Published: 29/07/2004, Volume II4, No. 5916 Page 19

Downing Street's monthly televised press conferences leave me with mixed feelings. They are modelled on a White House tradition, now so rare and so stylised in practice that they are barely worth the electricity.

At least with our version reporters can still try to ask Tony Blair proper questions - even if we often fail.

This month Mr Blair and Michael Barber, head of the Number 10 delivery unit (not babies, better public services! ) subjected the captive press corps to a series of graphs and bar charts designed to demonstrate rising numbers of nurses and falling numbers of cancer deaths, among other things.

I am almost as suspicious of bar charts (the difference between 0.1 per cent and 0.2 per cent can be made to look so large) as I am of slick press conferences. So I used my question to ask how voters can be expected to trust such figures when that very morning's crime data had produced 'crime soars/crime plummets' headlines in our great national dailies.

On crime, he said his figures were right. It is falling, although there are problems over violence and the drink culture. Indeed, fear of crime or of yobs is often more powerful than the reality.

Likewise with the NHS where most people I speak to ('we only spent an hour in A&E') finally think it is getting better.

With that in mind I rang Alan Milburn to tell him he had been described in last week's HSJ as Bevan's heir, the saviour of the NHS, the man whose NHS plan refocused the service as it teetered towards the brink.

There was a time when Darren Murphy, Mr Milburn's special adviser, would have told him immediately. But the former health secretary is trying to stand back from his old bailiwick and no longer follows the details closely.He is spending all his spare time catching up - bonding with his two sons.

But what did he think of the recent dramas, the quango cull instituted by his successor, John Reid, and the rise and fall of all those hospital stars?

To my surprise Mr Milburn was both sanguine and supportive.

'The structure was bound to need time to bed down, ' he said.

'People get very excited about lost stars, but they should try to look ahead and see the big picture.'

And what is that exactly? Mr Milburn believes that devolved power in the NHS, more autonomous providers (as the jargon puts it) together with extra cash, of course, and patient power (more jargon) are the drivers of a better service. But which is in pole position: autonomy or patient power?

'I believe that John has resolved that in his own mind in favour of the latter. That is also where I think we have to get, ' says Mr Milburn.

Incidentally, he also thinks that health has now overtaken education in providing this kind of reformorientated shift, although Charles Clarke recently told me he thinks comparisons between the two services unhelpful.

Education, after all, has been local authority driven. For better and worse, Bevan kept them out of the NHS, although they are creeping back in now.

Ifyou are happy with the overall way things are going, then hospital star problems or the fluctuating powers of primary care trusts in relation to GPs or the central budget are what Milburn dismisses as 'second or third order problems'. 'Everyone can get very excited but it does not alter the direction of travel.'

He is calm too about the quango cull, many of the closures and mergers being DobsonMilburn creations. 'It is perfectly sensible - I set it off with the decision to downsize the department. If power is being shifted to the locality and the patient you do not need such a large centrally run authority.'

I wonder if you think It is quite as simple as that?

Remember, Mr Milburn has the pre-holiday calm of a retiree, though how long he remains out of the fray is still unclear.He even tells me those disappointing participation rates for foundation hospitals can be bettered with more work.

Friends at the Department of Health tell me things are calmer postMilburn.

Mr Reid is older, more selfassured, and has the Milburn road map which makes life easier.

He does not chase issues or headlines as fiercely. But Milburn the Mellow has changed, too.As NHS drivers go, he is back within the speed limit.