Published: 08/09/2005, Volume II5, No. 5972 Page 35

Many people think finance departments can perform miracles to turn deficits around through some secret process at year-end. Finance professionals are under constant pressure to balance the books year after year.

At the same time, there is major service change and structural uncertainty, an increasing range of political targets, and fundamental changes in the NHS financial regime.

Despite the bleak situation, there remains an absolute faith in finance, that 'it'll be alright on the night'.

But there is also a perception, held by many working in finance, that the field is not valued as highly as other activities under Agenda for Change.

These contrasting views exist, to varying degrees, throughout the NHS.

With the 2004-05 annual accounts nearing completion, time will tell whether the resilience, skills and experience of the finance function have once again risen to the challenge.

I for one remain confident that my colleagues will again deliver with dedication, focus and professionalism.

A recent report from the National Audit Office (news, page 6, 30 June) raised major concerns relating to financial management - not financial managers - across the NHS in England.

The report advocated stronger financial management across organisations, not just within the finance function. The NAO did recognise, however, that there are stiffer challenges for the financial manager to address, compared with a few years ago.

All of this adds up to a career that offers challenges, variety and a sense of purpose that is rarely available in other sectors. I have been extremely fortunate that my career in NHS finance has offered me the opportunity to work in a broad range of areas and to expand my skill-base to general management, procurement, IT and the estates function, to name but a few. All of this with a clear sense of doing my bit to contribute to a much-valued public service.

I cannot think of anywhere else I could achieve that sense of personal fulfilment - can you?

Scott Haldane is director of finance and deputy chief executive for NHS National Services Scotland and chair of the Healthcare Financial Management Association.