Decisions on a further four applications to start in April are expected shortly and another two have been deferred until October

Decisions on a further four applications to start in April are expected shortly and another two have been deferred until October. "Local GPs and nurses see 90 per cent of all patients seen by the NHS. By shifting power to primary care we have got a very powerful driver to re-shape the NHS," he said. "The public will see more of the services they currently get in hospital delivered closer to home and their care much better organised." Mr Denham added: "GPs and nurses know where the current system breaks down because patients have to wait too long for treatment or because different agencies do not work together. For the first time primary care trusts will give GPs, nurses and other health professionals the opportunity to use every legal power to overcome these problems."However, it was unclear yesterday how soon, if ever, the trusts will cover the whole country. The 13 trusts in the first wave have been selected from 481 primary care groups in England, which have been working towards trust status for the past year.

Many will run their own community hospitals.John Denham, a Health minister, said the 13 pioneers had met tough standards, demonstrating their clear vision, local support, and robust management. An era of "high touch, low tech" care is ushered in today with the announcement of the first 13 primary care trusts, which will take control of 80 per cent of the NHS's budgets for their areas. An era of "high touch, low tech" care is ushered in today with the announcement of the first 13 primary care trusts, which will take control of 80 per cent of the NHS's budgets for their areas. The 13 pioneers, to be established in April, have been appointed to head a transformation of the NHS into a service led by GPs and nurses that which will aim to care for more people in or near their homes.Ministers believe that by putting GPs and nurses in the driving seat of the NHS they will deliver a service that is more humane, caring and convenient than the consultant-led, high-tech hospitals that dominated the medical landscape of the last century.The change represents a seismic shift of power within the NHS, switching control from consultants to family doctors, but has attracted less attention than the introduction of walk-in centres or the NHS direct telephone advice service.Primary care trusts - clusters of about 50 GPs covering a population of around 100,000 - will take control of the lion's share of the NHS's funding, commissioning services for cancer, heart and other patients from local hospitals, but also moving some clinics and services into their surgeries. At the the Royal Sussex County Hospital in Brighton, the accident and emergency consultant, John Ryan, said: "We are busy seeing a lot of people, especially the elderly and those with respiratory problems."They often need intensive care and that has meant transporting people to hospitals the other side of London."The Government's emergency beds service said yesterday demand had been easing slowly. At the outbreak's peak, every intensive care bed in England was taken.Northwick Park Hospital, in north-west London, was forced earlier this week to examine patients in a mobile St John Ambulance clinic in the car park because its accident and emergency department was inundated. Officials insisted demand was less intense than during last year's epidemic, when temporary mortuaries were set up in hospital car parks, or in 1989, when there were 29,000 flu-related deaths..

In Wales the number more than doubled to 128 per 100,000 - higher than expected.Large numbers of elderly and vulnerable people are now in hospital with flu. Doctors have had to ship patients hundreds of miles to intensive care units. The latest figures were within "expected" levels, and officials now hope the outbreak is close to its peak.In Scotland, where an epidemic is defined differently, 539 people per 100,000 were struck. "In recent years we have got a lot better at matching the strains of flu around with the strains in the vaccine, so it is effective."A spokeswoman for the charity Age Concern said: "The Department of Health has done everything it can to encourage people to get the vaccine and we don't think they could have done any more."Despite the beds crisis, health officials in England saidthe outbreak did not qualify as an epidemic, which requires 400 per 100,000 people to have contracted flu. The flu outbreak around the country has been made worse by elderly and vulnerable people failing to take up a potentially life-saving vaccine. The flu outbreak around the country has been made worse by elderly and vulnerable people failing to take up a potentially life-saving vaccine. Hundreds of thousands of doses of the vaccine are still in stock while major hospitals have been struggling to find intensive care beds for those worst affected by the bug.At one stage yesterday, there were no intensive care beds available in London as the number of serious cases of flu in England rose to 144 people per 100,000.Some hospitals were forced to use mobile clinics and emergency and operation resuscitation beds.Specialists at the Public Health Laboratory Service said yesterday that only about 40 per cent of high-risk people - those aged 65 and over - and 15 per cent of vulnerable people - those under 65 with existing breathing or lung disorders - had taken the vaccine.As a result, the Department of Health said "hundreds of thousands" of doses were still on GPs' shelves, despite a major national advertising campaign last autumn to persuade high-risk groups to seekthe vaccine."The uptake is very low and is not what it should be in the high-risk groups," said a spokesman for the Public Health Laboratory Service. Both players are due to make their professional debuts on the WTA Tour this year.In the Hopman Cup mixed team tournament in Perth, Amanda Coetzer and Wayne Ferreira secured South Africa's place in the final despite losing 2-1 to the United States yesterday.

Thailand are strong favourites to face them in the final after their defeat of the second seeds, Slovakia.. The teenager showed her potential by breaking Pierce four times in the 90-minute match. Razzano is the world's No 2 junior girl, behind the 15-year-old Russian Lyna Krasnoroutskaya. But the latter is only 16 and her performance of undoubted talent was only spoiled by a string of double-faults.

Henman found his best form in the final set and claimed two breaks en route to taking it 6-2.Henman will now meet the French eighth seed, Nicolas Escude, who beat the Czech Republic player, Slava Dosedel, 7-6, 6-4 earlier in the day.In the women's Millennium Cup exhibition tournament in Hong Kong yesterday, the top seeded Mary Pierce beat another Frenchwoman, Virgine Razzano, 7-5, 7-6. The British No 1 struggled through 3-6, 6-4, 6-2 against the world No 138, but was far from convincing in the early evening match.Lisnard was quick to take advantage of Henman's poor start and claimed the first set before his opponent was able to establish a rhythm in his game.Henman, the world No 12, opted to play in the Adelaide tournament rather than his usual season-opener in Doha in order to gain the best preparation for this month's Australian Open, and he fought back by taking a tight second set 6-4 to upset the Frenchman's hopes of claiming the biggest win of his career. "Tim Henman earned a place in the third round of the Australian men's hardcourt championships with a hard-fought victory over the French 20-year-old Jean-René Lisnard in Adelaide yesterday. "The first set was disappointing but you've got to remember I was playing a guy ranked about 50 places above me, so any victory is a good result."I've got Golmard next and he's a quality player.