POLITICS

Alan Milburn may be hopping all over the airwaves appointing cancer czars and being dynamic. But he's still Tony Blair's second political prisoner. Second, that is, after General Pinochet, waiting for a verdict all those months.

Who says so? Why, his Tory shadow, Dr Liam Fox. He sort of said it within minutes of the two MPs squaring up to each other for the first time at the dispatch box on the very afternoon the Commons returned from its summer break. He'd rehearsed the line on reporters earlier.

'Apart from General Pinochet, Alan Milburn is Britain's other political prisoner, ' Dr Fox said. What did he mean? That the incoming health secretary is a prisoner of Labour's election commitment to cut waiting lists by 100,000 below the May 1997 level. What he should have the courage to do is abandon waiting lists in favour of waiting times, the policy the post Bottomley Tories have adopted.

'Patients care not how many people are behind them or in front of them in the list, but how long they and their families will have to wait for treatment, ' he told MPs - and every radio station that would listen.

Hospital care, in other words, is about first treating those who are most sick and not about 'distorting clinical priorities' by bullying NHS managers and doctors into pushing cases requiring less theatre time further up the queue.

I had presumed that Minister Milburn was aware of all this because his first policy shift was, as you know, to prioritise the 'three Cs' and 'ensure that patients are seen in a timely fashion'. Well, within 18 months.

Actually, no. Dr Fox believes that the new health secretary is falling into another trap - narrowly avoided by the Opposition, Dr Fox admits - that of 'prioritising by condition'.

Prostatic cancer, colonic tumours, post-menopausal bleeding which might (or might not) indicate cervical problems. . . GPs cannot send everyone off to hospital within two weeks. Some might need emergency treatment, others can safely wait 10 months, says ex-surgeon, ex-GP Dr Fox, with the confidence of his trade.

Water off a duck's back to Mr Milburn, of course.

Taunted with his imprisonment by 'the prime minister's ego', he duffed up the Tories for accusing him of fiddling the figures. 'They fiddled the employment figures, not once, not twice, but more than 30 times. They tortured the statistics until they confessed, ' he snarled at Dr Fox.

Though a Glaswegian, Dr Fox seems less menacing than his instinctively aggressive Geordie opponent. On the basis of the exchange The Guardian 's sketchwriter, Simon Hoggart, memorably explained: 'Mr Milburn has a parliamentary manner that always reminds me of a Tyneside bouncer addressing a bunch of under-age girls trying to get into his club.'

Be that as it may, the basis of Liam Fox's confidence is work that his team and their expert allies are doing using computer models to see what would happen if priorities were set according to what he calls 'broad-brush categories, done for headlines and whatever is on the Richard and Judy show'. Yes, ministers can set broad priorities, he concedes, but not for each patient.

Dr Fox's own solution seems to be that the royal colleges, with which he appears to be getting on nicely, should develop a much stronger role in policing the quality of clinical outcomes and the performance of their own members.

I had a conversation inside the Whitehall machine the other day which confirmed for me that the royal colleges have realised since the medical and public relations disaster at the Bristol Royal Infirmary that they will have to raise their game. Thus Professor George Alberti, president of the Royal College of Physicians, is now chairing the external reference group on heart disease.

He is not the only top medic now working inside the Blairite big tent as the prime minister urges us all to abandon our trenches among the forces of conservatism and join his progressive army.

'Yes, I understand the feeling in the public services that we are sometimes pushing reform and change too fast. But I have got the public behind me, pushing me to go faster and to deliver this quicker, ' as Mr Blair told the BBC's Niall Dickson last week.