The distribution of a £60m 'award' for GPs has been agreed by health ministers and the British Medical Association.

The award, recommended by the doctors' and dentists' review body last year, will be divided between older GPs, those providing 'good quality service' and practices in deprived areas.

The BMA's GP committee resisted linking the recurring funding to quality measures. But£18m will be spent on a quality allowance.

GPC negotiator Dr Laurence Buckman said 86 per cent of GPs would gain: 'You have got to be young, in an affluent area, giving a low quality service and not interested in local development schemes to not qualify,' he said.

The NHS Confederation has expressed 'dismay' at a decision by the BMA's junior doctors' committee to survey members' views on industrial action.

Human resources policy director Andrew Foster said a 'vast amount' had been achieved in reducing working hours for junior doctors and that they had 'consistently received higher than inflation pay increases'.

But JDC chair Dr Andrew Hobart said his members were 'fed up with working extremely long hours for often derisory rates of pay, often as little as£4.02 an hour'.

Mr Foster said this was 'the rate paid to first-year house officers, on call at the lowest intensity of work'.

'For every hour's work that they are paid£4.02, there is at least one hour when they are not working and still being paid£4.02,' he said.

Just 6 per cent of English trusts have concluded negotiations with staff sides over the introduction of discretionary points for nurses, midwives and professions allied to medicine, according to a survey by the NHS Confederation.

Trusts were strongly criticised by this year's nurses' pay review body for the delay in introducing the discretionary points, awarded by last year's review.

The survey shows that trusts are allocating an average of£35,000 to pay discretionary points in 1999-2000, with 40 per cent expected to start the payments in April.

Of the 115 trusts which responded, 41 per cent said they would backdate payments to September 1998.

Mr Foster said: 'The process has been very unpopular, with managers complaining of a process that is costly but with little benefit.'