Public health minister Jane Ellison has said that the Government no longer has "day-to-day control" of the NHS and compared the situation to being "on a high wire without a net", in comments leaked from a private meeting.
The Conservative minister said as a result of the sweeping reforms under former health secretary Andrew Lansley "we pretty much gave away control" of the NHS.
But Labour accused ministers of "washing their hands of responsibility for our NHS".
In the recording, leaked to The Observer, Ellison said: "I don't know how much any of you realise that with the Lansley act we pretty much gave away control of the NHS, which means that the thing that most people talk about in terms of health, the NHS, we have some important strategic mechanisms but we don't really have day-to-day control."
At the meeting on June 8 she said that "from a political point of view, it is a bit like being on a high wire without a net at times, it can be quite exciting".
The Department of Health said that the reforms had given greater powers to doctors and nurses and insisted that ministers "can and do grip the system" when it needs it.
A spokesman said: "Giving operational control for the day-to-day running of services to doctors was the right decision - but we have always been clear that ministers are responsible for the NHS, and we are proud of its performance in challenging circumstances."
But shadow health minister Jamie Reed told The Observer that while Ms Ellison might find the newly-constituted NHS exciting, patients "in full-to-bursting A&E departments will not".
He added: "Andrew Lansley's NHS shake-up was a £3 billion fiasco that nobody wanted and nobody voted for. All it succeeded in doing was in increasing bureaucracy and driving costs up. Now ministers are simply washing their hands of responsibility for our NHS."Suggest a correction