Setting out his Programme for Government yesterday, Swinney announced the number of health boards would be cut from 14 to 2 in the ‘most significant structural reform of our NHS in the devolution era' as part of public services reform.

Swinney said: ‘This ambitious Programme for Government has radical and widespread public service reform at its heart to deliver real, lasting improvements to people's lives.

‘By rewiring a system of services designed for the last century, we will simplify and reshape organisations on which everyone relies and ensure every pound of investment achieves maximum impact.'

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Colin Poolman, executive director, RCN Scotland said: ‘We have been frustrated by the lack of transparency around the sub national planning approach that has prepared the way for today's announcement on the reduction in the number of health boards. This must improve going forward and staff must have a voice in change. Proposals must clearly set out how service delivery will be improved and establish clear measures to monitor whether this is achieved.'

Councillor Shona Morrison, president of council body, COSLA, said the changes had ‘important implications for local government and council services' and, particularly social care, which would take time to consider.

Roz Foyer, general secretary of the Scottish Trades Union Congress, said: ‘Crushing down Scotland's health boards into two may seem bold on paper but further centralising power when local communities are crying out for health and social care services tailored to their needs seems more reckless than revolutionary.

‘This is not the way to do public sector reform. Before the axe is swung on any public service, whether health, council or social care, Scottish Government ministers would do well to engage meaningfully and purposefully with the workers who deliver on the ground.'

Dr Iain Kennedy, chair of BMA Scotland, said: ‘Disappointingly, given the scale of the changes proposed, we have very little detail on these reforms beyond the broad headlines provided in the Programme for Government. As a result, BMA Scotland will await further information in order to provide full and thorough scrutiny of these proposals.'

Professor Mark Strachan, president of the Royal College of Physicians of Edinburgh said: ‘In order to call the merger a success, it must lead to less duplication, more consistent care, shared specialist workforces and better access for patients, particularly those in rural and island communities.'

‘A King's Fund review in 2014 specifically found that the greater the degree of organisational change, the greater the risk that the promised benefits are not delivered.

‘The Scottish Government must bear this in mind as they take their plan forward.'

Scottish Liberal Democrat leader Alex Cole-Hamilton, said: ‘We are in favour of communities being in charge and are instinctively nervous about the proposed merger of health boards.'