With the reliable wisdom of our old friend General Hindsight it may well be that the most constructive contribution to the health of the nation last week came from neither front bench but from Richard Allan, the Liberal Democrat standard-bearer in Sheffield.

The steel city is important to the NHS debate for other reasons, but it was Mr Allan who introduced the Protection of Human Gene Sequence Bill, the purpose of which is to prevent large US biotech firms like Myriad Genetics patenting our genes for commercial purposes.

'I would argue that the rewards can instead come from the proper patenting of specific applications of the technology without granting the patent on the genes themselves, 'Mr Allan told fellow MPs. Better to let them secure a patent on a mousetrap than on the process of mice killing, as others have put it.

Bravo. Few in Europe (where the Strasbourg parliament has taken a stand) would disagree with that, I expect, though I spotted no Tory backers for his bill.

Alas, within a few minutes, the reflective mood gave way to another setpiece debate on the state of the NHS.

No point in burdening you with another catalogue of ministers' 'clinical and financial mismanagement' (Tory version) or of the NHS's steady progress which would be undone by Tory semi-privatisation plans (Milburn).But was there anything new?

Certainly, Tony Blair's BBC Newsnight debate, reported in last week's HSJ , has made an impact. Mr Blair saying he has 'absolutely no ideological problem' with NHS managers using private healthcare to help clear backlogs, if the money is there, looks set to be used against Alan Milburn in the same way that he uses Liam Fox's Sunday Times interview in January.

That is the one in which Dr Fox suggested that private health insurance should be deployed to cover 'hip and knee replacements, hernia and cataract operations', leaving the NHS more space and money to tackle 'life-threatening conditions'. If he ever sought a correction it has not appeared, and Labour will use it as a health scare slogan - despite Tory insistence that the NHS will remain free at the point of use. Hips, eyes and knees are old people's illnesses, Bouncer Milburn points out with cheerful ruthlessness.

The way to square this particular circle is Blair's way, the way discouraged by Dobson and Milburn in 1997 before Dobbo mellowed. When I wrote last week that Americans from Maine go to Quebec to buy cheaper prescriptions, I omitted to add that Quebec is starting to buy non-urgent surgery from private hospitals in Maine - ie the Blair way. The issue is money. Tory MPs and Lib Dems are starting to make real headway with their claims - familiar to HSJ readers - that ministerial announcements are repackaged as 'new' money, which is double-counted.

As one medic told Lib Dem MP Nick Harvey, if his child grows 3 inches every year for three years, 'surely the child has grown 9 inches, but under this government's accounting methods the child has grown 18 inches' - ie three plus six plus nine.

On this occasion, the most eloquent plea came from Simon Burns, Tory MP for Chelmsford West, who described how Mid Essex has lost out again to resource allocation working party-style redistribution of funds into east London.

The result? That 9,985 people were waiting for surgery in December (against 8,361 in March 1997) and that 1,060 were waiting more than a year, 10 times the 1997 figure. A Unison survey of trolley waits - up to 12 hours - at Broomfield Hospital found 120 cases - bad enough, but surely not as bad as 201 operations cancelled on the day of admission.' That is terrible, ' said Mr Burns.

During my weekend calls I found Labour backbenchers and ministers starting to get twitchy about what this means to loyal Labour supporters who will not vote in 2001 unless they can see improvements.

'Panic' was the word several MPs used on the eve of Gordon Brown's fourth budget.

No wonder, when a smart City accountancy firm, PWC, predicts that real NHS spending increases will be only 0.4 per cent of GNP by 2001-02 - disputed figures but not impressive. Richard Allan won Sheffield in 1997 because of dismay at long, local Labour rule. Since when his party has won control of City Hall. Lib Dem, SNP, Tory? Other options are creeping back.