Who is the most feared man in the NHS? Health secretary Alan Milburn, perhaps? Chief executive Nigel Crisp?
Nope. By their own admission, both are in thrall to a more terrifying figure. Step forward Paul Dacre, editor of the Daily Mail.
Mr Milburn told the annual human resources in the NHS conference that one of the worst parts of his job each morning is reading the Mail.
Mr Crisp opened his speech by repeating comments he had already made at a Chartered Institute of Public Finance and Accountancy conference a week earlier about having to remain in 'purdah' while the press attacked the health service during the general election campaign.
'I resented all the talk about the third-world NHS, ' he said. ('The third-world NHS' is a favourite Mail phrase).
'It is a gross insult to the NHS and what needs to be done in the third world. We need a sense of perspective. Life expectancy here is longer than in the US. I deliberately chose the US because there healthcare really is world class - for two thirds of the people, but not for the other third.
'That is why it is worth remembering what we have here: a system that is about reducing inequalities and delivering to all. '
Mr Crisp clearly does not believe that everything in the NHS is wonderful. Three-quarters of his speech was about the need to push ahead with reform.
Mr Milburn also had a ringing endorsement of the NHS, its principles and the people in it - and then emphasised the need for change.
Although he has talked before about the need to prove rightwing critics of public services wrong, fear that reform will not take hold may be the demon snapping at Mr Milburn's heels.
NHS director of human resources Andrew Foster was worried about press coverage for another reason: the poor image of the NHS conveyed to potential staff that it needs to recruit.
A MORI poll conducted before last year's Royal College of Nursing congress had found that 79 per cent of staff were satisfied in their jobs - a figure so high that MORI had remarked on it, he said. Yet this hadn't been reported because staff organisations always talked up 'low morale and high workload'.
'I want to forge a pro-NHS alliance to show what a good job you can have in the NHS, ' he said.
A workshop inserted into the programme at the last minute, on how the NHS could work with the media also revealed some deepseated resentment.
One manager from Wolverhampton complained about his 'terrible' experiences and claimed the press would take information and still 'write what they like'.
Not so, said conference chair and Radio 4 Woman's Hour presenter Jenni Murray, who pointed out that even the BBC had a remit to entertain as well as inform because 'without being entertaining we do not have an audience'.
Coverage of Bristol and Alder Hey, she argued, had revealed important information about public attitudes that would help managers push for change.
The key to dealing with the press was not to panic if bad news got out, to choose good spokespeople, steer clear of jargon, learn about the media and cultivate contacts.
Whether this practical response will head off the creeping paranoia about the press remains to be seen. But media coverage of the conference itself was interesting.
The London papers had been fed an advance titbit from Mr Milburn's speech about how abusive patients would be given yellow and red cards, even though this is not quite what he said.
Reporters who wanted to go to Birmingham had faced huge difficulties getting information about the conference.
This new alliance has some way to go.