The internal market reforms are being discredited by the breakneck speed of their implementation, says King's Fund College director Gordon Best. He told HSJ that in 20 years he had 'never before seen such intense top-down political pressure. Honest dissent is now categorised as opposition'. He added: 'I know from personal discussion with many managers that what they say in public about the progress of the reforms is not what they think in private'.

All future money for reducing waiting lists would be tied to specific targets, announced Mike Malone-Lee, operations director for the NHS Management Executive. 'Every opinion poll tells us that the long wait so many people have for treatment is the greatest criticism of the NHS,'he said. He denied that more money was necessary to cut lists, arguing that validating lists was the most effective way of reducing them.

Family health services authorities face under-spending between 6 and 20 per cent of their budgets for GP staff and premises, according to Essex FHSA general manager Graham Butland. This could destroy the authorities' credibility when they complain about lack of resources, he warned.

General and senior managers are to receive pay rises of between 7.9 and 8.5 per cent, backdated to 1 September. The 20 per cent ceilings for senior managers' performance-related pay have been abolished.

Most GPs do not intend to make major changes to their referral patterns when the internal market is implemented next April, according to a statement from NHS deputy chief executive Peter Griffiths. He said that 90 per cent of health authorities had now got the message about working more closely with GPs, having 'carried out questionnaires or met them face to face'.