Little 'Red' Riding Hoodwolfs down NHS disquiet

No point in blaming Dobbo for misleading leaks, as some in the trade are doing. The Sun's 'exclusive' was lifted Sun-style from an obscure public finance magazine. Hints that he threatened Tony Blair with resignation if the review body's report was staged again went unconfirmed. That kind of coat-trailing is not the Dobson style.

In any case, the story isn't over. Pay restructuring (eight nursing grades reduced to three does not sound like a means of providing greater pay flexibility to me) and Blairite performance-related pay are part of the next chapter. So is Gordon Brown's Budget, announced last week as 9 March.

Travelling to a Euro-conference last weekend with a well-placed Tory, I was struck by just how bullish he was about the public finances: there may be serious dispute about growth in 1999 - will it be 1 percent plus, as the chancellor insists, or just 0.4 per cent, or worse, as some critics say? Either way, the tax revenues keep rolling in better than expected.

Last week's news that the US economy grew at an annual rate of 5.6 per cent is not just good news for bad boy Bill Clinton. If that mighty engine of global growth helps us stay buoyant, it is good news for Rodney Bickerstaffe's Unison members too, though not this week. Mr Brown may have been right to be cautious, but the stance will be harder.

But what of the Tory attitude? Is this week's bust-up the start of the fight-back? Do they have owt worth saying yet? Does Billy-the-Kid Hague deserve a PRP rise? By coincidence I heard Ann Widdecombe perform the other day. She is not one of those shadow ministers tipped for the heave-ho. Far from it. A few headbanging pundits see her as leadership material.

She's not that. But she is impressive, lucid and fearless - what the late Dick Crossman called 'a cross between Little Red Riding Hood and the Big Bad Wolf ' when he heard her speak at the Oxford Union. Colleagues who warned her not to be outspoken about the NHS have been proved wrong, she insists.

People know there is a problem: not enough cash to meet expectations - staff 's or patients'.

But does she have the answers yet? Yes and no, but mainly no, though she does have some of the questions. Everyone knows there is NHS rationing: 'If you are an MS victim you can now get Viagra (on prescription), but not beta-interferon, ' as she waspishly puts it.

'No matter how much you spend on the NHS it is never going to be able to do it all.'

Fine, fine. The answer, says Little Blue Wolf, is not the wasteful US system, but a 2-3 per cent top-up of health funding from GNP - we now spend 6 per cent - provided by private sector health purchasing of the kind that happens (in different ways) in Europe or Australia. William Rees-Mogg, the top Tory pundit, also says this is a theme for health and education that Hague could champion.

But how, Ann, how? At the lunch I attended she ruled out charges for visits to the GP or consultant and for hospital hotel costs. 'Where services are now free I don't favour charges as an option, ' she said more than once. She doesn't want an Oregon-type list either.

What I think she does want is that those of us who can afford it should use our BUPA/PPP cards to get more treatment and help ease the strain.

'How do you cater for lower priorities? If you take the pressure off, the NHS can account for lower priorities, ' she suggested. And 'a penny spent on health is a penny spent'. Well no, it isn't quite because we know that wealthier groups simply commandeer more health resources than they need. But we're all for the rational debate that Little Blue Wolf demands and the NHS's 100th birthday cake she wants in 2048. At a mere 101 she might even be present.