The new body has the power to close wards or issue public warnings if it feels safety is at risk. Speaking at a King's Fund debate last week, Baroness Young said that ministers had told her a mark of the body's success would be that it never has to use its full powers.
But she added: 'We will use the nuclear option. Because I can predict places where that will be necessary.'
She also said that ministers' other ambitions for the body - such as ending NHS scandals and healthcare acquired infections - were unrealistic.
Baroness Young told the conference that she had asked the government to give the new regulator 10 years to achieve its aims.
She stressed that she wanted to work with clinicians and managers, and to help spread good practice instead of just attacking mistakes.
'We want to work with struggling PCTs, rather than standing behind the hedge and waiting to jump out when things go wrong,' she said.
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