Scores of GP practices have formally registered an interest in fundholding, due to begin next year. Regional health authorities say they have typically received 20 to 40 expressions of interest. One regional co-ordinator commented: It ay be they just don't want to miss the boat and it might all fizzle out - but I don't think so. The British Medical Association said GPs were expressing interest because it was the only way they could find out more information.

GP leader Dr Michael Wilson has written to family practitioner committee general managers saying GPs will co-operate with them to implement the GP contract. The move follows fears that GPs would resist co-operation because health secretary Kenneth Clarke had imposed the settlement against the professions wishes.

The national bill for backlog maintenance and repairs to NHS buildings now totals more than£1.8m. District estates managers blame the practice of raiding maintenance funds to keep patient services running on under-funded budgets as a major obstacle to beating the backlog.

RHAs financial assumptions for 1990-91 look set to be overwhelmed as increases in NHS pay and prices edge towards 8 per cent or more. Regions are planning on districts reserving an extra 1.5 per cent above the 5 per cent allowed for in the chancellors Autumn Statement. One regional treasurer commented: All he signs show that we are going to have problems .

Ambulance union leaders are to appeal to a mass meeting of crews in north-west London not to go on all-out strike. London NUPE officer Stuart Barber warned that members would risk alienating the public and managers.

Meanwhile health secretary Kenneth Clarke admitted on television that the dispute had been neglected, and called for a two-tier service.