The New Deal to help unemployed people back into work was launched in the NHS just over a year ago with a fanfare by the then health minister, Alan Milburn. He pledged that the health service would find 1,000 jobs as its contribution to this essential plank in the government's Welfare to Work programme. And that was just for starters.
One of Mr Milburn's first actions on returning to the Department of Health as secretary of state has been to check progress - and he is evidently not happy. Although he was able to boast at last year's launch that 100 health authorities and trusts had already signed up to the New Deal, 16 months later only 126 of the promised 1,000 jobs have materialised. 'It is clear that more, much more, needs to be done, ' remarks a circular telling managers that they now have eight months to find the remainder of the 1,000 jobs.
So far, a third of HAs and trusts have yet to sign agreements with their local Jobcentres, with which few have traditionally had strong links. Given the maelstrom of policy initiatives, restructuring and mergers preoccupying the service for over a year, it is unsurprising that this particular government edict has been overlooked.
Staff displaced amid these changes have rightly taken priority for redeployment, while the relentless search for efficiency savings in the service's perennially tight financial environment means most NHS employers are more used to job cuts than job creation.
The New Deal was always going to pose an ambitious target. Financed from the windfall levy on privatised utilities, it is aimed at 250,000 disadvantaged young unemployed people. They may have disabilities, be lone parents, come from ethnic minority groups or formerly have been in council care. Some may have criminal convictions or a history of drug offences or mental illness.
Probably most will lack confidence and have low self-esteem. All of which means they may not initially appear easily employable in NHS organisations.
Yet they bring advantages, too. The posts they fill attract short-term subsidies. In non professional jobs where turnover is high, they could be an important source of recruitment. Most important of all, measures to reduce unemployment will - in the long term - improve health, and as the country's largest employer the NHS has an obvious dual responsibility here.
So the government is right to keep pushing the New Deal. But it must ensure the NHS has appropriate support, resources and access to training to make the scheme work in the health service. Only then can managers realistically be expected to hit the target of 1,000 jobs by next June .