comment : Anxiety about traffic-lighting persists as day of reckoning approaches

Although there was little talk of performance management and traffic-lighting in formal speeches at Manchester, there was a good deal during informal discussion.

As the health secretary pointed out, many managers could probably already name the dozen or so trusts that will be given a red light, but there was speculation that their identities would not be formally revealed for a while yet. The Department of Health may be getting cold feet in its anxiety to avoid embarrassment, or it may be simply buying some time to come up with solutions for those so-called failing trusts.

Franchising is being presented as the answer to perceived failure. But the concept still puzzles many and smacks of government trying to build a policy on the back of a soundbite - not the best way to achieve success. There may be mileage in the buddy system whereby a small team from a 'strong' trust spends a day or so a week helping to support change in a weaker organisation. There could be benefits for both organisations, with opportunities for the stronger trust to recognise early warnings to avoid problems of its own and to prevent its managers becoming 'stale'.

But it is surely unwise for the health service to be rushed into implementing these policies and risk further damage to public confidence, staff morale and management credibility. Stalling a little may be a good thing if it enables government to work out how to help red lights change colour.