conference focus: In the wake of another bad year, members of the Institute of Health Services Management gathered in Birmingham for their annual conference to assess what the future may hold as the reforms begin to bite

NHS Executive human resources director Hugh Taylor admitted that he recognised the frustration of many in the NHS at the Department of Health's approach to millennium pay.

'I am very conscious of the feeling across the service that a national deal would have been a better way to go,' he told a breakfast meeting on the final day of the conference.

He said there had been split views when the service was consulted, and conceded that more had advocated a national deal than the approach that had been followed.

'Ministers quite properly took the final decision,' he said. It was consistent with the view taken on other 24-hour services such as the police and fire services, and was a 'strong view' on the part of the health secretary and other ministers.

In the same session, NHS finance director Colin Reeves said long-awaited guidance on the private finance initiative was now 'very imminent'.

He admitted having first said the document was 'imminent' as long ago as March 1998, but told David Johnson, chief executive of Leeds Teaching Hospitals trust, that there were three key reasons for the delay.

The main hold-up had been caused by negotiations between the Treasury and the Accounting Standards Board about accounting treatment and whether PFI deals would be on or off the balance sheet. There was now 'clear blue water' on the issue, and Mr Reeves was 'optimistic' the Treasury would be able to conclude negotiations 'very imminently'.

That would mean the NHS Executive being able to announce the third wave of PFI schemes.

He hoped that up to half a dozen schemes would be announced in the 'not- too-distant future', depending on the outcome of the negotiations between the ASB and the Treasury.

The other things that had held the guidance back were the need to establish the right relationship between employer and employee, and difficulties over the definition of what services should be excluded from PFI.

Mr Johnson had asked for light to be shed on what was happening to major capital developments because many reconfiguration plans were about safety and quality, and he wanted to be able to go back and tell people what was happening.

But NHS chief executive Sir Alan Langlands said it should not have been necessary for him to come to an 8am breakfast meeting at the IHSM conference to get the information. 'We must get smarter in our communications,' he admitted.

Sir Alan also said he found the format of the meeting, in which the Executive board answered questions, 'much more valuable' than a podium speech. And he praised the IHSM for inviting the press.