A gulf has split doctors and managers at the hospital since the board - comprising five representatives of hongs and three medics - replaced Dr Henderson with a retired banker last year.

The overnight leadership switch on October 31 saw former Hongkong Bank Taiwan manager Ian Menzies take over as chief executive, triggering an 11-week crisis of doctors' confidence.

The letter addressed to Mr Lang, a Jardine Pacific director, states: 'As businessmen, many members of the board have no appreciation of the exigencies of medical practice and the reality of operating a hospital.

'We have reached the unanimous opinion that the constitution of the board as presently structured is an anachronistic legacy and requires urgent address . . . we therefore state we no longer have confidence in your chairmanship of the board or indeed in the non-medical members of the Board.' The letter expressed concern at the 'unwarranted dismissal' of Dr Henderson and supported his opposition to a board proposal to close Hasler Ward.

'Since its closure under the new regime at the hospital, the staff morale of the hospital has crashed to the lowest levels we have experienced,' it added.

A signatory said doctors were still awaiting a response to the letter, sent about two weeks ago. Several feared for the future of the 90-year-old institution, funded by a charitable trust.

Another said: 'We have a responsibility to say 'no more'. This is a public charity and the principle of who runs medicine is quite important.

'We have a board sitting on a large pile of money and extraordinary decisions are being made. They have replaced a doctor with a banker who knows nothing about administering hospitals.' John Swire and Sons board representative Paul Etchells said: 'The board has agreed the communications should go through the chairman.' Mr Lang's secretary said: 'He has no time to return your calls because he has overseas visitors in town.'