The government is alienating its vital partners in NHS reform

It seemed too good to be true. But the Budget billions for the NHS were real and£600m is already on its way to the service. Yet managers remain curiously downbeat about the government's largesse: and for that another piece of misguided spin is to blame.

The presentation of the allocation of the first£600m of Budget cash - with its sideswipe at health authority 'bureaucrats' - looked pretty shabby last week. Now, it is clear it has done real harm.

Managers - who are told to their faces that they are vital partners in NHS reform - are unsure what ministers really think of them. HAs have no idea what the future holds. This is prompting disillusionment with a Labour government, which was discreetly welcomed three years ago by many senior public servants who believed things could really change.

Bradford HA chair Dr Joan Firth stepped down this week to register how 'appalled' she was by the government's behaviour. How many other chief executives and chairs could be tempted to do the same? Health secretary Alan Milburn said Ms Firth's resignation was prompted by a 'misunderstanding' of how the£600m would be allocated. But if there was a 'misunderstanding', it was one generated by anonymous briefings.

Ken Jarrold, another highly respected figure, rightly says spin doctors should not be allowed to undermine government policy in this way. But Labour seems incapable of giving up the habits of opposition: and that could well do further harm.

With her 'six months to save the NHS' speech this week, Royal College of Nursing general secretary Christine Hancock gave the press the perfect excuse to look for a winter crisis next year. And it is hard to believe it won't find one if, as the government has come close to implying, the standard of NHS success is gleaming accident and emergency departments across the land and not a single patient on a trolley.

Managers know there is little time to achieve this - if it can be achieved. But failure could lead to renewed pressure from the public, press and impatient ministers to look again at private provision.

That drink in the last-chance saloon, suggested by Unison's Bob Abberley, could yet turn out to be a very swift one. Which would be a sad outcome of the genuine commitment shown to the NHS by the government over the past few weeks. l