Political correspondents, who had been summoned at short notice, had to wait a few minutes in the foyer of the Department of Health in Whitehall while the secretary of state's previous engagement overran. The wait only served to heighten the drama.

Eventually we were taken upstairs and ushered into Alan Milburn's spacious office overlooking the Cenotaph and - glimpsed at a tantalising distance - Downing Street. We found him seated at the long conference table, flanked by his two special advisers, former NHS manager Simon Stevens and exGeordie councillor Darren Murphy.

Other officials were on hand to advise, but the striking feature was the trio in white shirts and dark ties. In terms of both policy-making and administration, this is a very political government, which thinks and acts with at least one eye firmly on the politics of any given situation - rarely more so than the young thrusters now running the DoH. They all looked very young indeed. You know you're heading for the bus pass when Cabinet ministers, as well as coppers, look that way.

We had been called in mid-afternoon to hear that the secretary of state was about to invoke powers granted him under section 20(1)(c) of the 1999 Health Act to send Dr Peter Homa, top man at the Commission for Health Improvement, into North Lakeland Healthcare trust to sort out persistent allegations of the abuse of mental patients in ward 21 - now known as Kielder House - at Garlands Hospital in Carlisle.

As you may know, the situation had defied local resolution three times since 1996 and several senior staff had been suspended.

Officials duly handed out a background note and letters sent to Dr Homa and the acting trust chair, Ian Stockdale, poor chap. Mr Milburn read his statement and took questions from behind a row of bottled water. The mood was severe.

It was not so much the substance of the dispute in sparsely-populated east Cumbria (just over the Pennines from Milburn's home base) which struck me, but the politics. The announcement was embargoed until midnight, and Dr Homa would be on the train next morning by the time Mr Stockdale received his letter by firstclass post. Section 20(1)(c) took effect the day after that, Saturday 1 April.

So far as I could tell, most North Lakeland managers had no prior intimation of what would hit them. Here was a naked act of authority by Whitehall over a distant corner of its empire - Hadrian's Wall, you might say. Mr Milburn repeatedly made two points. One was that most NHS staff, including most staff at North Lakeland trust who were 'not involved', provide excellent service to patients.

The other was that 'all patients are entitled to the highest-quality care, wherever they live, especially the most vulnerable', by which I took him to mean, even psychiatric patients, and even in remote Cumbria. The inquiry would be 'thorough, challenging and fair', he stressed. We stayed about 20 minutes, then left to inform our news editors ('Milburn knows they like late-breaking stories', murmured one colleague). In the event it made only the inside pages. Mr Milburn was out-gunned by the row over Lord Ashcroft of Belize.

I paint the picture in some detail, aware it will impress some readers by its decisiveness, horrify others by its overtones of draconian centralisation in pursuit of best practice. The dilemma has been there since Nye Bevan spoke of the minister of health (this was before title-inflation) being responsible every time a nurse drops a bedpan on the ward. William Hague was mocking its current incarnation only on Sunday.

Mr Blair, he said, is 'a control freak who has lost control'.

What struck me was Minister Milburn's steely determination, a contrast with the apparent indecision of his North East neighbour and friendly rival, Steve Byers, who has been caught off-balance (not for the first time) by the Rover-BMW row and now looks damaged goods.

Milburn has plenty of scope to fall down very deep NHS wells between now and election day. But not yet.

Glancing around, I thought of Tory former health secretary Stephen Dorrell's portrait of Oliver Cromwell, the one he picked from the national archives (a ministerial perk) to carry round his Whitehall offices - an unlikely hero for such a mild man. Milburn prefers boldly composed modernism, large abstract canvases, several in bright colours. I counted 11, plus two abstract offerings by the Milburn children - the reassuring human touch. l