Hunter gatherer

'Platitudes, generalisations and good intentions do not wash with him, ' said National Institute for Clinical Excellence chair Sir Michael Rawlins as he introduced one of health secretary Alan Milburn's understudies, junior health minister and managers' friend Lord Hunt, to the assembled throng.

Who better to understand the niceties of making funding NICE guidance compulsory than the former voice of health authorities and trusts?

So the minister did his best to assure delegates that, while he sympathised with the difficulties of making decisions about funding priorities, the NHS was getting more money than ever before.

The numbers were reeled off - health spending up 6.8 per cent in real terms, up more than a third in two spending reviews, up another£1bn next year alone.And a bewildering list of numbers about how much NICE decisions had already cost the NHS -£76m on drugs for heart disease,£250m on drugs for breast and ovarian cancer,£12m for dementia drugs... on it went as if it were an episode of Countdown.

But he didn't seem quite able to say what he had meant to.'Let me be absolutely clear on this - the money is there, ' it said on the copy of the ministerial speech distributed with the usual 'check against delivery' warning.

'I want to be absolutely clear about this - the NHS is currently receiving the largest sustained increase in funding in its history, ' were the words uttered by the wily minister, unwilling to be completely backed into a corner by his former peers.

He assured delegates that NICE was a wonderful invention and so widely known that contestants on University Challenge and 15-to-1 had correctly identified it.

Acknowledging that he was not 'going to pretend to anyone in the service that they will have an easy time on decisions of money issues and priorities', he squirmed when one questioner put to him the possibility that HAs might ration in different ways now, by instead not funding drugs that hadn't been through a NICE appraisal.

After a variety of 'hmms', 'ahs'and pauses, he conceded there was no doubt about previous chronic underfunding of the NHS and 'if we can maintain the levels of investment, we ought to be able to ensure that doesn't happen'.

Though full of praise for NICE's sterling work, Lord Hunt wasn't quite able to do the public relations exercise speechwriters envisaged.He skipped pages dedicated to the number of hits NICE's website gets daily and other generous tributes to NICE's work, claiming lack of time.

Ah well, That is rationing.