But a leaked copy of a 13-page paper sent by him to board members ahead of his appointment has been criticised by politicians including Alasdair Morrison, the islands' MSP.

In the report, entitled Western Isles Health Board; key message for a change of environment - a public affairs strategy, Mr MacLeod attacks critics of the board, including Mr Morrison, a councillor and a local newspaper. He appears to suggest the board should side more with the SNP rather than Labour, Mr Morrison's party.

He also comments that the average GP has "an ego the size of the Clisham", a reference to a 2,620ft local hill.

And the paper refers to today's patients being more demanding than in the past: "Ours is a day where a mother-to-be expects to be consulted and pandered to at every point of antenatal care and final confinement ... and that, as a God-given right, the child will be born alive, immaculate and healthy. If these 'rights' are not met, she will be encouraged to look for someone to blame. There is an increasing and real possibility that she will sue."

Mr MacLeod says the board has been plagued by "ill-informed and wholly unfair" bad publicity since 2002.

A public meeting was held earlier this year, arranged by councillors Angus Graham and Angus McCormack, as the board sought to address a projected £3 million loss, concerns over a ward closure and a freeze on jobs to reduce the deficit, as well as claims of bullying.

In his paper, Mr MacLeod was critical of both Mr Morrison and Mr Graham.

Mr MacLeod also says the board should deal more with the islands' MP (the SNP's Angus MacNeill) and the SNP candidate for the Scottish Parliament, who he said might be more receptive than Mr Morrison to the board's message.

Yesterday, Mr MacLeod said he wrote the paper several weeks ago, before he was appointed.

He said: "The views expressed in it are my own; I take full responsibility for them and in no way should they be taken as the views of Western Isles Health Board."

Mr Morrison said last night: "Mr MacLeod was clearly employed with a mandate to relate closely to the SNP while attacking me and other elected politicians. It is a remarkable departure for any public body."

Dr John Smith, the board's medical director, said the paper makes "fascinating reading" but added that he is not concerned about its content.

Mr Graham said: "The board have to date shown total professional and managerial incompetence in many of their actions and this continues with this latest farce."