The headline 'Milburn offers big bribe to doctors to stay in NHS' (Independent) rapidly gave way to 'Consultants fight seven-year ban on private work' (Daily Telegraph) after the secretary of state had published details of his plans to provide what The Guardian called 'golden NHS handcuffs' for the heirs of Sir Lancelot Spratt.

Within 48 hours the Mail, never a paper to miss a scare, had young consultants being 'forced to work abroad' in a brain-drain response to being required to work exclusively for the NHS for seven years after finally acquiring that long-sought status.

As usual, this column has a debilitating weakness for seeing both sides of this argument.

Alan Milburn's starting point, you may recall, was that the contract was fundamentally unchanged from Nye Bevan's famous compromises with the BMA during the difficult birth of the NHS.

Milburn, who knows his history, has also mixed carrot and stick, as the July 2000 plan promised: in return for that seven-year pledge, an extra£10,000 up-front with bonuses and merit money worth almost double that over the next 10-16 years, which would produce an average£82,500 among what will - in theory - be 39,000 consultants instead of 26,000 by 2009.

That is real money, is it not? And Dr Howard Stoate, the Labour GP-MP who will be defending ultra-marginal Dartford in a few weeks' time, was quick to make a crucial point. While some NHS specialists, especially in the major cities, may make over£100,000 a year on top of their salaries, the Milburn 10K is 'a lot more than a majority of consultants can expect to make'.

But Philip Hammond, the Tories' assiduous junior spokesman, also makes a valid hit. The Milburn model is 'Jurassic' in seeking to manipulate contractual obligations. It offends both liberty and markets and will prove counter-productive. For instance, cardiac surgeons will emigrate or go private, thus further dividing the UK healthcare system and denying the NHS the benefits of developments that private practice can afford.

More to the point, the move runs counter, argues Hammond, to Milburn's partnership overtures to the private sector, notably the concordat to treat more NHS patients. He had thought that Milburn had grasped the crucial distinction between the NHS funding health care, free at the point of use, and the NHS as a monopoly provider.

If that sounds a far cry from weekend reports that Tory medic Dr Michael Goldsmith wants us to adopt the German health insurance model, you're right.

Hammond says Goldsmith is 'no longer in the inner circle'.

Dr Stoate, meanwhile, argues that GPs have long felt that the reform was overdue.

Whenever he has to refer a patient for private treatment (as a GP, not an MP! ), he thinks:

'What's this consultant done for me? I look for people who have done well by the NHS. '

He calls Milburn a 'hard-nosed market pragmatist' who is interested in what the private sector can deliver - ops and new hospitals.

So to the Lib Dems and the Isle of Wight's Dr Peter Brand, another GP-MP. He calls the move 'pretty sad'.

'Surely you can find another way to manage people and their skills without bribing them.

He's gone a bit absolutist. My hunch is that It is a sop to the David Hinchliffes of this world, a man I've enormous respect for. It is a counterblast to his private finance initiative obsession. '

In short, Brand is a Hammondite on this one. Lib Dems want a 'mixed economy' on healthcare. Yet Milburn has placed 'total reliance on PFI' on the building front, while doing a Nye Bevan in trying to bribe the doctors by (Bevan's phrase) 'stuffing their mouths with gold' again.

But the world is much more market-oriented now, more porous, too. Doctors can move to the US and from Spain. Brand fears a split ethical system where the private sector will do anything for money, and the NHS uses ethical scruples as an excuse to ration treatment. Like Nye, Al may compromise.