A SHEFFIELD health trust and Yorkshire's ambulance service face being taken over by private sector management unless they improve, the Government has indicated.
The Department of Health said executives from companies, or from better-performing NHS trusts, could be used to replace existing bosses.
Ministers outlined the idea as one of a range of options aimed at improving performance at struggling health trusts, but insist no NHS assets or staff would be transferred to private companies.
Sheffield Primary Care Trust and Yorkshire Ambulance Service are both in the spotlight because they were last year listed among 20 trusts assessed by the Health Care Commission as being "weak" for quality of services and the use of resources.
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Health minister Ben Bradshaw said the Government would only turn to the private sector to turn around failing hospitals if managers could not be found from within the NHS.
"In practice I think it will be the last resort," he said, but added: "If in a situation where a hospital is deemed to need to be taken over, and there's no NHS hospital nearby or in the country, obviously we would look at that as an option."
Ministers have yet to release a hit-list of trusts but a spokesman for the Department of Health said it was working from the same list of 'weak' hospitals as that compiled by the Healthcare Commission last autumn.
In October the Government is to publish new criteria for quality, safety and financial performance, which all NHS trusts in England will be expected to meet.
But the British Medical Association warned the scheme amounted effectively to privatising parts of the NHS and could lead to "fragmentation" within the health service.
Dr Jonathan Fielden, said: "You can't just fly in management. There is no evidence that private management is any better in the NHS."
A Sheffield PCT spokeswoman admitted its community services were "running below par" when it was formed 18 months ago.
But she added: "We have already made huge strides and our rating for this year is on course to show a significant improvement. The historical debt is gone and we are investing an extra 36 million this year to improve both health services and the health of Sheffield people.
"We are in a very strong position and refute any suggestion we could be taken over."
The Government's document released in Westminster only referred to under-performing hospitals and PCTs but a Department of Health spokesman confirmed struggling ambulance trusts are also included in the plans.
A spokeswoman for Yorkshire Ambulance Service said it had made great strides since its Health Care Commission rating.
"Since then a great deal of progress has been made to address the weaknesses identified and the organisation now has extra resources and is in financial balance," she said.
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