White paper funding... paring down the regions... Labour's plans for management... junior doctors' hours... public sector pay

An extra 1,000 accountants and an increase in funding will be needed to implement the internal market white paper proposals, NHS treasurers have warned. Without extra resources it will be impossible to increase throughput, says the Healthcare Financial Management Association. It supports the idea of competition, but doubts it will be significant outside metropolitan areas. Meanwhile, health secretary Kenneth Clarke announced an extra£40m, expected to be spent on developing resource management, medical audit and GP information systems.

Estates management and computer services have been targeted by regional health authorities as key areas to be disposed of to private companies or management buy-outs under plans to pare down regional headquarters. But some regions are lining up ambulance services, blood transfusion, central supplies and training to be transferred to districts or new independent units.

Managers will be encouraged to gain direct experience of the NHS from the viewpoint of users and frontline staff, under Labour's new plans. That might include staffing a receptionist's desk for a day or sampling health services at first hand. Staff would be entitled to a minimum wage.

Junior doctors work a 90 to 108-hour week, according to a survey in Lothian which shadowed three juniors for two weeks. It suggests several hours of filing could be done by clerical staff and the taking of blood samples by phlebotomists.

Hospital ancillary workers gained the smallest rise of all public sector employees in the 1980s, according to the Public Finance Foundation. Public sector pay fell by 1.5 per cent in the 1970s, relative to pay in the rest of the economy, and by another 0.5 per cent in the 1980s.