Beverly Malone, general secretary of the Royal College of Nursing, gave notice yesterday that she will step down in January to return to the US.

Dr Malone prompted rage among ministers when she allowed Patricia Hewitt, the health secretary, to be humiliated at the RCN congress in Bournemouth, and upset other other health service unions whose leaders thought she should not have withdrawn a legal action against the government without consulting them.

Before moving to the RCN in June 2001, Dr Malone was deputy assistant secretary for health in the Clinton administration.