The health service in Wales has faced unprecedented change over the past year, director of NHS Wales Peter Gregory told managers last week.

At the Institute of Health Management in Wales' annual conference in Swansea, Mr Gregory said key political and managerial figures had left the scene, while the Welsh Assembly and new trusts had arrived. 'Even in 1974, I do not think there was quite the policy change on top of the structural change we have been through, ' he said. 'Is it any surprise that the message I get is that the service is a bit uncertain?'

But he said policy would continue to change as the Assembly found its feet, and the vision put forward by health and social services minister Jane Hutt was quite 'new'.

In her conference speech, Ms Hutt emphasised the importance of health improvement, regeneration and 'inclusive' policies. She said the key issue for managers would be 'negotiating change'.