Published: 10/02/2005, Volume II5, No. 5942 Page 11

NHS managers probably do not much like general elections. Health will be a top priority for parties, and the NHS is dear to public hearts. Nigel Lawson, the '80s Conservative chancellor, once famously described the service as the 'national religion'.

All parties will be battling it out to support doctors and nurses and show them and the public that they have their interests at heart.

But managers do not get much of a look-in. Unloved and misunderstood by the public, they are associated with red tape and the 'target' culture - and likely to be vilified on the election trail.

If improvements are not coming on stream fast enough, despite vast amounts of money being ploughed into the service, managers become convenient scapegoats - especially to the Conservatives.

But it is Labour's plans which managers will be most interested to hear. They are, after all, almost certain to win.

'I would expect Labour to focus quite a bit on public health, ' said one manager (see story, left). 'They've just published a big white paper so I would be surprised if they didn't do a lot of implementation stuff in the manifesto.' Another said: 'I am expecting there to be policies on more voluntary sector involvement, more choice, more plurality, and encouragement for people to take a more active role in their own health.

'We might see direct payments being widened out from just social care: possibly some form of patient budgets for health, particularly as regards long-term conditions and physical disability.' A strategic health authority chief executive said he was expecting something radical to change the role of GPs. 'GPs think they are being pushed around at the moment but I do not think they've seen anything yet, ' he said.

'And there could well be something about eradicating unnecessary waits; although how they will quantify that is anyone's guess.' But one senior manager urged calm. 'The government should have the courage of its convictions - to believe in its own policies and see them through, ' he said.

With the prime minister calling for a radical manifesto which is 'unremittingly New Labour', he may well be disappointed.