Steve Bundred is stepping up at a pivotal time

Mr Bundred, who has just stepped down as chief executive of the Audit Commission, can be relied upon to maintain Monitor’s reputation for being independent from government and rigorous in its oversight of foundation trusts.

He certainly speaks his mind. A year ago he blew open the true scale of the crisis in public spending with a Times article headlined “Our public debt is hitting Armageddon levels”. A few months later he was again leading the debate, pushing the need for public sector pay freezes.

With a reputation for a robust style backed up with hard-edged analysis, Mr Bundred takes over at a tough time for Monitor. As NHS funding contracts, the regulator will be in the front line when it comes to the financial, political and service consequences of foundation trusts getting into debt. There is a very high risk of trusts failing.

Meanwhile the pipeline of FT applications is looking more like a dribbling tap, and there is no coherent plan for dealing with the rump who have no hope of making it.

And its role may be about to change; an incoming Conservative government would expand its remit to that of an overarching economic regulator, taking powers out of the hands of the Department of Health. With promises to reduce DH control, Monitor under the Tories might well become the most powerful organisation in the NHS as the financial storm hits.