The roles of NHS chief executive and Department of Health permanent secretary would be separated again by a Conservative government, said shadow health secretary Dr Liam Fox.

'Those applying for the job should know that on returning to office I would immediately separate the two roles, 'he said. Combining them, as Labour was about to do, was 'a perversion of the civil service culture'.

Dr Fox said the health secretary's powers to interfere in NHS management had to be reduced in order to depoliticise the NHS.

'Management must be free to manage - liberated from the intrusive and bullying culture which is the hallmark of the current government, and in particular the current secretary of state.' He added: 'Ministers should not be issuing endless circulars on everything from cleaning to catering.'

A Conservative government would match Labour's spending plans, 'but we would also seek ways of expanding private provision on top of this'.

To reduce bureaucracy it would phase out health authorities in favour of a smaller number of 'umbrella authorities. . . closer to the old regional level'.