What an anti-climax. The government achieved its waiting-list target last week and the event passed almost unnoticed. Health secretary Alan Milburn issued a low-key press release focusing more on reform of the NHS than the figures. Realistically, he also admitted these would move with 'peaks and troughs' in demand.
Managers can breathe a sigh of relief at last. Press releases from trusts which have achieved their waiting-list targets for the first time in years, often by just one or two patients, shows how much effort has gone into meeting this political imperative which has dominated the first years of the Blair administration.
How disappointing, then, that received wisdom has moved on and decided that the achievement means little because the target was the wrong one to set.
Labour made huge capital out of rising waiting lists under the Conservatives. So it is hardly surprising that the party fashioned its 'early pledge' on health around the number of people waiting, rather than how long they had to wait.
Having achieved the pledge, however, Mr Milburn is starting to talk about variations in waiting times. In a speech to the Royal College of Surgeons last week, he also described 'a guaranteed maximum wait of a year and a half ' as 'no longer defensible with either clinicians or the public'. A guaranteed shorter wait seems a logical next step.
Such a shift in emphasis must be welcomed. It is nonsensical for an operation on unsightly varicose veins to have the same 18-month deadline as a heart bypass. But unless Mr Milburn means to impose shorter waiting times for all treatments - which would be risky, given pressure on the system - some element of prioritisation may have to be introduced.
The Conservatives are already talking in these terms. But they have a clear agenda - those varicose vein operations with potentially endless waits will end up in an expanded private sector, while the NHS is left to deal with the 'core' cardiac surgery.
Despite Labour's relaxed attitude to the private sector these days, it seems unlikely that ministers will be happy to push patients explicitly out of the NHS. They will need to expand provision - and possibly try to choke off some supply - instead.
There is every sign that Mr Milburn knows this very well. In his Royal College of Surgeons speech he mused aloud on the need to 'tackle the perverse incentives' that 'help sustain long waits for surgery'.
He could have chosen any number of examples. The one he picked was, 'Does the fact that consultants employed on 'maximum part-time'' contracts earn nearly as much from the private sector as they do from the NHS act as a perverse incentive?' It is difficult not to say, 'Yes'.
He also talked, again, about 'inflexible partitions' between primary care and hospitals and the need to make people healthier, so they don't need to use the resources of the NHS in the first place.
Mr Milburn's rhetoric is getting more Bevanite with every speech he makes. He talks about the NHS as one of Labour's 'proudest achievements' and about the 'national plan' with which he intends to secure its future for another 50 years.
But it was Nye Bevan who famously said he 'stuffed (consultants') mouths with gold' to persuade them to back the NHS.
Managers would love Mr Milburn to remove that wadding. If he is prepared to, he will be helped by a change in the public's perception of doctors, pushed by Bristol, Shipman and other scandals.
When the government launched its consultation on a 'national plan' for the NHS, the question asked was whether it was a sham or a real attempt to tackle fundamental problems in the health service. Indications are starting to emerge that it could be the latter. Don't be disappointed by the lack of cheers this week. Instead, raise a toast to the end of the distractions of the waiting-list target.
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