Managers will have access to medical audit results, health secretary Kenneth Clarke pledged when he announced £31m to develop the system in hospitals and general practice. I have yet to hear a convincing argument why someone managing a hospital should not have access to the general results of clinical audit, he said.

Mr Clarke has sent a new year s message to regional general managers explaining why the government is standing firm in the four-month-old ambulance dispute. He says that an improved pay offer would mean closing wards. Trade union NUPE claimed the letter was an attempt to provoke staff into an all-out strike, which could lose them support.

Uncertainty still reigns over how to finance medical negligence awards, which became health authorities responsibility on 1 January . Negotiations on whether the government will set up a central pool to pay the biggest compensation claims are continuing. Meanwhile, HAs have complained of having to set budgets for 1990-91 without knowing who will pay for medical errors.

The first allocations since the abolition of the R A WP formula have left every region with more revenue than last summer s resource assumptions had led them to expect. The Department of Health said: W e re not going to say there will be no service reductions, but it should be possible to plan so you don t have to come up with unplanned changes in the future.

Managers are being offered a guarantee of confidentiality to join an alliance opposing the NHS Bill. Eight pressure groups have set up a federation, led by Guy s consultant Harry Keen, who said W e would warmly welcome people from management who were in a desperate position and needed a way out of implementing the reforms without losing face.