Published: 08/08/2002, Volume II2, No. 5817 PageHave you heard Alan Milburn's joke? No, do not wrack your brains - There is only the one. NHS managers could be forgiven for thinking that the health secretary is not an entirely funny man, but diligent conference-goers know better. For Big Al has, for the last two years, charmed audiences with his witty anecdote over and over again. The gist is that Al is forced to confront media coverage of the NHS over breakfast. First he reads The Daily Telegraph, and then he reads the Daily Mail - to cheer himself up!

Boom boom! Monitor can picture the audiences clutching their sides in mirth.

But those fortunate enough to hear Alan speak regularly have ventured that, with just one joke, the routine is getting a little - how shall we say? - tired.

Not to worry. Big Al has introduced a variant, where after a recap of his travails with The Telegraph and Mail, he says: 'Then I turned to The Guardian - and decided I was better off with the Mail!' Cue renewed hilarity at the expense of those cynical Guardian hacks, clearly more off-message than the right-wing press. Strange that at the Department of Health's health and social care awards last week, of which The Guardian is a media sponsor, Mr Milburn described his breakfast perusal of the Mail, The Telegraph... and that regular read for ministers, the Morning Star.

And now, an update on Big Al's moue. Fans of our health secretary may recall a splendid recent interview in the not-too-hostile NHS Magazine in which our man was described as he 'purses his lips in a moue'. Monitor had been quite taken by news of this innovation in Mr Milgurn's facial repertoire - which had previously tended more towards the grimace - and asked whether the moue-ment signalled 'a move towards a lighter, frothier, kissy-kissy Mr Milburn'. It now appears Monitor could not have been more right. Presenting the health and social care awards, Big Al was seen to plant a supportive and developmental kiss on the face of every winner. Well, not quite every winner - a colleague of Monitor's couldn't help noticing a certain discrimination against the male winners, who remained sadly un-kissed. Prince Charles - surely a handshake man - suggested a 'kissing award' for his efforts, while the BBC's Michael Buerk thanked 'Alan Hotlips Milburn' for doing the honours as well. Monitor wonders whether it is too late to change the performance assessment system. Surely a big sloppy kiss from Hotlips is worth far more than a star.