Frank Dobson looks back as NHS turns 60

He came in with two thoughts in mind. "I had been a shadow health minister in the 1980s and carried out the first-ever national survey of cervical cancer call and recall systems," he says.

"It showed very few places have them. That coloured my view that there was always going to be a role for central government and a secretary of state to say that certain things simply had to be done - but how you go about doing it is up to you."

The other was the reform fatigue he detected. "The NHS had been reformed to death and everybody was sick to the back teeth with it."

So Mr Dobson arrived to find a run-down health system with decrepit buildings, too few staff and equipment that did not work. He had the goodwill of the British Medical Association and royal colleges and a manifesto that pledged to get rid of the hated internal market. But he had no money as he was bound by the manifesto's pledge to stay within the previous regime's spending limits.

He remains proud to this day of what he achieved. "My feeling was that there were things we could put in place without spending a lot of money and without structural reform," he says.

He gave hospital boards responsibility for the quality of treatment and care - something that had not been done before.

He took up and developed the Tories' introduction of national service frameworks, established the National Institute for Health and Clinical Excellence and set up NHS Direct.

This is his legacy. "And I think they will be legging along for many a year yet," he says. "It would take an extremely stupid person to get rid of them, although I suppose you can't rule it out."

There were other proud moments too, such as bringing in the meningitis C vaccination scheme a year earlier than might have been the case had he not intervened strongly.

Then there was the waiting list reduction achieved in the first two years of the New Labour government. "It came down by 225,000 and that was down to the doctors and nurses in the service, nothing to do with competition. My job was just to help them," he says.

His main frustration, he says, was with Downing Street leaking statements to the press before they had been announced in Parliament.

After leaving office in 1999, Mr Dobson famously opposed the foundation trust legislation. Today he is sceptical about competition and scathing of choice.

On the latter he says: "What most people want is their nearest hospital to be able to deal with them properly and promptly."

"I am against the reintroduction of competition," he adds. "I think it is unnatural. Healthcare provision has to be based on co-operation not competition."