Only the gentlest heat was turned on health minister John Denham at the distinctly on-message New Health Network's conference. Kaye McIntosh reports

'Privately, he didn't answer the question, ' said one manager.

But publicly, no-one was admitting it. It would be a courageous manager who risked their career by daring to criticise a health minister's speech in public.

It would be even more surprising if a member of the New Health Network admitted that minister John Denham had failed to give a full and frank admission of error.

The audience at the network's London conference were fully signed up to the government's primary care reforms. Or, as the network puts it, they are 'a broad coalition of individuals and corporate supporters strongly committed to modernising the NHS'.

They will put serious questions, but prefer to voice their doubts about the answers anonymously.

Former fundholding pioneer Dr Howard Freeman, now joint chair of Nelson primary care group in south London, called Mr Denham 'brave' for turning up to a question and answer session - described by the conference chair as a 'grilling' - particularly on the day he was revealing just how many PCGs want to spearhead the government's NHS revolution.

Dr Freeman's is one of 68 PCGs bidding for trust status, which will allow them to develop from mere sub-committees of health authorities to be independent bodies, providing all primary and community care.

If all the bidders survive local consultation, there will be 19 primary care trusts in the first wave next April, with 44 more following in October.

Claire Perry, chair of the network's executive group, said: 'It is a huge vote of confidence in the policy. If they didn't believe in the policy they wouldn't have applied.'

And conference chair Dr Tom Coffey added: 'PCGs themselves have said they want to try this out.'

But it would be misleading to claim the network is wholly uncritical. The hot topic of PCGs grappling with debts caused by rising prescription drug prices was raised by Ms Perry, better known as the chief executive of Bromley HA.

Many PCGs were doing exactly what the government meant them to do and were coming up with innovative plans for developing primary care, she said.

'My fear is that some of these plans will be held in abeyance because for the first year PCGs will have to struggle with substantial overspends.'

Why, she asked, had PCGs been left to cope with the first-ever cash-limited prescribing budgets in their first year of operation?

Mr Denham said shortages of cheaper generic drugs were 'not a reason to do nothing about prescribing challenges'.

And PCGs had the power to work with other parts of the NHS and social services to deal with the problem, he said.

As for introducing limits on prescribing budgets at the same time as launching PCGs, Mr Denham said:

'We had to set this up and get things in place, it wouldn't have worked if we had dribbled it out.'

But he did promise to review the problems of PCGs' first year of operation. 'We will be coming back to this in one or two years' time.'

Later Ms Perry said the issue still 'worries me greatly'.

'I don't see why they had to introduce unified prescribing budgets this year.'

Dr Freeman said: 'Retrospectively, there is nothing they can do about it now. Prospectively there was too much change for PCGs to address from the start.'

PCG chair and network executive member Dr Coffey said of the minister: 'He did recognise that there is a problem with cash-limited budgets, he didn't shy away from that. We will just have to wait and see what solutions he comes up with.'

Mr Denham was, naturally, positive about the progress of the reforms. It was all about 'delivering high-quality services to patients'.

He praised PCGs for 'coming together for the first time across professional boundaries'.

Geoffrey Hulme, an independent accountant, warned that it would be a long time before the reforms actually saved any money. 'You have to persuade the prime minister and the Treasury that more growth money will be needed than you have managed to secure so far.'

Mr Denham avoided any outright pledges but promised: 'The debate about resources continues to happen.'

But, he said, some parts of the NHS used their funds more effectively than others.

A PCG board member hit back, with a plea to be more open with the electorate. 'I would like the government to be much more honest in their presentation of the rationing debate, ' said Dr Faruk Majid, of North Lewisham PCG.

Each year the government claimed to be spending more on the NHS but 'much of the money is always swallowed up in the pay round', he added.

The minister tried to deflect the point with a rant about taking the NHS 'outside party politics'.

'One of the reasons for modernising the NHS is that we have to be careful, we have to ward off the people who say it can't manage, ' he added.

The word 'rationing' only passes a politician's lips when they are in opposition. Mr Denham contented himself with pointing out that 'like every other health service the NHS has to set priorities'.