Ken Livingstone may have appointed a health adviser, but his bold campaign pledges about a healthier London have made way for more cautious words. Laura Donnelly meets the mayor

Whatever happened to Red Ken? If absolute power corrupts absolutely, partial power appears to be marked by more of a sedative effect.

As Mr Livingstone's campaign took hold over London, pronouncements on what his mayoralty could do for the health, wealth and happiness of the capital's citizens became ever more extreme.

On health, in particular, he showed little awareness of the limitations of his new post in taking on the NHS, vowing to put London region under the control of the Greater London Assembly.

But the fighting talk is over. Speaking to HSJ, Mr Livingstone is in conciliatory mode.

Quizzed as to how he plans to wrest authority from the regional office, he says: 'I think eventually the government will devolve the health service to the new regional assemblies. It might be 10 years. It might be 25 years. . . but there is an inevitability about it. It will devolve to a lower tier.'

He later adds: 'I am not interested in telling the NHS in London how it should take management decisions.'

Last week Mr Livingstone appointed a health adviser, Dr Sue Atkinson, public health director for London region.

Dr Atkinson expects to put in one or two days a week working for the GLA while carrying on with her current position.

Mr Livingstone does little to rebuff suggestions that the appointment of a civil servant to the key role could make for a somewhat cosy relationship between government and mayor. What would happen if his views were at odds with government policy?

'I don't see that's likely to be a problem. If we suddenly had a pretty rightwing government then we might complain about it, ' he says, suggesting he will be able to work happily with a government now 'locked in to' promises to increase NHS funding.

Hardly the mouthy maverick. And for a man who based much of his campaign on his opposition to privatisation of the Tube, Mr Livingstone has remarkably little to say on the subject of the private finance initiative in the NHS, and whether he would resist further schemes in the capital.

'I don't think the health authorities are using PFI as a matter of choice - it is all that's on offer. That's a wider government policy.'

In an HSJ debate in April, the independent candidate's three main rivals agreed that the mayor should create a medical officer for health.

Mr Livingstone thinks not. Instead he plans to create a London health commission to examine the health implications of all GLA activity.

The commission will build on work already done by London regional office, which has set up a coalition for health and regeneration. Mr Livingstone wheels out cycle lanes and improvements in public transport as obvious ways in which the GLA could 'build healthier ways of living' into other policies.

'The alternative was to. . . have somebody like a London medical officer solely answerable to the mayor. I see no need to do that when we have an NHS working to do the best for London.'

Mr Livingstone appears relatively sanguine about the constraints he is working under.

'The mayor gets to have this overarching view on health but doesn't have any powers or any money for health so it's a question of how we can put health thinking into other things, ' he says.

'They have set out this mayoral system and they are waiting to see what we can make of it.'

On the question of funding, Mr Livingstone says 'where London needs special treatment is the sheer volume of people bringing diseases we are not used to tackling, people who escape dictatorships'.

However, 'in the short term' he will be happy if London gets the funding promised to the rest of the country, to bring it up to European levels .

'That's something that's essential.

When Tony Blair said we will go up to European funding, Scotland already has that, it's just the rest of us. . . I would be prepared to get up to Scottish levels in the short term.'

In the interests of fairness, he is also prepared to see the capital lose some of the special treatment it currently receives: 'As we move towards regional government each will want their own teaching capacity, so inevitably London will have less .'

Mr Livingstone is more enthusiastic about what the GLA can do to address problems recruiting and retaining staff, and nurses in particular, and on the NHS role in supporting the capital's economy.

In his inaugural address, Mr Livingstone announced that Chris Holmes, the director of homelessness charity Shelter, would be chairing an inquiry to tackle the 'rocketing housing costs. . . driving police officers, nurses and teachers out of the city.'

'There are only two ways out: either we build a lot of houses at affordable rents or prices or we increase London weighting dramatically, ' says Mr Livingstone, who suggests that the latter might put prices up overall.

But he also admits: 'I have no power to build new houses, ' only to bring together 'a broad coalition' to find a solution.

He also flags up the NHS's own responsibility to support the capital's economy.

When contracts for new projects are being negotiated 'one thing we could do is get some sort of deal to employ local people. Something that hasn't been done for years.'

Who's your friend, Ken?

Dr Sue Atkinson plays down suggestions that it was a shock when Mr Livingstone chose an 'insider' from London region to give him advice.

'I don't know whether surprise is the word I would use. It is very gratifying that there is that pragmatism. Clearly other suggestions had been made, not necessarily by Ken, but by some of the other candidates.'

Like Mr Livingstone, she concentrates on the practical consequences of links between the regional office and the GLA.

'We don't want to reinvent the wheel; there's no point sitting in separate camps. All of us have limited resources.'

Her work with the GLA will 'move on' work London regional office has already done to bring 41 partners from the NHS, local government and voluntary sector together in a coalition for health and regeneration.

Dr Atkinson insists there is little conflict in serving two masters: 'The mayor's role on health is very consistent with my role.' But her appointment was made two weeks after the bulk of the posts to his cabinet were announced, and Dr Atkinson admits that the political sensitivities of combining the two roles played a part in that delay.

'Because I am a civil servant I did have to have discussions with the Department of Health to make sure they were happy with that side of things.'

Her new role will largely involve participating in Mr Livingstone's cabinet meetings and anticipating the health implications from his eight key strategies.

Director of public health for London region since last year, Dr Atkinson, 56, held the same post at South Thames from 1994.Before that, she was regional director of public health for South and West regional health authority, director of public health and acting chief executive at South East London HA and director of public health and service development at Lewisham and North Southwark HA.

During a varied career Dr Atkinson has been a research fellow in epidemiology and preventative medicine in Western Australia, a specialist in paediatrics and a GP. Before training in medicine, Dr Atkinson read zoology at North Wales University in Bangor.