The health secretary, Patricia Hewitt, is almost certain to be sacked by Gordon Brown when he forms his first cabinet in July.

The prime minister-in-waiting has respect for Hewitt and may still offer her another job in the cabinet but health is such an important issue for Brown that he wants to start with a fresh face in charge.

Even Hewitt’s allies believe she will be axed from health and some believe it is likely she will be moved out of the cabinet after six years.

Hewitt came under fire last week over security lapses in an online recruitment system for junior doctors. It was discovered that the troubled system was not matching candidates properly and their personal details found their way onto the internet.

Brown has yet to decide on a replacement for Hewitt, as it could rest on the outcome of the deputy leadership contest, but MPs close to the chancellor suggest he may give the post to an experienced minister such as Hilary Benn, the international development secretary, or John Hutton, the work and pensions secretary. He may may surprise colleagues by promoting a fresh and younger face to the cabinet such as Andy Burnham, minister of state for health, or Yvette Cooper, the housing minister.

Meanwhile, David Cameron, the Tory leader, plans to criticise the chancellor over National Health Service policy in a speech tomorrow. He will say the problems in the health service are too pressing and important for the government to wait until Brown is officially anointed prime minister on June 27. He will list several areas where the government should make immediate changes.

Last week Brown declared health would be his “passion” when he takes over as prime minister. However, Harriet Harman, a deputy leadership contender, has said it is acceptable for cabinet ministers to opt out of the NHS.

In an interview in The Sunday Times she argues ministers should be free to use private health insurance and send their children to selective schools if they wish, saying that politicians are no different from other parents faced with such decisions.

“Parents make their own choices, whether they are politicians or not,” she said.

The MP for Camberwell & Peckham in London made it clear she had no regrets over how, under the Tory government, she had sent her children to schools that had opted out of local authority control.

She said: “We’ve got a policy for free education, and that’s what we’re in government to do. Parents have got to make their own decisions. No government dictates to any parent what choice they should make.”

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