Royal colleges' challenge to reforms. . . Clarke's 'disregard' slammed. . . Consultant opposition. . .Fears over chaplains. . . New pay structure. . .

A committee of all the royal colleges is secretly drawing up a Lords amendment to the NHS Bill which would pose the toughest legislative challenge to the reforms so far. It is understood the amendment would satisfy the medical profession's fears by proposing a researched evaluation of the reforms before their widespread introduction. Health secretary Kenneth Clarke has invited the colleges for talks.

Mr Clarke had shown 'disregard for constitutional constraints reminiscent of the Stuart monarchs', the High Court has heard. In a case taken up by consultants led by Professor Harry Keen of Guy's Hospital, Mr Clarke was accused of 'jumping the gun' in allocating millions of pounds to prepare for the NHS Bill ahead of royal assent.

Consultants in 50 out of 68 hospitals which took part in a British Medical Association survey of units applying to become trusts said they were opposed to or unsure about the move. Managers would face 'grave difficulties', the BMA warned.

Church representatives have met Department of Health officials to seek assurances over the future of hospital chaplains.

Some fear hospitals could opt out of providing their services to save funds in the internal market. They want to ensure health authorities stipulate the need for chaplains when drawing up contracts. One commented that he spent more than half his time talking to staff - many of them anxious about the effects of the reforms.

A new pay structure for managers has been announced by the Department of Health.

Regional general managers will now be able to earn between£45,000 and£65,000, district general managers between£35,000 and£58,500 and unit general managers will take home between£24,000 and£44,500.