A kick in the goolies for Willie, the NHS's friend

Didn't I realise how demoralised the NHS had become, my friend asked after all the gimmicks and initiatives, the despair at the prospect of a 'Soviet-style structure' now being put into place by young Alan?

'The NHS is being run by a committee chaired by the prime minister, who knows nothing about the NHS, ' said my chum, who, in fairness, knows a great deal. No wonder so many key players were leaving.

I thought of this exchange when I came to examine William Hague's solution to the service's problems.

Oddly enough it was delivered to the Thatcherite think-tank, the Centre for Policy Studies, 24 hours before Mr Blair unveiled the real thing.

Unsurprisingly it got little or no publicity.

As we noted here last week, the Tory leader starts in a spirit which is less than generous. He bemoans the poor cancer and cardiac results compared with France or Germany, the indignity of mixed-sex wards and long waiting lists, the 'bureaucratic devices and perverse incentives that mean that clinical need has taken a back seat'.

'I am not going to pretend the problems began on May 1 1997, 'Hague admits. But by then it's too late for this listener. When he mentions nurse or doctor shortages, I mutter: 'Who said there was no pay problem because there was no recruitment problem?'

Why, Virginia Bottomley did, and Gerry Malone.

But let's be positive and set young Billy a good example. In his CPS speech Mr Hague flagged up seven key issues:

Clinical priorities, not political priorities. That means enforcing his patient's guarantee - ie treatment of serious cases within three months in the NHS or have it paid for in the private sector.

Real choice for patients, based on access to information about waiting times and treatment success rates in different hospitals.

Dedicated surgical units to deal with routine operations like cataracts and hip replacement, with some ops performed by GPs.

The creation of an exceptional medicines fund, financed by the DoH, run by an expert medical committee on the advice of the National Institute for Clinical Excellence, all to end the 'postcode lottery' problem for costly medicines like beta interferon.

Taking 'party politics out of the management of NHS trusts and health authorities', via an independent review of appointments.

Less micro-management of the NHS, leaving professionals, including managers, to get on with the job; also more specialisation among GPs.

Encouraging a larger private sector via personal health insurance, with tax incentives to match.

A generous view would say that the NHS plan moved halfway to meeting several of Mr Hague's ideas: more information, specialist surgical units, independent information, even the 'concordat' with the private sector, though not with private insurers.

'Anyone who knows me, my family and upbringing in South Yorkshire knows that the idea that I want to privatise the NHS is complete and utter rubbish, ' the NHS-using Mr Hague declared before endorsing the comprehensive NHS concept, 'free at the point of use' for what he called 'the great majority'.

I need hardly tell you that Bouncer Milburn responded with a brisk kick in the Hague groin. Press releases denouncing the Tories for wanting to undermine and privatise the service poured out of Millbank.

Though he must be exhausted by the last six months' endeavours, Bouncer also took time out from his stay-at-home holiday in Darlington to unveil a cruel poster which invited passing voters to cut along the dotted lines and keep - yes, keep - the doctors and nurses in the poster.He claimed this would be the effect of Mr Hague's policies.

Just in case anyone misses the point, Labour is also sending out customised leaflets for distribution in 200 key marginals, which itemise what the government has done in the locality: that new school roof, that modernised A&E centre, all under threat from youknow-who. Not so much Soviet management as Orwellian propaganda.