Click here to skip to content

Welfare Reform on the Web (November 2009): National Health Service - funding

Cut NHS costs to pay off debt, Britain warned

L. Elliott

The Guardian, Oct 2nd 2009, p. 1

The IMF has called on the Government to reform spending on the NHS and pensions, in order to reduce the size of the UK's budget deficit, despite improved predictions for growth in the economy in 2010.

DH eyes patient cap for new tariff rules

S. Gainsbury

Health Service Journal, Oct. 22nd 2009, p. 4-5

Reports that the Department of Health is considering capping the number of patients each hospital trust will be paid in full for treating in 2010/11. Patients over the threshold will be paid for at 'marginal cost' - for example at half the standard tariff price. The Department is also looking to make any increase in the tariff contingent on meeting quality and innovation targets, instead of simply increasing the baseline as it has done in previous years.

Drug that fights arthritis pain blocked on NHS

R. Smith

Daily Telegraph, Oct. 7th 2009, p. 16

Rheumatoid arthritis sufferers given the new drug abatacept were twice as likely to experience an improvement in their condition. However at 10,000 per patient per year, the National Institute for Health and Clinical Excellence has said that the improvements were not significant enough to justify its use by the NHS. It is estimated that abatacept could help about 3,500 patients by treating the severe symptoms that other drugs have failed to alleviate.

Job cut warning for staff: just 1pc on pay risks the axe for 10,000 jobs

S. Gainsbury

Health Service Journal, Sept. 24th 2009, p. 4-5

Senior NHS managers have called for a pay freeze from 2011/12 together with a fundamental review of staff terms and conditions in the face of expected financial constraints. Foundation trust senior managers have started to consider using their freedoms to opt out of the Agenda for Change standardised pay and conditions for nurses and other non-medical staff. (See also Health Service Journal, Oct. 29th 2009, p. 4-5)

PCTs neglect value in general practice

S. Gainsbury

Health Service Journal, Oct. 1st 2009, p. 5

An internal NHS survey shows a 50% difference in what primary care trusts (PCTs) are paying GP practices. This ranges from 107.00 to 157.00 per head, weighted by the health needs of registered patients. This variation exists because some PCTs are paying extra for services which others have negotiated as part of their core contract with their GPs. If all PCTs had paid their GP practices at the lowest average rate of 107.00 per patient, analysis shows that the NHS would have saved around 1.2bn of its 7bn primary care bill in 2007/08.

Satisfaction guaranteed: the future of payment by results?

R. Evans

Health Service Journal, Sept. 24th 2009, p.12-13

The Health Secretary has promised to link a much bigger proportion of hospital trusts' income to patient and staff satisfaction levels under payment by results. Because patient satisfaction is generally quite high, trusts will need large samples to demonstrate statistically significant improvements. There is also a risk of misleading results due to poor question design, bias in patient reports and inconsistent measurement.

Should prospective payments be differentiated for public and private healthcare providers?

A. Mason and others

Health Economics, Policy and Law, vol. 4, 2009, p. 383-403

In 2003, the Labour government signed the first contracts with private hospitals to provide care for NHS patients. The intention was, and remains, that both public and private providers of care should be reimbursed on the same basis under prospective payment arrangements, with private providers forming an extended choice network. The English form of prospective payments is called Payment by Results (PbR). However, it is not a pure form of prospective payment for public hospitals, which receive additional payments to account for variations in the costs of land, buildings and staff through the Market Forces Factor. The entry of private providers into the market raises the question of whether and how PbR arrangements should take into account any similar exogenous cost factors they might face. This article aims to identify and assess exogenous cost differentials between public and private providers that could make prospective payment unfair, and to determine the best policy instrument to correct for such differences.

Search Welfare Reform on the Web