Published:25/04/2002, Volume II2, No. 5802, Page 7

NHS chief executives have welcomed the long-term financial stability for the health service signalled by the Budget and the Wanless report, but have warned that meeting the public's raised expectations in the short term could prove very difficult.

Lewisham Hospital trust chief executive Claire Perry said the new money was 'beyond our wildest dreams', but 'there are issues about meeting expectations and balancing targeting with underlying pressures', such as new drug costs and the need for appropriate staffing levels.

Dorset and Somerset strategic health authority chief executive Ian Carruthers said: 'We have stabilised the system and we can drive through reform. However, we shouldn't underestimate the difficulties. The monies are very high, but there is a balance to strike between investing in the workforce to increase pay and ensuring that adequate amounts are available to deliver the services and some of the changes.'

This is a 'defining moment' for the NHS, according to University College London Hospitals trust chief executive Robert Naylor, who said the long-term investment was great news. But he added that important questions remained over whether primary care trusts were sufficiently developed to make the most of the extra billions.He said. 'We have to accept that PCTs are new embryonic organisations that have not got up to speed yet. Some are not even at the starting line.'

Whittington Hospital trust chief executive Trevor Campbell Davis said the Budget represented longterm planning 'in a way we have not had before', and welcomed the move to streamline NHS inspection. He said it was 'important that It is a singular body and we take away all the other bits of inspection'. His own trust had been visited by 33 different types of inspector at the last count.

University Hospital Birmingham trust chief executive Mark Britnell said: 'The surprise for me, and the real gem, has been the Wanless report and the sheer size of investment he feels we need.' He said, in that context, the award for the first five years was 'quite sophisticated' as 'they set the level at 7.4 per cent, because they didn't want to increase pay and price inflation'.

Chelsea and Westminster Healthcare trust chief executive Heather Lawrence said: 'There are concerns about whether we get the doctors and nurses. There are specific issues in London about recruitment, such as transport and housing costs, and we would urge the government to do something about that.'

South Birmingham PCT chief executive Cynthia Bower said the extra money was fantastic news and would mean radical change.

She said: 'Given the level of investment they are putting in, we feel absolutely determined we are going to change things. How many other organisations can say this is how much money we will have in five years' time? By knowing what the investment is going to be, we are going to be able to produce some radical plans.'

See new focus, pages 11-13; editorial, page 15; politics, page 17.