Published: 10/03/2005, Volume II5, No. 5946 Page 3

At every election the NHS comes under the media spotlight. But - if they were feeling in a very philosophical mood - HSJ's readers might look on the various recent health controversies as some kind of triumph.

Yes, the stories of Mrs Dixon's shoulder (news, page 9) or Great Ormond Street Hospital (news, page 6) have damaged the reputation of the individual institutions and raised the spectre of another election campaign full of 'NHS in crisis' scares.

But the great majority of this coverage has had to struggle very hard to identify some deep-seated malaise. Only criticism around MRSA has come close to sticking.

London's Evening Standard had a go at suggesting that NHS's problems cannot be solved 'with money alone', by commissioning Harriet Sergeant - author of Managing Not to Manage: management in the NHS. The piece was given the forbidding title 'Sickness at the heart of the NHS' and criticised the NHS for various things: over-centralised control, poor IT, under-use of the independent sector, and an inspection scheme that does not take sufficient notice of the views of patients and staff. In every one of those areas the NHS is moving forward - not fast enough in some, it is true - but the trend is well established.

There is another cause for cheer:

Labour, odds on to form the next government, has issued a manifesto on health which does not signal any changes in direction on NHS reform (news, page 5). There are signs of acceleration in some policy areas - on plurality and choice. But equally, the health secretary's declaration that NHS spend in the independent sector is unlikely to rise above 15 per cent in his political lifetime indicates a recognition of the limits of reform.

The absence of any new 'big ideas' may give greater space to the anecdotal health stories beloved of politicians and the media during election time. But once the dust has settled, the NHS will not be faced with a batch of shiny new ideas hatched to win an election and needing serious re-engineering.

For this - during this trying time of misinformation and scare-mongering - NHS managers can at least give thanks.