Public health minister Jane Ellison has acknowledged 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".
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 comments recorded at a private meeting of the Tory Reform Group, Ms Ellison is heard praising Health Secretary Jeremy Hunt, Mr Lansley's successor, for doing a "brilliant job" and "turning the narrative around".
In the recording, leaked to The Observer, she 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 "f rom 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 challen ging 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."
Shadow health secretary Andy Burnham claimed the coalition had turned the NHS into "the biggest quango in the world".
He said that at a time when targets are being missed, ministers cannot change anything and claimed democratic accountability for what happens in the NHS had been eroded.
Mr Burnham told Sky News's Murnaghan programme: "When waiting lists are coming up to a six year high, when you have the cancer target being breached for the first time ever, the public will say to people like me do something about it, that's not good enough, people are suffering here.
"But obviously this current Government can't do anything about it because they turned the NHS into the biggest quango in the world.
"Who gave them permission to do that? Who voted for this change? The answer is nobody gave them permission to do this to our National Health Service.
"That is the point - it's not about politicians meddling all the time, it's about proper democratic accountability for what happens in a public service that spends more than £100 billion of taxpayers' money.
"That is why I will repeal the Bill that does this and I will restore democratic control and accountability to our NHS."