Paying the price of speaking one's mind. . . Controlling the internal market. . . Cervical cytology tests . . . A new round of HA mergers

A manager has been sacked after accusing senior colleagues of wasting time and money discussing plans to become a trust. Wakefield HA finance director Ray Corner refused to attend a meeting at a Boroughbridge hotel. 'I cannot help but reflect that one does not need to be particularly scrupulous to realise that it would be wrong for senior public servants to stay unnecessarily at public expense at a hotel many miles from their base, ' he wrote to district general manager Brian Birchall.

Regional health authorities are to carefully control the first year of the internal market to prevent 'unintentional harm' from unexpected changes to patient flow. Moves to set up contracts which alter existing referral patterns will have to be agreed with RHAs. The decision reflects recognition that HAs are at very different stages of readiness to implement the reforms, but regional general managers say that at a minimum every HA must have contracts in place based on capitation funding. NHS deputy chief executive Peter Griffiths denied suggestions that the reforms were being scaled down or implementation slowed.

GPs have performed up to a third more cervical cytology tests in time for the imposition of the new GP contract this week. They are eligible for payment from 1 April for work done since January. Those with an average list will be paid£2,280 for screening 80 per cent but only£760 if they screen 50 per cent.

Proposals are being drawn up for a new round of HA mergers as community health councils in London have attacked previous mergers as 'piecemeal planning'. Warning of the dangers of merging HAs, they say that merger discussions in the past have excluded CHCs and senior managers.