and see things develop in a style which is in accordance with what people at the front line really want. If there is an evolution so that PCTs share some of the back-room functions that's fine.'
The health secretary said a future Labour government would 'allow more of the development of PCTs in accordance with the wishes of those involved in PCTs themselves'.
He continued: 'Up to this point we've been saying no to any mergers, to any rationalisation, no to any attempt to bring together back-room facilities, so we're prepared to be more flexible on that and to allow both PCTs and other aspects of the middle organisation to develop in a more efficient way.
'But there will be no slashing of these in a false attempt to cut frontline expenditure which will only end up with all the tasks they do being thrown onto frontline staff like doctors and nurses.'
Mr Reid contrasted Labour's plans to allow flexibility with Conservative plans to 'slash to zero all targets, get rid of PCTs and get rid of all SHAs, 'which he said would 'amount to the real destruction of frontline services'.
On devolving all commissioning to GPs he said: 'What happens under the Tory plans is that the doctors who are already hard pressed meeting demands of today's patients are going to have all that commissioning thrown on top of them with not one penny compensation.
'On SHAs, the savings envisaged must mean not only getting rid of the personnel but all of the training functions, so all of the training and infection control would be destroyed.'