Health secretary Patricia Hewitt used her speech to the NHS Confederation's annual conference to acknowledge a 'difficult, often bruising' year and to attack media 'myths'.

Ms Hewitt, expected to be moved from her post in this week's reshuffle, told delegates their jobs were made 'all the harder when the reality you are creating is so different from the myths we keep hearing'.

Ms Hewitt urged managers to 'take control of [your] own destiny, not looking upward to the Department of Health for instructions or permission but looking outwards'.

On the Conservative Party's calls for NHS independence, she said: 'Handing [the NHS] over to an independent board is a distraction from the real business of making sure you on the front line have the freedom [to deliver] the best possible care.'