You can imagine my distress on returning from foreign parts to discover that things have been going on in the political health arena behind my back, much of it driven by a succession of top-level leaks to this very magazine.

Ministers and senior officials were furious, as they usually are when documents in very restricted circulation are leaked, as was the case here with the papers on workforce, pay and MRSA. It means someone is disaffected.

The latter paper had been sent in October to ministers who had decided to fight on with their targets, hence their rapid response on TV. Even as we speak, chief medical officer Professor Sir Liam Donaldson's team are studying the Dutch 'search and destroy' approach to those nasty bugs if they can be traced, for instance, to a nursing home. The trend is still downwards.

The workforce and pay papers had been kicking around the department since the autumn, part of private discussions on Gordon Brown's forthcoming three-year comprehensive spending review which, as everyone knows, will mark the end of the seven Biblical fat NHS years and usher in some leaner ones.

It will not have pleased the NHS trade unions (I include the British Medical Association in this category) to hear their pay and career prospects thus discussed in private without consultation. Re-reading the Crossman Diaries (1964-70)recently reminded me that governments behave in this way.

Leak inquiries have therefore been under way, although it is never wise to hold one's breath while awaiting a result of this particular Whitehall ritual.

Despite all this and Andrew Lansley's volley of festive brickbats from the Tory benches, Patricia Hewitt and her sidekicks enter the new year in good heart. Why so? Primarily because they believe
the worst may be over on the budgetary front after months of media pain and back-bench anger, demos and petitions.

'Patricia is quite bullish on the financial figures. We will balance the books in April. There will be some deficits, but the net overall figures may even be in slight surplus,' says one of my sources with access to as yet unpublished trends. Top-level sources naturally. Since when did you hear a journalist ascribe an opinion to 'someone completely in the dark' or a 'tea-making source'?

Others confirm it. Barring disasters (did anyone say 'late cold snap' or 'flu'?), the financial year is ending on a stronger note.

Even The Guardian's revelation that at least 11 ministers have been fighting local NHS closures has its bright side, they say. It helps disprove repeated claims that Ms Hewitt and Labour chair Hazel Blears (one of the protesters) have a 'heat map' to protect their party's interests in vulnerable seats.

Having attended a Fabian Society conference on 'the next decade' at the weekend, I am more convinced than ever how vulnerable such seats may be in 2009-10. 'Why is the government shutting accident and emergency and maternity services?' asked one delegate. They are the two points of contact most people feel they have with the NHS, since they identify it with hospitals, not GPs, said another speaker.

A good point. Ed Balls, Brown's number-1 henchperson, was on the Fabian panel taking questions. He stressed the need for greater co-operation between GPs, hospitals and primary care - not competition'. The MP also said the 'free-at-the-point-of-use model is the best in the world, it needs more money and will get more money. It's not just the best for Britain but will be seen around the world as the best healthcare model.'

Several NHS specialists in the hall told me they took that as a repudiation of the Blair NHS legacy. I'm not convinced, preferring Daniel Martin's excellent analysis, which stressed continuity of health policy after the takeover. Mr Brown may dislike Blair's touching faith in market efficiency, but he is also a value-for-money man. Hence the manpower worries in that leaked paper.

At the Fabian conference, pollster Deborah Mattinson put Brown's 2009 dilemma this way. Elections boil down to two choices - 'steady as we go' versus 'time for a change.' Voters are up for a change. It's Gordon's job to persuade them that he's it.

Michael White is assistant editor (politics) of The Guardian.