this week

Health minister John Denham has been warned of the 'difficult task' awaiting him as he takes office just three months before the start of the government's massive NHS reform programme.

Senior health service figures have also expressed mixed views about the timing of the departure of his predecessor, Alan Milburn, who is commonly regarded as the architect of the reforms.

Mr Milburn, who was promoted to the Treasury after the resignation of trade and industry secretary Peter Mandelson, leaves a demanding agenda. It includes ushering in the reforms, developing a new pay system and refining the private finance initiative.

'It's a very difficult job... There are lots of balls in the air at the moment, and a lot of potential for coming unstuck,' said John Chisholm, chair of the British Medical Association's GP committee, this week.

Unison head of health Bob Abberley warned that designing a new NHS pay system would be a mammoth task. 'If we go into those negotiations I think that it's going to tie John Denham up for the first part of the year.'

It is the second time in two months that the Department of Health has lost a minister in an unplanned reshuffle at a crucial stage of policy development.

In November, former junior health minister Paul Boateng moved on weeks before the publication of the NHS mental health strategy, for which he had responsibility.

Mr Denham, who was a minister at the Department of Social Security with responsibility for pensions, arrives with a reputation as a politician comfortable with technical policy briefs.

'He's always enthusiastic, a minister who showed he could get to grips with complex subjects,' says one pensions industry commentator. 'He was very much a consulting minister who liked to get out and meet people. He is a safe pair of hands in a difficult situation.'

Like his predecessor, Mr Denham has made the transformation from left- wing firebrand to Blairite loyalist. In the early 1980s he was a follower of Tony Benn; he now says he is 'happy with the moderniser label'.

Elected to Southampton Itchen in 1992, he has shown a close interest in local health issues. He claimed much of the credit for bringing the Wessex regional health authority computer scandal to light in the early 1990s.

Karen Caines, director of the Institute of Health Services Management, said it was crucial that Mr Denham's arrival heralded a period of stability at the DoH. 'It is important that he is around for at least a couple of years and that he does not come in with a new bag of ideas,' she said.

She felt that although Mr Milburn had left at what seemed an inconvenient time, it was not disastrous. 'Having him in the Treasury is not bad as he goes with a real understanding of the financial priorities of the NHS.'

See Comment, page 13;

Politics, page 15.