news: Wards may reopen. . .Maximum two-year wait promised. . .Leak angers Winterton. . .Greenshields is finance director. . .Consultants'millions

Health authorities may have to re-open wards at a cost of millions of pounds, if the Department of Health bows to Treasury pressure to outlaw 'toppingup'payments when elderly patients are transferred from hospitals to private nursing homes.One London district estimated it would have to re-open four 20bed wards at a cost of£1.8m a year.The NHS closed 60,000 continuing care beds between 1979 and 1990.

The Citizen's Charter, launched this week, demands that no patient should wait more than two years for treatment and calls for local maximum waiting times for key treatments.It outlines a new system of redress for complaints, and says competitive tendering will be simplified to encourage more private bids - as well as being extended to cover management services, nonemergency transport and distribution.

Health select committee chair Nicholas Winterton is considering disciplinary action after a copy of his confidential draft report on NHS finances was leaked to the DoH.Mr Winterton's fellow Conservative committee members subsequently voted to delete a 17-page section criticising government policy on trusts which he had written.He suspects DoH officials drew up a flood of last-minute amendments, including more than 30 from one member.

Gordon Greenshields is to replace Sheila Masters as NHS finance director.He is currently a consultant with Coopers and Lybrand Deloitte, which advised the DoH that only 12 to 14 of the 65 first-wave bids for trust status should be approved.

Management consultants earned£17m from NHS contracts in 1990, an increase of more than 40 per cent on the year before.Their trade association said the recession had brought a downturn in business but the volume of NHS work was 'rising rapidly'.