A major shift of resources from secondary to primary care has been signalled by NHS chief executive Duncan Nichol. He called for greater integration of health authorities and family health services authorities, and said that in the long term money would move from hospitals to GP practices. But he denied he had plans to merge HAs and FHSAs.

Ministers are ignoring evidence that consultants' private work is causing waiting lists to grow, said John Yates, who has now quit his role as the Department of Health's waiting list expert. He said that he alerted ministers to the link four years ago: his research suggested that the more pay beds a hospital had, the longer its waiting lists, but the DoH had failed to commission a study. 'The latest reason they have given is that they do not want to upset the medical profession this year. '

Junior health minister Stephen Dorrell told the Oxford University medical society that the falling number of NHS acute beds was 'a reliable indicator of the improving quality of healthcare'.

Better treatment had led to quicker recovery times, he argued.

A survey of outpatients by the Consumers' Association found one in five left a medical consultation without knowing what was wrong with them or what their treatment should be.

Meanwhile, the National Audit Office has highlighted large variations in waiting times for first routine outpatient appointments, ranging from five weeks to 22.

A crackdown on HAs transferring long-stay patients to private and voluntary homes while maintaining management control appears to be in the pipeline. Social security secretary Tony Newton has told local authorities that he is concerned about how they and HAs were making use of the benefits system.