Some trusts have revealed they plan to impose individual contracts on consultants.The Department of Health said all trust staff could increasingly expect to have performance targets written into their terms of service.Joint consultants'committee chair Paddy Ross defended national conditions of service, agreed in 1948, as they ensured equal distribution of consultants across the country.

Trusts are to form their own organisation in a bid to ensure their concerns are heard by government.Forty of the 57 first-wave trusts have pledged their support and are to break away from the National Association of Health Authorities and Trusts.One of the prime movers, St James'University Hospital trust chair John Greetham, said: 'NAHAT does not represent trusts. . . What is clear is that we need a single independent voice.'

A group of 17 managers has challenged the trend towards bigger health authorities.In a direct counterattack on the move to merge HAs, they argue that it will produce massive bureaucracies which are remote from patients.One blueprint mooted by the NHS Management Executive entails merging HAs into 50 or 60 organisations.

Health service clothes and medical equipment worth£50,000 are being sold off because they have been covered with pigeon droppings.Blackburn, Hyndburn and Ribble Valley HA is having to write off hundreds of nurses'uniforms, boiler suits, chefs'hats and aprons, as well as surgical appliances.They were all kept in a storeroom at a Blackburn hospital which had been home to generations of pigeons.

Birmingham could become the first city in Britain to embrace patient hotels, pioneered in Sweden.It is thought this could halve the cost of treating certain types of patient, especially mothers and babies and those receiving radiotherapy.