Milburn's mission: to get results at health

ALAN MILBURN has been moved into the Department of Health with a single objective: to deliver results on Labour's health promises before the general election.

ALAN MILBURN has been moved into the Department of Health with a single objective: to deliver results on Labour's health promises before the general election.

Frank Dobson leaves behind a legacy of reforms, largely completed, and a £21bn dowry, but the NHS remains stubbornly resistant to change, and it is alarmingly high on the list of concerns among the focus groups. While Mr Milburn's mission is to keep up the pace of change, above all he must deliver improvements to convince voters that Labour is keeping its commitments to a better health service.

As Mr Dobson's minister of state when Labour came into office, 41-year-old Mr Milburn, the MP for Darlington, performed the task of initiating reforms to the NHS, such as replacing GP fundholding with primary care groups. Tony Blair was infuriated this summer when GPs at their annual conference objected to the pace of change, and questioned his commitment to the NHS.

Mr Blair warned the British Medical Association in his keynote speech to the Labour Party conference that he would not be thwarted in his determination to change the NHS.

Mr Dobson and Mr Milburn operated as a "soft cop, tough cop" team, and the latter will now have to soften his hard-headed image, and lay to rest the impression that he is being moved from his post as Chief Secretary to the Treasury to get a firmer grip on NHS finances.

Under-resourcing has become an increasing problem for the Health Secretary and the goodwill that Mr Dobson built up in his early months in the job has become frayed. Doctors complained last week about low morale when they put in their pay claim, while nurses say they are still underpaid.

Shortage of cash is leading to increased rationing to rein in the soaring NHS drugs bill. Mr Dobson limited the use of Viagra, and last week he endorsed the findings of the new National Institute for Clinical Excellence (NICE) to advise GPs not to prescribe Relenza, the anti-flu drug, on the NHS.

And the key manifesto pledge - regarded as a mistake by all sides - to cut 100,000 off the waiting lists remains to be achieved. The Tories see the private sector as the solution,but Mr Dobson ferociously resisted any shift towards easing the pressure on NHS care through private health insurance. Mr Milburn may be well placed to insist on more money to continue this policy.

ALAN MILBURN, 41,

Secretary of State for Health

Strength: moderniser, good at detail.

Weakness: may be seen as a "cutter" by the doctors.

Rating: A dark horse who could replace Blair one day.

GEOFF HOON, 45,

Secretary of State for Defence

Strength: Blairite, won't "go native".

Weakness: lawyer, with no background on defence.Cabinet rating: regarded, could be a big player.

ANDREW SMITH, 48,

Chief Secretary to the Treasury.

Strengths: Assiduous eye for detail.

Weaknesses: Quiet approach verges on dullness.

Cabinet rating: Brainy, media-savvy Blairite.