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Welfare Reform on the Web (January 2010): National Health Service - funding

Clinical trials

N. Plumridge

Public Finance, Nov. 20th-26th 2009, p. 20-23

The system of paying NHS hospitals per clinical procedure according to a fixed national tariff was introduced in 2004 to encourage productivity at a time of unacceptably long waiting lists. This approach may not be appropriate during the current recession and in the face of funding cuts. This article explores alternative funding methods.

Hospitals 'could cut numbers of doctors'

R. Smith

Daily Telegraph, Dec. 15th 2009, p. 6

Currently the Department of Health pays for the time a doctor spends training to be a GP or a consultant while the hospital trust pays for the time they spend treating patients. However some training posts are paid for entirely from central funds while the costs of others are split evenly between the Department of Health and the hospital. Proposals to make the system fairer will see some hospitals losing substantial sums, prompting warnings that they may be forced to employ fewer junior doctors and replace them with nurses.

Monitor cap on private income ruled unlawful

S. Gainsbury

Health Service Journal, Dec. 17th 2009, p. 11

The private patient income cap limits the income which foundation trusts can earn from such patients. The High Court has ruled that Monitor was breaking the law by allowing foundations to discount private patient income channelled through certain structures such as charities. Monitor must now amend its rules so as to capture more income when it calculates compliance with the cap.

Pre-budget report

R. Creamer (editor)

Health Service Journal, Dec. 17th 2009, p. 25-31

This special report considers the implications of the 2009 Pre-budget Report for the NHS. The pre-budget report states that frontline NHS spending will rise in line with inflation in 2011-12 and 2012-13, the equivalent to a real terms freeze. The Department of Health has set primary care trusts and strategic health authorities the target of reducing their management costs by 30% over the next four years, inevitably leading to redundancies. The tariff for acute hospitals will be frozen next year, implying a real terms cut in funding. Moreover, hospitals will only be paid 30% of the tariff price for emergency procedures over their 2008/09 volumes. NHS staff will face real terms pay cuts from 2011/12 due to the 1% cap on pay rises across the public sector imposed by government. One way of coping with funding cuts may be the Total Place programme, which involves pooling the budgets, powers and expertise of some of all of the public sector in designated areas to tackle agreed problems. (See also, Health Service Journal, Dec. 17th 2009, p. 4-5)

Scandal of lawyers' NHS payout bills

J. Laurance

The Independent, Dec. 18th 2009, p. 13

Figures obtained by the Tories, in response to parliamentary questions, show that the cost of fighting clinical negligence claims against the NHS is soaring with most of the payouts going to lawyers. There have been 52,000 clinical negligence claims over the past five years which have cost the NHS more than 8bn. More than one in 10 - 5,500 - has resulted in a legal bill bigger than the victim's payout. On average, lawyers received 36,000 per case last year whereas victims received 15,000.

Windmill 2009: NHS response to the financial storm

S. Harvey, A. Liddell and L. McMahon

Kings Fund, 2009

Report claims that the NHS is facing a 'perfect storm' of budget cuts, rising costs and an increasing workload due to population ageing. Health service managers and politicians need to be honest about the scale of the challenge.

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