Published: 14/04/2005, Volume II5, No. 5951 Page 9

The NHS Confederation has warned healthcare managers to brace themselves for 'a very rough month' as the three main parties publish their manifestos.

Chief executive Dr Gill Morgan said she expected the Labour Party manifesto - due to be published after HSJ went to press - to set out a 'direction of travel' towards cutbacks in management.

She said: 'I would anticipate something about management in the manifesto. But It is not going to be about abolishing tiers, It is going to be about the direction of travel.' Asked if she expected the manifesto to pave the way for commitments from the Labour Party on reducing the number of primary care trusts and strategic health authorities, she said: 'I would be surprised if there wasn't something.

I think managers should prepare for a very rough month.' She said management spending remained the greatest temptation for parties keen to score quick political points. 'It is very difficult for any of the parties to avoid talking about reducing management spend.' Drivers like practice-based commissioning and increasing numbers of foundation trusts would mean fewer PCTs and strategic health authorities.

Dr Morgan said it would be better to let change follow its own pace, rather than to set political deadlines: 'We have already got an awful lot of organic change... what I can't call is what the political imperative is, and what decisions are being taken in smoke-filled rooms.' The Conservatives and Liberal Democrats have already pledged to abolish SHAs. The Tories would halve the number of PCTs, while the Liberal Democrats would transfer commissioning to local authorities.