Getting rid of the chief executive is an easy option but not necessarily a wise one

Will Sir David Nicholson still be running the NHS’s sprawling empire from his desk in Whitehall by the time you read these words? I say he will. More important, so do David Cameron and Jeremy Hunt, most emphatically.

But the formidable Daily Mail is orchestrating forces which want to sack “the man with no shame.” Lucky Nicholson that the Fleet Street wolf pack has now found an even juicier victim: Chris Rennard, Lib Dem strategist and alleged groper.

The Nicholson tussle was predicted before the Francis verdict on the Mid Staffs disaster. But the gagging row which blew up at United Lincolnshire Hospitals fuelled the fire. Newspapers dug up Sir David’s apparently complacent verdict on Mid Staffs during his brief 2005-06 tenure as strategic health authority chief in the West Midlands and other awkward links.

Brush aside warnings

There was also what some insiders regard as his lack of contrition about his role during post-Francis interviews. There were groans at the DH as they watched him toughing it out on TV; pure Nicholson bravado. It clearly goaded another macho tough guy: Paul Dacre, editor-in-chief of the Mail, clever, censorious and convinced (wrongly) he has a hotline to Middle Britain.

The Get Nicholson crowd have some solid ground. He was the regional health chief, he did promote some of those who later failed (and have been ousted). He did brush aside some warnings and he did push targets, especially financial ones, at the behest of assorted political masters.

“He’s a bottom line man, not interested in quality,” one primary care official told me recently. “That’s not fair,” reply MPs who want Nicholson to stay. ”He’s a formidable manager who could make a lot more money in the private sector.”

The Mail reports that the second Lady Nicholson, 22 years his junior (they have a three-month-old baby), has enjoyed a dramatic rise up the NHS hierarchy. Sheer talent, no doubt.

GP/MP Sarah Wollaston, outspoken Tory MP from Totnes, thinks his survival will blight the NHS Commissioning Board at a crucial juncture. Bristol Tory MP Charlotte Leslie has tabled a “sack Dave” Commons motion to test the water. It won’t go far.

Trial by media

The Mail has over-promoted online polls that suggest 90 per cent of NHS staff have lost confidence, though Mr Dacre must know that such polls aren’t worth the paper they’re not written on.

“Can anyone imagine it would be tolerated if 1,000-plus deaths had been caused by the police or prison service?” asks Doc Wollaston. Or the private sector, some say. Alas, that’s not true.

Other MPs on the Commons health committee are reserving judgement until they have grilled Sir D on March 5, though chairman Stephen Dorrell is known to regard him as indispensable to the task of steering the service through the storm. Another (Labour) ex-health secretary concurs: Francis blamed others, but not Nicholson.

“Now we have trial by media. He’s the best NHS manager around and to drive him out now would be perverse,” he says.

That’s my view too (and HSJ’s anonymous columnist). He’s damaged and might be in trouble if he were not so important. It’s a pragmatic judgement which Cameron and Hunt share. We all understand why victims’ families want blood sacrifice, but newspapers just enjoy a lynch mob. The Mail is a brilliant, ruthless operation, often (it pains me to admit) right.

But it is also ideologically motivated, an enemy of the NHS just as it is of the BBC whose boss, Chris Patten, is also in its sights along with Rennard, a hated Lib Dem.

But we all know the Mail also attacks taxes and the nanny state while demanding more state intervention on an adjoining page. Humbug! My money is on Nicholson (57) outlasting Paul Dacre (64).

Michael White writes about politics for The Guardian