THE REALITIES of government come home to Tony Blair as, in sharp contrast to Labour's election pledge to cut hospital waiting lists by 100,000, a row breaks out over them rising by that much to record levels since the party came to power.

But the patients on those lengthened waiting lists will not be interested in the parliamentary point-scoring as the pocket-sized pledge cards, which Labour issued to voters containing this promise, are waved at the Prime Minister by the opposition.

Rather, they will want swift action.

But will they get it? And can the government afford it?

Certainly, health ministers will be putting pressure on the trusts with the longest lists to shorten the queues. And, in return, managers will point to high levels of bed occupancy and patient through-put - in short, that they are doing the most they can with what they have got.

The issue returns, then, to that ever-present NHS problem - resources. The £300million extra ploughed into the service last autumn may have helped to prevent a dreaded winter crisis of bed shortages but it has not done anything for the less-urgent cases waiting their turn.

And with the government still pledged to adhere to the Tories' spending plans for their first two years in office, there is, on paper, little room for manoeuvre.

Meantime, the government tests the public's tolerance on waiting lists, promising the promise will be kept over the lifetime of this Parliament - a somewhat different notion, we think, of what the voters thought the list-cutting pledge meant.

It looks, then, like a case of wait and see - whether the Chancellor boosts NHS resources in his Budget next month, or Mr Blair plays that big trump card a little later, or whether the real jump in resources comes much later...towards the end of the Parliament and when there is an election to be fought.

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