If he fails to flesh out rumour, Confederation audience will be sold short

One subject will inevitably dominate the NHS Confederation's annual conference in Glasgow this week, though it does not appear explicitly anywhere on the programme and will not affect the health service in Scotland - officially, at least. It is, of course, the national plan for the NHS in England, to be unveiled by health secretary Alan Milburn next month. He has dropped broad hints that the plan is to be 'radical' and will 'reconstruct the 1948 settlement' - a threat or a promise, depending on your point of view.

Delegates will have to wait until the conference finale to hear Mr Milburn's address and learn whether they are to be afforded a sneak preview of what they will have to begin implementing. If nothing else, billing Mr Milburn last will undoubtedly prove an effective means of stopping delegates from leaving early. Two and a half days of fevered speculation will have preceded the moment when he walks onto the stage.

Is the service south of the border to be sent in any new and unexpected directions, other than those already trailed in what look suspiciously like a myriad of officially inspired leaks? Mr Milburn will have to unveil the full national plan to Parliament first. But if he fails to flesh out the gossip and rumour, he will preside over a colossal anti-climax to the conference - and miss a valuable opportunity to talk face to face about his aims with the people who will turn them into reality.

The conference's other preoccupation, given its venue, is likely to be the progress of the NHS reforms in Scotland and the fate of the service since devolution. Many NHS managers in England have looked enviously at some aspects of the Scottish reforms; whether they are quite so envious of the intense scrutiny from politicians encouraged by the proximity of the Scottish Parliament is rather more doubtful.

It is five years since this conference was held in Glasgow. Then it was under the auspices of the National Association of Health Authorities and Trusts, Virginia Bottomley was health secretary and her Labour shadow was Margaret Beckett - who delivered her speech on the day her party unveiled its health policy for the general election (fundholding to be phased out over five years).

Elsewhere, John Redwood was challenging John Major for the Conservative leadership. Much has changed since then. Much more will change in the next five years.