Published: 18/04/2002, Volume II2, No. 5801 Page 10

Bottomley faces funding battle... longest waits for British patients... reorganisation more stressful than strikes... free market reform causes acrimony New health secretary Virginia Bottomley faces a bitter battle to maintain this year's growth in resources for the NHS.Within days of her appointment, advisers and economists warned of a tough public spending round ahead and likelihood of more hospital closures and cuts in 1993-94.Ms Bottomley, who in her first interview after her promotion vowed to 'get politics out of healthcare', also faces fraught political decisions over community care funding and the future of London's teaching hospitals.

British patients have to put up with the longest waiting times in Europe for hospital appointments and surgery, a report claims.A survey of referral patterns in 15 European countries has found 15 per cent of British patients have to wait more than 16 weeks to see a specialists, and more than 41 per cent have to wait more than 16 weeks between seeing a specialist and having surgery.

Health staff undergoing reorganisation felt a reduction in their personal involvement which 'greatly increased' stress, according to a report given to the British Psychological Society.The BPS report dealt with a period beginning during the 1989-90 ambulance dispute and followed the service during and after reorganisation. It showed stress was worse after reorganisation than during the dispute because staff felt they had no control.

The first round of 'free market'healthcare contracting designed to make the NHS more businesslike and efficient had led, in many cases, to stalemate and acrimony between purchasers and providers, initial reports suggest.As regions complete their audits of 1992-93 negotiations, a 'widespread'picture is emerging of unsigned contracts on 1 April, with regions preparing to arbitration in local disputes.