Why is Alan Milburn concentrating on heart disease?

Heart disease is the biggest killer in the UK. Some 260,000 people die every year from it.

While tens of thousands of people do receive treatment in time, a number - approximately 500 in England - have to wait more than a year for treatment.

Mr Milburn has had personal experience of the effect this can have. A friend of his died while waiting for a heart bypass.

What does this say about government policy? Is it a major change of direction?

The government has always put a high priority on heart disease and treating it.

This is not so much a major change in policy as in emphasis.

A new report outlining a strategy for dealing with heart disease has been considered by the Treasury and Number 10. It is expected to be published shortly.

Does this imply a downgrading of the pledge to cut waiting lists by 100,000?

It would take an extraordinary combination of circumstances for the Prime Minister Tony Blair to agree to scrap the Waiting List pledge.

He is committed to cutting 100,000 off the hospital waiting lists in England - Scotland and Wales have their own targets - before the next election.

Mr Milburn is not going to abandon that pledge and achieving it will still be the highest political priority he has to deal with.

Has the government accepted that cutting waiting lists is not the best way to tackle the ills of the health service?

Publically, ministers do not accept the criticisms leveled at the waiting list pledge.

Alan Milburn is determined to stamp his mark on the health department

Their argument is that by cutting the total number of people waiting for surgery, they are also shortening waiting times.

They use the analogy of the queue - the fewer there are in front of you the less time you have to wait.

However, that is not how many in the NHS see it. The British Medical Association says by focusing on overall numbers, doctors are being forced to treat less sick people before the very ill.

Hence the problem of people waiting for bypasses.

Is the 100,000 pledge still achievable?

Yes the pledge is still achievable. At present they're about thirty thousand short.

But that figure may actually rise as the winter kicks in. If we have a cold snap hospitals will need to devote more of their beds to emergency cases - delaying routine operations.

Trusts are also bracing themselves for the effect of the Millenium celebrations - and cancelling all non-emergency work in late December.