Westcountry NHS chiefs have been handed "golden goodbyes" of up to £150,000 as the health service is dismantled in the region, the Western Morning News has found.

Annual reports for health bodies in Devon and Cornwall reveal 266 staff "exited" the service last year, chiefly under a national severance scheme but also through compulsory redundancy, costing £4.9 million.

Four managers in Devon and Cornwall pocketed up to £150,000. The Government was accused of wasting taxpayers' money as many are likely to be re-employed by the NHS at a later date.

South Devon NHS Foundation Trust saw 66 staff take a generous redundancy settlement in 2010/11, which cost £866,000.

Elsewhere, the body in charge of Derriford Hospital in Plymouth recorded 36 "exits", with payouts totalling £933,000.

Under the "mutually agreed resignation scheme" (MARS), where scores of pay-offs stem from, managers who wanted to leave the NHS were able to apply for up to a year's pay.

The average pay for chief executives of local health bodies is £137,500, while the most senior grade managers get just under £100,000.

The programme was aimed at enticing managers to leave the service, minimising compulsory redundancy, and saving money ahead of the biggest NHS reforms in decades.

As many as 3,000 NHS jobs across the Westcountry are estimated to be going over next few years, including doctors, nurses and ancillary workers.

Clauses should prevent managers from taking the pay-off and quickly being re-employed elsewhere in the NHS, although many believe they could return under a new-look structure post-2013. When the scheme was launched last year, the Department of Health estimated between 3,000 and 6,500 managers and administration staff would leave.

MARS was time-limited, and closed in October last year, but staff were selected in the following months after applying to leave.

Sarah Wollaston, family doctor-turned-Westcountry MP, has already expressed concern that the radical overhaul of the health service could prompt a mass exodus of managers.

Many feared primary care trusts (PCTs), which commission local healthcare, would be left rudderless before being abolished in 2013. Former Health Minister Ben Bradshaw, Labour MP for Exeter, said: "Well-run organisations always seek to reduce management costs, but you also need good management for a successful hospital or PCT.

"My concern here is waste – the huge cost of these redundancies to the NHS when many of the people leaving the PCTs are likely to be re-employed to manage the GP Commissioning Groups that are replacing them.

"GPs have made clear they don't have the expertise or desire to manage the system and someone's going to have to."

NHS chief executive Sir David Nicholson told a committee of MPs more than £40 million in redundancy payments had been handed out to more than 2,000 staff across the country.

Sir David defended the loss on the grounds that it would save £70 million each year.

The programme left vacancies in positions which do not need to be replaced or which can be filled by redeployment, it was argued.

Dr Wollaston, who sits on the health select committee, questioned whether the departures were happening in a "somewhat uncontrolled" way and whether the health service was "haemorrhaging" the very best people.

She said: "The trouble is that, in many other areas of the country, we are seeing PCT managers disappearing and PCTs effectively in meltdown."

The voluntary payouts are seen as the first stage of the huge shake-up of the NHS. After abolishing PCTs, consortiums of family doctors will be given control of most of NHS spending in an area.

But critics warned many of the thousands of management staff who lost their jobs will be re-employed by the GP groups as administrators and will still be required locally.

The cost of NHS exits

In 2010/11, two managers at RD&E Hospital Trust, one at Devon Partnership NHS Trust and one at Derriford Hospital Trust received between £100,000 to £150,000.

One manager at South Devon Healthcare NHS Foundation Trust got between £50,000 and £100,000.

At each of the RCHT, Devon PCT, Plymouth PCT and Torbay Care Trust, three people received payments of between £40,000 and £100,000.

Cornwall PCT saw five people leave, costing £21,000. Devon PCT recorded 32 people leaving voluntarily, which cost £525,000. The bill was £369,000 for Plymouth PCT for 11 staff.

RCHT paid out a total of £395,000 to 28 people. RD&E Hospital agreed to 32 exits, costing £822,000, and Torbay Care Trust shed 30 staff at a cost of £428,000. Just seven people exited North Devon Healthcare Trust, with pay-outs totalling £96,000.

Cornwall NHS Foundation Trust lost three managers and administrative staff, costing £85,000, and Devon Partnership NHS Trust recorded 17 “exits” at £358,000.