Billions of extra pounds are to be pumped into the N. But is it a case of 'never mind the quality, feel the width'? Health correspondent Barry Nelson takes the pulse of North-East health workers

ON the face of it, everything is rosy in Health Secretary Alan Milburn's garden this morning. After years of behind-the-scenes lobbying, the Darlington MP has finally hit the jackpot, persuading the once-parsimonious Gordon Brown to open the funding floodgates for the NHS.

Finally, all the promises the lad from Tow Law has made about reinvigorating the creaking health service, seem to be within his grasp.

The eternally fence-sitting New Labour Government suddenly appears to have tax-raising, even Socialist teeth.

Yesterday, Mr Milburn, the former left-winger turned pillar of the establishment, flashed his cufflinks and gave more details of how the extra £40bn promised by the Chancellor will be invested over the next five years.

Mr Milburn rattled off an impressive list of 40 new hospitals, 500 new health centres, 35,000 more nurses and 15,000 more doctors.

According to the Health Secretary, the new money will also lead to maximum waiting times for hospital operations being cut from the present 15 months to just three months by 2008, with the average wait going down to six weeks.

A particular highlight for Mr Milburn was his confirmation that, from this summer, NHS patients who have been waiting six months for a heart operation will be able to go to any hospital - public or private - which can offer a quicker service.

This is a long way towards fulfilling his promise to The Northern Echo to tackle the UK's woeful record of treating patients with coronary heart disease.

That pledge was made after the death three years ago of Mr Milburn's constituent and friend Ian Weir, 38, who died on the waiting list for heart surgery. It follows an award-winning campaign by The Northern Echo which called for the UK's long waiting times for heart patients to be brought down to the Dutch maximum waiting time of three months.

Accompanying the Chancellor's largesse is a promise of more reforms, more monitoring of performance and more rewards for hospitals which treat patients more quickly.

There is also the promise of finding a solution to the apparently intractable problem of delayed hospital discharges, otherwise known as bed-blocking, by borrowing a carrot and stick approach pioneered by the Swedish. This could result in local councils having to pay hospitals bed and board for bed-blocked patients.

So far, all well and good, but a strawpoll of health care workers in the North-East suggests that the NHS workforce is the most critical of his proposals. While most of the managers within the NHS are keeping their heads down and planning how they are going to be able to hit the blizzard of future targets to be announced by the Department of Health, doctors, nurses and back-up staff are deeply sceptical about the future.

Yes, we want the extra money, they all seem to say. But please back off and let us get on with the job in hand, is the common response.

Yesterday, Dr Bill Ryder, an experienced and long-serving consultant who chairs the British Medical Association's Northern Consultants and Specialists Committee, expressed his fears that much of the extra money will be "wasted" on spin and quangoes.

Far from welcoming the incessant waiting list initiatives and the tougher and tougher waiting time targets, Dr Ryder, an anaesthetist at Queen Elizabeth Hospital in Gateshead, says quality is being sacrificed to quantity and the end result will be an increase in medical negligence claims. "My crystal ball tells me that two-thirds of the money will go on bureaucracy and, if we are lucky, a third will eventually reach the sharp end where it is desperately needed," he says.

As for Mr Milburn's announcement that he intends to set up yet another agency to monitor quality within the NHS and that more reform is needed to improve performance, Dr Ryder is blunt: "More reorganisation is absolutely the last thing we need. He should stop all these reforms and policing agencies and let us get on with the job."

Today, Mr Ahmed Ali, an orthopaedic surgeon at Mr Milburn's constituency Darlington Memorial Hospital, says he fears that the Government has not listened to pleas from rank and file doctors who question the headlong dash towards achieving shorter waiting lists at the expense of a more considered approach to health care.

Mr Ali, along with many other doctors, are concerned at the renewed obsession with "the numbers game", delivering results to appease a fickle electorate.

He is echoed by Peter Johnson, chief officer of South Tees Community Health Council, which helps patients let down by the NHS.

"Unless the extra money allows the NHS to have time, space and extra capacity to perform better and to be able to assess current methods against new methods, it could be throwing good money after bad," says Mr Johnson.

At a recent meeting attended by many of the region's orthopaedic consultants, it emerged that the average retirement age for Mr Ali's peers is now 57, a reflection of the frantic pace of today's NHS.

Taking the pressure off staff and allowing them to concentrate on providing high quality care is essential if the NHS is not to see the leaching away of specialists before they can be replaced by younger doctors.

"Improving the working conditions of NHS staff must now be the priority along with patient satisfaction," the consultant says.

Mr Milburn has asked the electorate to bear with him while he turns around the NHS supertanker, but he must make more effort to ensure the exhausted and potentially mutinous rank and file health service staff stay on board during the journey.