Published: 27/05/2004, Volume II4, No. 5907 Page 19

Pundits in the broadsheets seemed happy to trumpet the improvements in the NHS reported by the modernisation board, though my friend David's verdict was: 'do not give me that rubbish again.'His wife has been ill for months and they feel badly let down.

Dave adds that, as a result of similar experiences, admittedly in never-typical London, several of his friends feel the same. I am trying to persuade them not to vote for Michael Howard.

That task may be made slightly easier by Oliver Letwin's latest foray in the direction of cutting public spending.He would promise to cut it a lot more if he did not know it would cost him the election, the shadow chancellor explained.

The difference was tactical.

All the same, these are nervous times. Not all ministers believe the general election, and certainly not 10 June, is in the bag under either Tony or Gordon.

What are those minor parties up to, the Greens, UKIP, Respect, the BNP?

Pinching votes?

You can see why health secretary John Reid unveiled that purge of the quangos ('Bureaucrats will make way for doctors and nurses') to which the Daily Mail devoted a lot less space than it did to the latest BSE/CJD panic. The idea, under interim review since last year, is to rationalise functions and consolidate overlaps.

Admirable. But there seemed to be some confusion about numbers.

According to the press release, by 2007-08 there will be a 50 per cent reduction in the number of arm's length bodies; saving in expenditure of£0.5bn; reduction in posts of 25 per cent. The review covers 42 separate arm's length bodies, employing more than 22,000 staff.

The combined annual budget is more than£2.5bn.

In addition, though few noticed, junior health minister Lord Stormin'Norman Warner has a separate initiative underway, more important to NHS staff, I suspect, to get the health regulators - led by the new Healthcare Commission - to cut the burden of regulatory inquiry and inspection.

'The idea is to get a concordat between the different bodies so that missives sent out do not constitute a ton of extra work or the same thing twice over, ' says My Man at the Ministry. Ideally it should lead to a single National Information Centre where a lot of queries can be answered.

I should point out - the Tories will point it out anyway - that bodies such as the National Information Authority are on the Reid-Warner list of 42 doomed quangos. This may account for the sceptical tone I encountered when I traced Andrew Lansley, the Opposition health spokesman.

'Seven of the 42 are due to disappear anyway. Half have been set up since 1997;

it begs a lot of questions, ' he said as his boss, Tim Yeo, declared that the purge proves what a shambles Labour has made of managing the NHS.

Mr Lansley also takes issue with the notion that an organisation like the National Blood Authority is on the list at all. 'By no one's calculation are they part of the bureaucracy of the NHS. They collect blood, ' he complains. Indeed they do.As I recall it was a Tory reform of the blood service and one that took a lot of time to bed down.

More wounding is Mr Lansley's complaint that Mr Reid is merely trying to show sceptical voters that he is bearing down on excessive pen-pushing in response to Tory criticisms. 'We have been saying this for ages.'Michael Howard made a similar jibe at Tony Blair during prime minister's question time last week, so watch out: it may be a Tory lineto-take in the election.

Mr Lansley's final warning to vigilant voters is to make sure that all those culled quangocrats are not just shifted to strategic health authorities or primary care trusts as they expand their remit.

I should add that the very word 'quango' prompted me to ring the Altrincham Tory MP, Graham Brady, who has long run a sub-specialism on the subject. I was wrong.His obsession is quango patronage - ie too many Labour appointees to trusts.

As a result of his campaigns, the MP claims, Dame Rennie Fritchie's Public Appointments Commission has greater independence. But too many Labour people have been recycled with a second reappointment. Pluralism is healthier, says Mr Brady. By coincidence Dame Rennie herself was complaining the other day about continuing ministerial interference. One to watch. l