For far too long the NHS has just been surviving

Nigel Crisp, NHS chief executive

Officials say the move will end the "unnatural division" that existed between the posts and help him to modernise the NHS.

Mr Crisp told the BBC's Today programme that he faced a big challenge.

"For far too long the NHS has just been surviving. There is too much pressure on too many staff, and we are not providing the level of service we want to.

"Now we are at a point of turning a corner. We have got a clear direction, we have got national standards, we have got investment - we have got to turn that into improvements for patients."

Mr Crisp defended the government's drive to reduce waiting lists, which critics claim has diverted resources away from more important areas.

He said: "People don't like waiting, it is very important that when people need care they are transferred into the system quickly, and they are looked at quickly."

'Superb manager'

Health Secretary Alan Milburn said the 48-year-old Cambridge graduate, who has worked in various divisions of the NHS for 14 years, had the wealth of experience needed to reform the system.

"Nigel Crisp will be a superb manager for the NHS and the Department of Health having worked in both the public and private sectors and in urban and rural areas," Mr Milburn said.

"He can bring to this job frontline experience of making change happen. I very much look forward to working with him."

Stephen Thornton, chief executive of the NHS Confederation which represents health authorities and trusts, welcomed Mr Crisp's appointment.

He said: "This appointment proves that the most able NHS managers stand comparison with the very best top private and public sector management in the country.

"When it comes to running an organisation as large and complex as the NHS, the government has found that only someone from within the NHS is really up to the job."

Mr Crisp, who starts his post on 1 November, takes over from Alan Langlands who resigned earlier this year to become vice-chancellor of Dundee University.

Alan Langlands resigned earlier this year

Appointed London regional director of the NHS Executive in 1999, Mr Crisp oversaw the merger of the two regions that had operated in the capital.

He spent five years as a community worker in Liverpool, followed by a period in industry, before working in the voluntary sector in Cambridgeshire.

In the 1980s he worked at a Mental Handicap Unit in Berkshire, moving on to become chief executive of the Heatherwood and Wrexham Park Hospitals Trust in Berkshire, managing acute and mental health services.

He later became the first chief executive of the Oxford Radcliffe Hospital NHS Trust and in 1997 was made South Thames regional director for the NHS Executive.