Health Service Journal, Feb. 26th 2009, p. 4-5
Intensity modulated radiotherapy, which has been in use in the USA and Europe for a decade is used to treat only 7% of eligible NHS patients. The treatment reduces side-effects by more precisely targeting radiation at cancer cells, but is expensive and requires specially trained physicists to deliver it. The NHS is struggling to invest in staff and technology.
National Audit Office
London: TSO, 2009 (House of Commons papers, session 2008/09: HC 63)
The NHS reported a surplus of £1.67 billion in 2007-08. The surplus has been carried forward into 2008-09 and the Department of Health (DH) has given a commitment that the NHS will be able to spend the surplus in future years. This report looks at the financial performance of, and financial management in, the NHS during 2007-08. It also explains some of the issues which are likely to provide financial challenges for the NHS in 2008-09 and beyond. The report concludes that in terms of delivery of healthcare the surplus reflects good resource utilisation rather than a failure to deliver. The NHS was able to make good progress against its national healthcare targets set out in the Operating Framework whilst delivering more cost savings than had been planned. The NHS also provided more healthcare activity in 2007-08 than in previous years, and the quality of that healthcare as rated by the Healthcare Commission improved.
Health Service Journal, Feb. 5th 2009, p. 12-13
Since the introduction of patient choice in April 2008, increasing numbers have opted to have treatment in private hospitals at NHS expense. However private providers are paid for NHS work at tariff, which means it is only attractive to them if they have spare capacity. There is also concern that the shift of NHS work to the private sector may financially destabilise some hospital trusts.
Public Finance, Jan. 23rd-29th 2009, p. 24-25
This paper considers the impact of the economic downturn on the NHS. It is argued that NHS spending is a major component of demand in the economy, affecting employment. Government healthcare spending supports higher levels of regional employment and investment than might otherwise be the case. The Department of Health and the Treasury are therefore unlikely to pursue drastic cuts.
Health Service Journal, Feb. 5th 2009, p. 17
National Cancer Director Prof. Richards has recommended that the National Institute of Health and Clinical Excellence should approve drugs for terminal patients costing up to £70,000 per quality-adjusted life year. This does not represent good value for money as these patients are in their last year of life, and may divert funding away from interventions that would reduce health inequalities, such as cutting early deaths from cardiovascular disease in deprived populations.
Health Service Journal, Feb. 12th 2009, p. 12-13
NHS organisations may need to remove failing chief executives quickly. One way of bypassing normal processes of dismissal and disciplinary hearings is to pay senior staff enough to ensure that they leave quietly. However using public money for this purpose has to be carefully justified and may need Treasury approval.