The NHS Confederation is planning a big hike in membership rates at the end of a year in which its chief executive admits it faced 'potential financial ruin'.

Stephen Thornton said last year's NHS 50th anniversary conference, run jointly with the Institute of Health Services Management, had jeopardised the confederation's future.

But he said that he was 'fully satisfied' that it now had 'a system of sound financial management' and a 'clearer focus about what

we do'.

Mr Thornton said last year's conference 'just about broke even.' This year's event in Harrogate is expected to make a£250,000 profit on a budget of£1.5m.

The confederation's new business plan warns that trust mergers in England will have 'profound implications' for subscription income.

Membership rates are to rise by 8.5 per cent - and almost 50 per cent in Wales - but Mr Thornton defended this by saying the cash would pay for 'a whole new range of services' and developing the confederation's work outside England.

'I realised very soon when I came to this job that we had an organisation that was far too London-oriented,' he said.

'In supporting devolution we really need to get our act together.'

The business plan, drawn up after a poll of confederation members, sets out high-priority areas, including lobbying ministers and working with the media.

Areas identified as low-priority include organising events and conferences.

The organisation is to end its links with the monthly magazine Healthcare Today and will produce fortnightly briefings on key issues, backed by a relaunched website.

'Healthcare Today - good though it is - has always been a pale imitation of your publication,' Mr Thornton admitted to HSJ.

Former confederation deputy chief executive Jean Trainor, who resigned shortly after Mr Thornton's arrival and is now a trust chair, was less convinced that a more limited publishing role would improve communication.

'The things that I find most valuable are the regular communications like briefings, papers and journals. I will be sorry to see them go,' she said.

Ms Trainor also warned the confederation to 'be very careful about raising subscriptions above levels of inflation at a time when the health service is facing severe financial constraints'.

But former special projects manager Chris Vellenoweth, who also left the confederation last year, said he accepted that 'very limited resources' meant work had to be prioritised.

'My personal view is that there is a need to inform policy by working very closely with the operational and service needs of trusts and health authorities,' he said.

The business plan also suggests setting up a development group for primary care and local health groups as 'a key early priority'.

But Mr Thornton said the confederation would not compete with 'more narrowly focused' organisations such as the NHS Primary Care Group Alliance and the National Association of Primary Care.

The NHS Confederation's future priorities and business plan 1999/2000.

www.nhsconfed.net