POLITICS

The demarcation line between public and private sectors in health was one of the election campaign's few real talking points, though when I asked Alan Milburn about the controversial IPPR think-tank report into such matters, he replied: 'I haven't read it.'

That did not stop Unison and other unions making more threatening noises about the fuss they plan to make when the election is over.

From their own perspective, Britain's 36,000 GPs made the most of the British Medical Association ballot to threaten a walk-out from the NHS. Sir Douglas Black, of Black Report fame, no less, added his name to a protest letter.

But where would we be without the Daily Mail? It ran a classic 'NHS: Fantasy and Reality' special which ranged across hospice fears ('we are promised money, but nothing has happened') to the 17year-old with 10 GCSEs who couldn't get a university place to train as a nurse: full up, she was told.

Politicians are relatively available during campaigns, so I have interviewed both Tony Blair and the health secretary since typing last week's column. The prime minister (I assume he's still prime minister! ) is adamant that the NHS will remain free at the point of use.

He praises 'some superb NHS managers', including Nigel Crisp - 'one of the most able people I have come across in the public service'.

It is not that he is trying to 'push people into private medical insurance or saying that the private sector should start taking over and running basic services for profit', he explains.

It is just that, on the evidence of private finance initiative hospitals that were built to cost and on time, he thinks that private managers can help: 'I do think that sometimes there can be advantages in having the private sector involved.'

This approach can seem naive, and I detected in another Guardian interview (not mine) that Gordon Brown thinks so too. He was stressing 'the public sector ethos' and the performance targets that he has set departments; a different form of discipline for NHS managers.

In reality, the difference between Blair and Brown is one of tone, not substance. Brown, too, wants private cash and expertise, he is just better at playing Old Labour tunes.

Mr Milburn has a foot in both camps.When we discussed criticisms of Labour's plans, he warned that 'ideological blinkers of the left' could deliver the NHS to its real enemies - Dr Liam Fox.His three 'red lines' are:

that the NHS should be free at the point of use;

that contracting out those non-urgent ops to BUPA or PPP (with their tempting 55 per cent bed occupancy) should only be done where there is value for money and benefit for the patient;

that everyone should understand he is not trying to create a two-tier healthcare system.

'The private sector is a very small player in the UK - for example, not a single private hospital provides a comprehensive range of health services.'

The key point seems to be no transfer of NHS staff to the private sector - if anything, a transfer back of ancillary staff to work under NHS ward sisters.

Private managers can worry about 'payroll, back office and car parking functions'.

Mr Milburn believes there has been wilful misunderstanding of his position. As he states it, the proposed role of the private sector seems very modest.

If modest, how can it make a significant contribution? I trust his motives but am still puzzled.

Two Labour politicians have just telephoned me. The Millbank official says: 'If we put an extra 5-6 per cent into the NHS for four years and it still doesn't deliver, Labour has an ideological problem on its hands.'

The senior minister agrees: 'If we do not get tangible improvements, especially in health, the next election will be much more difficult.'