IF you were looking for a supreme example of the Prime Minister surrounding himself with people who would only express the opinions that we wanted to hear, then Downing Street was the place to be yesterday morning.

By Graham Dines

IF you were looking for a supreme example of the Prime Minister surrounding himself with people who would only express the opinions that we wanted to hear, then Downing Street was the place to be yesterday morning.

At 8.30am, the Prime Minister hosted a seminar “Financial Recovery in the NHS.” Mr Blair is determined to push ahead with his reform agenda no matter who gets hurt in the process and to hell with troublesome, dinosaur Labour MPs on the unrepentant left of the party.

With the Prime Minister was his health secretary Patricia Hewitt, the acting NHS chief executive Sir Ian Carruthers, and chief executives, medical directors and chairmen of trusts up and down the land which had been some of the worst over spenders but who had now seen the light, shaken off all their bad habits, and were pushing forward with financial rectitude on the great reform agenda.

They were the examples everyone should follow. In Suffolk, hospitals and PCTs are making £73m of cuts, many deeply unpopular. No matter. In the Prime Minister's words: “If we back away, we are not doing patients a service.”

And, he insisted, it was not the bureaucrats who mattered, it was the patients. And, of course, for patients read voters.

Not to reform would be an easy option, allowing trusts to build up massive debts. “In the short term, there would be less noise, but long term, we will not be doing our job properly. Reform will be a challenge, but it is necessary to make it. The turnaround has to be done for the sake of the HNS in the future.”

Mr Blair was speaking against a backdrop of continuing job cuts across the NHS as trusts struggle to cope with serious financial deficits. “The hard thing is that when change is happening there's enormous resistance but sometimes what's important is to hold your own and have confidence that the change will deliver a better service.

“This is time not to step back from the changes we have made but to push on with them because they do offer us the best chance of getting the NHS we want to see.”

Sir Ian said the plan was that by the end of the year 2006/7, the NHS would be in net balance. Just 39 trusts owed half of the total deficit.