conference focus :

The government is loosening its grip on the NHS and allowing managers to get on with the job of improving services, according to NHS Confederation chief executive Stephen Thornton.

He told delegates that 'politicians' perceptions have significantly shifted' on the government's obsession with centralised control. He said prime minister Tony Blair's first term in office had resulted in frantic financial earmarking and the 'issuing of endless central diktats on everything from the employment of matrons to the cooking of mung beans in Matlock.'

But he said: 'After today's speech from the secretary of state, I believe we have no reason to doubt his conversion to the cause of shifting the balance of power.He is right when he says, 'I do not provide GP services. I do not manage hospitals.You do.''' But there was also a call on what Mr Thornton described as the 'one essential prerequisite' - more cash.

'Just like on the railways, the extent of 30 years of under-investment is only just becoming apparent. It will take much longer to repair than was originally thought.'

The confederation would maintain its strong links with the Treasury in 'making the right arguments' for additional resources, he said.He also warned delegates that the estimated£100m saving from the abolition of heath authorities was 'highly unlikely'.

'This and more will be needed by the primary care trusts. The secretary of state described PCTs this morning as the 'engine of change in the NHS'. They must not be set up to fail.'