COMMENT - MANAGEMENT

Published: 17/11/2005 Volume 115 No. 5982 Page 17

Anyone who has edited a magazine grows used to what might kindly be called 'regular correspondents' - those people who write long, rambling letters in spidery hand, protesting on the subject of their particular hobbyhorse. Often the subject appears quite legitimate, but the argument soon veers off down the familiar labyrinthine path of plots and conspiracies.

Which brings us to the Conservative Party's announcement that the NHS is£1bn in deficit and Tuesday's Opposition Commons debate on NHS finances. The Tories claim that four strategic health authorities account for more than 40 per cent of the total shortfall (news, page 5).

So far, so reasonable. But they simply cannot help themselves - the deficit is apparently the fault of 'Labour's army of administrators' who are costing an extra£1.3bn compared to 2000. Surely, our regular correspondent Mr A Lansley fumes, the fact that the two figures are so similar is 'no coincidence'.

There is something plain flaky about the rhetoric of the Opposition when it comes to bureaucracy-bashing that undermines even legitimate questions on efficiency.

The Tories fare no better in their other big announcement this week. They claim that 30 community hospitals are to close - and 150 will shut 'if figures are extrapolated across England'. Which only serves to show why extrapolation is not always a very useful statistical tool.

The financial problems facing the NHS are serious ones. NHS chief executive Sir Nigel's Crisp's memo leaked to HSJ last week (news, pages 5-6, 10 November) made it clear that not all the extra funding of the last three years has been used efficiently. Trusts know there is short-term pain to come - they also know that the deficit culture is dead.

Health minister Lord Warner made it plain this week that good commissioning holds the key to financial probity. There is certainly merit in the suggestion that primary care trust managers' preparations for that commissioning challenge need to be improved, and that they may have been distracted by the reconfiguration.

The Conservatives will have to put away their crayons to take a full part in that debate.