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Welfare Reform on the Web (April 2000): National Health Service - Funding

BLAIR HINTS AT RISE IN FUNDING TO 'REBUILD' THE NHS

S. Schaefer

Independent, Jan. 13th 2000, p.8

Reports admission by Tony Blair that there is a shortage of doctors, nurses and intensive care beds in the NHS, which has been exposed by the flu epidemic. Promises substantial extra funding in the run-up to the next general election.

BLAIR RETREAT OVER NHS CASH PLEDGE

G. Jones

Daily Telegraph, Jun. 19th 2000, p.1

The Treasury has stressed that Blair's promise to increase health spending by nearly 5% per year above inflation was an aspiration and not a specific pledge. There is concern that the government will be unable to find the extra £11bn a year promised without cutting other public services, starving other programmes such as education of investment or raising taxes.

(See also Independent, Jan. 19th 2000, p.1; Financial Times, Jan. 19th 2000, p.2).

BLAIR SAYS HE STICKS BY HEALTH PLEDGE

P. Webster

Times, Jan. 20th 2000, p.2

Tony Blair has confirmed his commitment to increasing health service spending by 5% per year up to 2004. As the Treasury will not increase overall public spending, it is likely that the money will have to be found by squeezing transport, education and Home Office budgets.

(See also Independent, Jan. 20th 2000, p.8; Daily Telegraph, Jan. 20th 2000, p.1)

CAN THE NHS SURVIVE?

Daily Telegraph, Jan. 19th 2000, p.4

If the government seriously plans to raise British health investment to the levels of other Western countries without raising taxes, it will have to explore the scope for greater private funding through some form of compulsory insurance or through charging for services. Article goes on to briefly summarise how other countries fund their health services.

CAN THE NHS SURVIVE?

Daily Telegraph, Jan. 20th 2000, p.10-11& 28

Presents various radical proposals for improving the NHS including charging for services, introduction of private insurance schemes, expansion of the role of nurses, and creation of a new breed of medical assistants to undertake routine procedures such as endoscopy and cataract removal.

THE COST AND AVAILABILITY OF GENERIC DRUGS TO THE NHS

Health Committee

London: TSO, 1999 (House of Commons papers. Session 1999/2000; 105).

Reports results of an investigation of a sudden sharp rise in the price of generic drugs supplied to the NHS. Industry representatives suggested that the problem was caused by the closure of a major manufacturer combined with the transition towards patient packs. Committee finds evidence that the industry has been manipulating the market and profiteering and calls on the Office of Fair Trading to investigate.

EPIDEMIC OR NOT, THE NHS IS SUFFERING

S. Ward

Public Finance, Jan. 14th-20th 2000, p.12

Warns that the annual 3% efficiency saving reduced bed capacity to the point where the service cannot cope with a widespread outbreak of flu. Problems are compounded by shortages of doctors and nurses, and by the impact of the Private Finance Initiative.

THE FAMOUS FIVE

P. Batler

Health Service Journal, vol. 110, Jan. 27th 2000, p.11-12

Presents, in sequence, various government statements on possible increases in NHS funding.

(See also Health Service Journal, vol. 110, Jun. 27th 2000, p.5).

FIT TO SPEND

J. Lenaghan

Guardian, Dec. 20th 1999, p.15

Although there is constant pressure on the government to increase NHS funding, there is no statistical evidence that higher spending on health care at the national level would lead to improved health.

'GAGGED' PEER RENEWS ATTACK ON NHS CASH

Times, Jan. 25th 2000, p.11

Reports that Lord Winston re-entered the debate over health spending by urging Tony Blair to make commitments to increasing NHS funding rather than voicing aspirations.

GPs CASH IN ON NHS 'GIFT' MONEY

M. Shutkerer

Daily Telegraph, Jan. 26th 2000, p.19

In an unforeseen consequence of fundholding, many practices have used large sums of public money to build new premises. Once the premises are build, the NHS pays the GP an annual rent for the use of the building. Not only can the GP sell the building at any time, but the rent is reassessed regularly to keep it in line with the prevailing rate for commercial buildings locally.

HEALTH TAX MAY HELP FUND NHS

C. Newman, R. Bennett and E. Crooks

Financial Times, Jan. 18th 2000, p.1

Reports that Tony Blair is coming under pressure from Cabinet colleagues to solve the funding crisis in the NHS by introducing a special ear-marked health tax.

HITTING THE ROOF

L. Whitfield

Health Service Journal, vol. 110, Jan. 6th 2000, p.10

Reports evidence to the Commons Public Accounts Committee about how an expected saving of £17m turned out to be £5m in the controversial PFI project at Dartford and Gravesham Hospital.

IS THE NHS COMING OFF THE SICK LIST?

M.A. Sieghart

Times, Jan. 14th 2000, p.22

Argues that public concern about the short-comings of the NHS has risen to such a pitch that the government will be forced to pump in more state funding, probably at the expense of education.

MILBURN PLEA FOR MORE NHS CASH

D. Brindle

Guardian, Dec. 21st 1999, p.9

Reports speech by the Health Secretary in which he argued that a rigorous approach to cost-effectiveness, coupled with real increases in government spending, could see off proposals for introduction of charges and encouragement of private health insurance. He also hinted that he might be willing to accept the extra funding in a hypothecated form, linked explicitly to a tax levy.

NHS (ENGLAND) SUMMARISED ACCOUNTS 1997-98

Committee of Public Accounts

London: TSO, 1999 (House of Commons papers, Session 1999-2000; 128)

Following their examination of the NHS (England) summarised accounts 1997-98, the Committee has identified:

  • need for better financial management;
  • need to avoid money draining away through fraud and clinical negligence;
  • need to secure greater efficiency.

NHS ILLS WILL TAKE YEARS TO CURE SAYS BLAIR

T. Baldwin

Times, Jan. 17th 2000, p.1 & 2

Announces government plans to increase spending on the NHS by 5% per year until 2005 and promises of an immediate cash injection to improve nurses' pay and provide more intensive care beds. Some 60,000 grade E nurses are to receive an annual pay rise of more than £1000 this year, and other medical personnel are to receive above-inflation increases of more than 3%. The promised new money, spread over five years, will take Britain up to the current European average of spending 8% of national income on health.

(See also Independent, Jan. 17th 2000, p.1; Daily Telegraph, Jan. 17th 2000, p.1 & 2; Guardian, Jan. 17th 2000, p.1; Financial Times, Jan. 17th 2000, p.1 & 2; Guardian, Jan. 19th 2000, p.18).

NHS STAFF TO GET PAY INCREASES OF UP TO 8.4%

N. Timmins and J. Kelly

Financial Times, Jan. 18th 2000, p.2

More than 600,000 nurses and doctors will receive inflation - plus pay rises of 3.4% and 3.3% respectively. Experienced staff, nurses at the tope of their pay scale will get a 7.8% rise to help retain staff. Rising generic drug prices combined with a financial deficit of more than £200m, mean that, with the pay award, little will be left over for service improvements.

(See also Independent, Jan. 18th 2000, p.4; Times, Jan. 18th 2000, p.1 & 4; Daily Telegraph, Jan. 18th 2000, p.4).

THE NOTIONAL HEALTH SERVICE

P. Foot

Guardian, Jan. 25th 2000, p.17

Argues for continued funding of the NHS from general taxation, rather than from private health insurance.

NS INTERVIEW: ROBERT WINSTON

M. Riddell

New Statesman, Jan. 17th 2000, p.14-15

Attacks the governments NHS reforms, which have eroded specialist care, failed to eradicate the Conservative internal market and offered a cash provision that is "not as good as Poland's". Improving NHS funding will require either raising taxation or introducing a health insurance system.

PAY RISES WILL PUT SQUEEZE ON NHS

D. Brindle

Guardian, Jan. 18th 2000, p.1 & 7

Government has made it clear that hospitals must bear the full cost of the inflation-plus pay rises announced for medical stuff, including the 7.8% rise for experienced stuff nurses. There will be no extra funding for the rises over and above the increase of 6.8% in cash terms already allocated to local authorities. Little money will be left for investing in improved services.

(See also Independent, Jan. 18th 2000, p.1).

PAYING FOR THE PM'S HEALTH CASH PLEDGE

L. Elliott and M. White

Guardian, Jan. 20th 2000, p.10

Argues that the government will be able to spend an extra £12bn on health and find more money for other priorities provided that the economy continues to do well and assuming above inflation taxes on cigarettes and petrol.

(See also Financial Times, Jan. 24th 2000, p.2).

PFI: BUILDING BEST VALUE INTO THE NHS

British Journal of Health Care Management, vol. 6, no. 1, 2000, Supplement. 13p

Covers key issues concerning:

  • contracting from IT services under the PFI;
  • how to tell if a PFI deal really offers value for money;
  • the development of standard terms for PFI contracts;
  • the exclusion of 'soft' non-clinical services from the scope of the PFI.

THE PITFALLS IN BUDGETING FOR THE HEALTH SERVICE

S. Hogg

The Independent, Jan. 24th 2000, p.15

Identifies pressure on NHS budgets as arising from:

  • an ageing; population;
  • rising public expectations;
  • recruitment difficulties leading to upward pressure on pay;
  • unlimited demand arising from the fact that the service is free at the point of use.

Solutions lie in prioritisation (rationing) and charging for services, at least in the short term.

THE PRICE OF A DECENT NHS

J. Willman

Financial Times, Jan. 18th 2000, p.19

Argues that health spending in the UK could be raised to the European average by charging patients for use of services.

RURAL HEALTH FORMULA REVISITED

C. White and R. Flowerdew

Public Finance, Dec. 10th-16th 1999, p.26-28

The current system for allocating NHS funds in England is seriously flawed. Rural areas are hit hard as there are few adjustments to reflect the additional costs of providing health services in sparsely populated areas. Pay adjustments in the English NHS are based on commercial salary levels locally. The fact that staff are paid on the same salary scales across the NHS is ignored, as is the fact that employees are usually on higher base salaries in rural areas.

SEVENTEENTH REPORT ON NURSING STAFF, MIDWIVES, AND HEALTH VISITORS 2000

Review Body for Nursing Staff, Health Visitors and Professions Allied to Medicine.

London: TSO, 2000 (Cm 4563)

Recommends a 3.4% increase for nurses over the 1999-2000 national salary scales. Grade E staff on the top of the current pay scale should received an immediate pay increase of 7.8% on April 1st 2000 due to problems with career progression. The demands of grade C merit a degree of overlap with Grade D, and a grade C nurse on the top of the pay scale should receive an immediate rise of 7% on April 1st 2000.

SEVENTEENTH REPORT ON PROFESSIONS ALLIED TO MEDICINE 2000

Review Body for Nursing Staff, Midwives, Health Visitors and Professions Allied to Medicine.

London: TSO, 2000 (Cm 4564)

Recommends PAM staff in 2000/01 a 3.4% increase in pay over the 1999/2000 national salary scales.

TAX BREAKS FOR PRIVATE HEALTH URGED

G. Jones

Daily Telegraph, Jan. 18th 2000, p.1 & 2

Conservatives are urging a review of the tax treatment of private health insurance premiums as part of a cross-party initiative aimed at boosting spending on health. The Conservatives remain committed to a publicly funded NHS free at the point of delivery, but urge more co-operation with the private sector. Patients should have a guaranteed waiting time determined by the clinical priorities of doctors. If the NHS cannot meet the guarantee, independent health resources should be used.

(See also Guardian, Jan-19th 2000, p.11; Independent, Jun. 19th 2000, p.8).

TWO GREAT INSTITUTIONS NEED SUPPORT. WE MUST PAY FOR IT

P. Toynbee

Guardian, Dec. 22nd 1999, p.16

There is increasing clamour from greedy commercial institutions for the privatisation and breaking up of the BBC and the NHS. The NHS requires an injection of public funding to ensure its survival. If the NHS does not offer state of the art treatment in pleasant surroundings with no queuing, the young, fit, and affluent who pay for it in their taxes will withdraw support and turn to private health schemes. The long threatened poor service for poor people would then eventuate.

TWO THIRDS THINK THAT BLAIR HAS LET NHS FALL INTO ILL HEALTH

A. King

Daily Telegraph, Jan. 24th 2000, p.2

An opinion poll shows that 36% of respondents thinks that the NHS is failing and 28% rate it as very poor. It is universally agreed that large scale increases in funding are required, and 67% would accept a substantial tax increase if the proceeds went directly to the NHS.

THE WAGES OF SPIN

A. Kaletsky

Times, Jan. 20th 2000, p.24

Points out that the 3.6% rise in the NHS salary bill is resulting from this year's pay awards is well below the 4.6 wage inflation in the economy as a whole, and is very close to level assumed in the Treasury's internal forecasts when it was drawing up its funding arrangements for the health service. It will not put extra pressure on NHS budgets. Secondly argues that the promised 5% increase in health spending over six years will not in reality raise funding to EU levels. In order to deliver an effective health service, the government needs to distinguish optional and discretionary services, which people should pay for, from those which for humanitarian reasons should be properly funded by the state.

WE MUST PROP UP THE NHS WITH SOME PRIVATE SPENDING

D. Aaronovitch

Independent. Review, Jan. 12th 2000, p.3

Argues for the injection of private funding into the ailing NHS through either charging or insurance to supplement inadequate state support.

WE NEED TO FIND AN EXTRA £100 A HEAD NHS. I'VE HEARD THAT PEOPLE PAY THAT FOR A HAIRCUT'

J. Laurance

Independent, Jan. 12th 2000, p.6

Medical organisations have questioned the capacity of the NHS to cope with the growing health needs of an ageing population, aggravated by seasonal fluctuating in demand. The widening gap between the UK and Europe in health spending is reflected in few hospital beds, fewer doctors and longer waiting lists in this country. The question for policy makers is whether taxpayers would be prepared to pay for a health service with extra beds and staff able to cope comfortably with winter pressures but which would be run at well below full capacity at other times of the year.

WHY LABOUR HAS DASHED ALL MY HOPES

R. Highfield

Daily Telegraph, Jan. 17th 2000, p.6

Reports that a funding change made in April 1999 has had the effect of removing resources from specialist centres and encouraging local hospitals to attempt unusual operations beyond their competence.

(See also Daily Telegraph, Jan. 18th 2000, p.20).

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