Sir Nigel announced he was leaving his post on Tuesday

At prime minister's questions in the Commons, Mr Cameron demanded to know whether outgoing NHS chief executive Sir Nigel Crisp had been sacked.

And he said the record NHS overspend was the latest sign of mismanagement.

But Tony Blair insisted Sir Nigel and ministers could both be proud of improvements made in healthcare.

Getting worse?

Earlier, Health Secretary Patricia Hewitt said she should be judged on resolving the financial crisis in NHS in the wake of its chief executive's resignation.

She has denied claims that Sir Nigel, who is being given a life peerage, was a fall guy for the predicted overspend for 2005/6.

But Mr Cameron said Sir Nigel had said he wanted to continue for at least another year.

"They've poured money into the NHS but there's an �800 million deficit and the outgoing chief executive said things are getting worse not better," he said.

The troubles, including ward closures, were the latest sign of mismanagement, said Mr Cameron.

He asked: "When will ministers take responsibility for their failures instead of seeking to blame others?"

The prime minister insisted ministers were responsible and pointed to achievements including falling cancer deaths and shorter waiting times.

"The NHS, on any basis, as every independent report has shown, is indeed getting better," said Mr Blair, arguing there were always challenges.