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Welfare Reform on the Web (November 2008): National Health Service - funding

The Auditors' Local Evaluation 2007/2008

Audit Commission


The report gives each of the 302 hospital trusts and primary care trusts a score out of four based on criteria including management, financial standing and value for money. A score of one means that the trust has not met minimum standards. The Commission found that 20 NHS trusts do not meet minimum standards in the management of their funds and that 12 of them have had severe problems for the last three years. Of the 20 failing trusts, 16 ran up deficits in 2007/08, six had failed to make progress in clearing historic debts, and three had poor financial management arrangements. Only 14 trusts scored four out of four.

Hold up: Treasury eyes NHS surplus

S. Gainsbury

Health Service Journal, Oct. 23rd 2008, p. 4-5

The NHS can expect a range of measures to claw back cash from its 1.7bn 2007/08 surplus. These may include:

  1. new 'must-dos' in the operating framework, possibly around bringing forward capital spending but without any extra resource to pay for it
  2. minimal increase in the hospital tariff, but higher targets for efficiency savings
  3. more top-slicing of primary care trust allocations to create contingency funds for the years after 2009/10
  4. surpluses to be taken into account when allocating PCT resources.

Impact of the reduction of the prescription charge in Wales on the prescribing of non-sedating antihistamines in primary care

T. Dhippayom and R. Walker

Health Policy, vol. 87, 2008, p. 309-315

The National Assembly for Wales decided in 2003 to phase out prescription charges, which were finally abolished in 2007. This study shows that during the period when the prescription charge was being reduced, there was an increase in the prescribing of non-sedating antihistamines, particularly in the least deprived communities. This would suggest a change in patient behaviour, in that some individuals were making the decision to obtain a free prescription for medication that they would previously have purchased over the counter at a pharmacy.

MPs condemn 'eye-watering' pay rise for GPs

J. Carvel

The Guardian, Oct.9th 2008, p. 11

According to the Commons Public Accounts Committee, GPs in England have gained 'eye-watering' pay increases of 58% under the revised NHS contract that reduced their working hours.

(See also The Telegraph, Oct. 9th 2008, p. 14 and The Independent, Oct. 9th 2008, p. 11)

Spectre of cuts looms as City shockwaves threaten budget

S. Gainsbury

Health Service Journal, Oct. 16th 2008, p. 4-5

Economists are warning that the government's plan to devote 38bn of public money to rescue Britain's banks will create a 'structural hole' in state finances that will make NHS funding cuts and claw-backs inevitable.

Top-up question sparks warning over health costs

P. Dicken

Public Finance, Sept. 19th-25th 2008, p. 12-13

There are calls from patients to allow them to pay for expensive cutting edge treatments without forfeiting their rights to free NHS care. On the other hand, critics point out that this would create a two-tier NHS, with those able to pay getting better treatment. This would undermine the health service's founding principle, that care should be given free at the point of use on the basis of need.

(For further expert views see British Journal of Healthcare Management, vol. 14, 2008, p. 428-431)

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