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

Exceptional funding: recommendations for improving access to cancer medicines and delivering better value for money for the NHS

Rarer Cancer Fund, 2010

This report finds that there is uncertainty about the exact level of costs associated with making available every cancer treatment which clinicians wish to prescribe, with estimates ranging from £175 million to £330 million per year. The lower figure is believed to be the most realistic estimate. The report makes 25 recommendations, including:

• The Treasury should deliver on the Government's promise to provide £200 million per year to the Cancer Drugs Fund, which has since been downgraded to an aspiration. The report estimates that, unless the government provides the full £200 million for the Cancer Drugs Fund, 3,600 patients will be denied treatment.
• The Cancer Drugs Fund should be used as a pilot for value based pricing, ensuring that the price paid by the NHS for cancer treatments better reflects the value they deliver to the NHS.
• The Cancer Drugs Fund should be administered on a national basis, reducing bureaucracy and minimising postcode prescribing.
• Manufacturers should be required to negotiate a commercially confidential cost cap, limiting the total amount they can earn from the NHS for a particular treatment. The cost cap should be calculated using the potential size of the eligible patient population; the listed unit price of the treatment; clinical effectiveness; and the extent to which the treatment addresses an unmet need.

Financial fears as axe falls on audit

D. West

Health Service Journal, Aug. 19th 2010, p. 4-5

The coalition government plans to abolish the Audit Commission at the same time as primary care trusts and strategic health authorities. There are concerns that this could lead to the Department of Health losing control of NHS financial management and to greater risk of fraud. In particular, how the new GP consortia will be accountable for the funds entrusted to them for commissioning services is unclear.

GPs' £2bn threat to commissioning budget

S. Gainsbury

Health Service Journal, Aug. 26th 2010, p.4-5

Analysis of the 2009/10 budgets and expenditure of 190 practice based commissioning consortia showed that they had overspent their indicative commissioning budgets by 2.5% or £289m. If the same scale of overspend was applied to the full NHS commissioning budget of £80bn, it would generate a deficit of £2bn every year.

Heart patients' lives at risk in switch to cheaper drugs

R. Smith

Daily Telegraph, Aug. 31st 2010, p.1 + 2

The government has for many years encouraged clinicians to cut costs by switching patients from branded to generic drugs. New research shows that heart patients switched from a branded statin to a cheaper generic one received a less powerful equivalent, increasing their risk of suffering a heart attack or stroke by about 3%.

Hundreds of dentists now earn £300,000

Daily Telegraph, Aug. 19th 2010, p. 10

Tax statistics have revealed that 410 dentists in England and Wales earned more then £300,000 in 2008/09, up 8% on the previous year. Almost 700 dentists earned more than £250,000 from NHS and private work. These figures will reignite the debate over highly paid health professionals when civil servants and private sector workers are losing their jobs.

Millions spent on doctor 'gagging orders' by NHS, investigation finds

N. Morris

The Independent, Aug. 2nd 2010, p. 4 A joint investigation by the Bureau of Investigative Journalism and Channel 4 News has found that at least 170 doctors in England and Wales have agreed to severance deals containing 'gagging orders' on quitting the NHS; a measure designed to deter them from speaking out against incompetence and mistakes in patience care. The settlements are believed to be backed up by pay-offs totalling more than £3m.

(See also The Independent, August 2nd 2010, p. 5)

NHS legal claims to cost £15bn

R. Smith

Daily Telegraph, Aug. 4th 2010, p.2

There are concerns about the rapidly rising costs of settling medical negligence claims against the NHS. Lawyers are taking higher fees for their work, and in some cases court costs can exceed the damages paid to the patient. The NHS Litigation Authority fears it will need £3bn more than it estimated two years ago to settle claims over the next 10-15 years.

NHS refuses offer of cancer drug

R. Smith

Daily Telegraph, Aug. 24th 2010, p. 6

Roche, manufacturers of Avastin, a drug for treating advanced bowel cancer, offered a deal to the NHS under which the cost would be fixed at £20,800 for a year, after which the treatment would be provided free. When this offer was refused, Roche proposed making a payment to the NHS for each new patient started on the drug. In spite of these inducements, the National Institute for Health and Clinical Excellence (NICE) has not recommended the use of Avastin in its draft guidance, on the grounds that it only prolongs life for about six weeks and so is not cost effective. Roche claims that Avastin often shrinks tumours enough for them to be removed by surgery.

(See also Guardian, Aug. 24th 2010, p. 4; Daily Telegraph, Aug. 26th 2010, p. 16)

NHS sheds 11,000 jobs, with many more at risk

S. Lister, D. Rose and N. Natarajan

The Times, Aug. 6th 2010, p. 1-2

The scale of cuts across the NHS has been announced and 11,000 job losses have been confirmed across the UK. Unison, the biggest public sector union, has threatened to take the government to a judicial review over the reform. Unison has accused ministers of 'conning' the public before the election with claims that they would protect frontline services.

NHS spends millions on websites that fail patients

R. Ramesh

The Guardian, Aug. 6th 2010, p. 1

The NHS spends up to £86m a year on thousands of websites that are difficult to find, badly designed, and irrelevant to patient needs, according to a leaked government report.