Closer working between clinicians and managers. . . purchaser provider split. . . Dorrell's promotion. . . community care reforms Guidance on consultants' contracts agreed between the Department of Health and the British Medical Association have been heralded as a breakthrough in closer working between clinicians and managers.

Consultants will get detailed job plans which apportion specific tasks. The BMA said it would stop consultants being 'Aunt Sallies subject to false accusations'.

Plans for a public relations adviser to be assigned to health secretary Kenneth Clarke have been abandoned. A Conservative Party spokesperson said the proposal was just 'an idea suggested a few months ago'.

Former Institute of Health Services Management president Barbara Young has said that a pure purchaser-provider split is unrealistic, at least within two years of the internal market reforms. She predicted that 98 per cent of hospital and community services would be run as directly managed units during that time.

Government assistant whip Stephen Dorrell has been named as the junior health minister to replace Roger Freeman, who has been appointed transport minister after 16 months at the Department of Health.

Bed blocking, inappropriate use of day hospitals and shortages of adapted housing for disabled people are likely to continue under the community care reforms, according to York University. It says that because funds will be divided among several budgets and money for local authorities will not be ring-fenced, services will still be difficult to plan.

Wide variations in health authorities' readiness for the internal market are expected to be revealed in the contracts regional HAs are about to agree with the NHS Management Executive. A source suggested regional general managers' performance in implementing the reforms was being carefully monitored.