Victor Paige was the first chair of the NHS management board in 1984, which later became the NHS Executive. He resigned less than two years later.

'It was impossible to do the job without interference at almost a domestic level by ministers, and I suspect that has been a continuing problem ever since, 'he told HSJ last week.

And he warned that too much central control could spark a wave of resignations. 'Able managers would wish to have genuine accountability, and if they don't get it they will leave.'

Mr Paige added: 'I think the implication is the minister will be in charge. It is a nice simple solution. It is a very interesting suggestion and I can understand why they might have done it. They may have problems finding an outstanding replacement, ' he added.