Community care white paper launched. . . Zero service growth predicted. . . Ambulance dispute worsens. . . Land-sale crisis. . . Mall costs dear. . .

The long-awaited community care white paper, Caring for People , has been launched. While the NHS's role remains essentially unaltered, local authorities are to become responsible for assessing individual need, designing care arrangements and securing their delivery within available resources. The white paper has been broadly welcomed, but most commentators say they remain concerned about the lack of specific funding to back the proposals.

Finance directors and health economists have predicted minimal or zero growth in services next year, despite an extra£2.4bn for the NHS in chancellor John Major's Autumn Statement. They say the government's 5 per cent inflation assumption is 'just not realistic', and are telling health authorities to budget for another 1.5 per cent on top of the official figure.

Unions claim the police and army will be unable to cope as the nine-week-old ambulance dispute spread this week, with crews providing emergency cover only.

NHS chief executive Duncan Nichol said troops could be used until Christmas if necessary to answer 999 calls.

Cuts in income from land sales mean that regional health authorities are having to delay their capital programmes by as long as two years. South West Thames regional health authority expected£40m from land sales as recently as July, but has since revised that to£15m following the rise in interest rates and tightening of investment in land holding.

Delays in opening an airport-style shopping mall at Charing Cross Hospital are costing£6,000 a month in lost income generation. The foyer is designed to make up to£300,000 a year for the hospital.

It was planned to open last April, but builders' problems and contractors' mistakes have put back full opening until January.