Private hospitals have complained to the Department of Health that health authority managers are failing to consider them for contracts to provide services to NHS patients under the internal market reforms.The Independent Healthcare Association says its members are facing unfair discrimination, and claims that HA managers are interpreting the DoH's emphasis on a 'steady state' in the reforms' first year as an excuse for no change at all.

Trust managers should beware of awarding themselves large pay increases, health secretary William Waldegrave has warned.'My view of the future does not include pay spirals for those at the very top, 'he said, as the 56 newly created trusts began competing for top managers. Mr Waldegrave said trusts should be 'mould-breakers', and pay was an area where they could break rigid national rules - but greater rewards had to come with improved performance.

Regional health authorities have offered fundholding status to 312 GP practices to date. Yorkshire is leading the way with 35, while East Anglian is bottom with 11.RHA managers deny there will be a last-minute collapse, as has happened in Scotland and Wales, but admit to widespread problems persisting. 'The big area of uncertainty is how fundholders will use their funds to get better services for their patients, 'said one.

London Ambulance Service is embroiled in a legal row with the supplier of its controversial computer-aided dispatch system, which should have gone live this month. LAS chief executive John Wilby denied rumours that costs had risen to£13m, claiming they were£7.5m.Staff have argued the project has been mismanaged. 'We are operating a computer-designed control room without the heart, and that creates problems, 'Mr Wilby said.