Don't count your dosh before it's delivered

'NHS charges ruled out by Dobson' was not the bit that caught the attention of the night staff on the ward. Like winter colds, that one comes and goes over the years. 'Treasury 'comes up with the dosh'' was the strap headline they noticed. A very Dobsonian phrase, to which was attached a£3bn price tag, though not in direct quotations from the secretary of state.

As large sums go it was an orphan: no parentage.

As the Journal noted last week, Mr Dobson was also making optimistic mood music on ITV's Jonathan Dimbleby . His optimism rests on a good working relationship with chancellor Brown and the belief that, once ministers have sorted out their priorities in the comprehensive spending review which Iron Gordon ordered, there'll be more dosh for the NHS.

But I wouldn't break open the Asti Spumante just yet. Few of the other newspapers picked up the£3bn figure between late editions, and the paragraph which I circled was the one in which Dobbo pooh-poohed the Royal College of Nursing's fears on pay. 'Surveys show that pay comes sixth or seventh for nurses in terms of importance. What has to be done is make working hours more attractive, ' he breezily declared.

That stress on flexibility and non-dosh rewards sounded very New Labour: ie not Dobbo at all. But we would all be wise to be cautious when such menacing developments as the Japanese financial crisis, the threat of higher interest rates and the impact of the euro - just nine months away - could push our buoyant economy back into recession - and with it, Dobbo's Dosh.

Which leaves us counting the pennies as Tory MP Andrew Lansley did during Mr Dobson's Commons statement on health action zones. No, the MP for rural South Cambridgeshire wasn't hostile to the idea, just anxious that 'health authorities should not have to jump through bureaucratic hoops to satisfy the secretary of state', when what they really needed was 'adequate funding and local freedom and responsibility' to do what they thought best.

More precisely, said Mr Lansley, an ex-head of research at Tory HQ, if there are 6 million people in Mr Dobson's 11 declared HAZs - acknowledging rural poverty as well as the inner city kind, I was relieved to see - then the£5.3m allocated to the initiative is less than a quid per head.

Indeed, conceded Dobbo, but there will be£30m more next year, plus 'all sorts of other additional funds'.

Though ministers are privately praising the quality of the 41 bids, they concede that even the winning bids will need extra work, with the help of the NHS Executive. All the same, Tory MPs, led by the waspish Patrick Nicholls in John Maples' absence, never quite pinned down where exactly the extra dosh was coming from. New Labour has long since abandoned the Tree-Grown Theory of Dosh, so it must be from existing funds. Labour backbenchers, most of them from old industrial areas where the legacy of ill health is huge, were simply grateful for the attention.

In view of the Journal 's recent editorial hope that the mayor of London may provide the capital with some strategic health vision, it is also worth pointing out that the HAZ scheme effectively neutralises the case for giving local government a greater say over local healthcare, a debate which has been rumbling on since 1948 when Nye Bevan defeated the municipalist ambitions of 'Mr London', aka Herbert Morrison, Peter Mandelson's grandpa.

You may recall that in the early 1990s David Blunkett, 'Mr Sheffield' in his time, flirted with the municipal health model when he was Labour's health spokesman. But that was then.

In the brave new dosh-constricted world of Cool Britannia the name of the game, say ministers, is not that the NHS should take over social services.

Or that local government should subsume chunks of the NHS. The name of the game is partnership. And any HA which is thinking of applying or re-applying for HAZ status next year will have to show that partnership is already producing dividends.