Differences between the direction of the NHS in Wales and England are expected to be unveiled today with the publication of the white paper on the future of the Welsh NHS.

Welsh Office health department director Peter Gregory has told Welsh health organisations that 'the thrust' of the paper will be the same as that of The New NHS: modern, dependable.

But Journal sources expect the protection extended to community trusts in the English white paper to be missing from the Welsh one.

A major programme of trust mergers is already underway in Wales, and all five health authorities have short-listed proposals which include mergers between acute and community trusts.

Future mergers could make it difficult for GP groups to combine with community trusts to form primary care trusts, which are a key feature of the English white paper.

Today's paper will also need to take account of the Welsh Assembly, which is due to take on most of the powers of the Welsh Office and some HA responsibilities.