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Welfare Reform on the Web (October 2011): National Health Service - funding

'All' elite trusts face dumbing down threat

B. Clover

Health Service Journal, Sept. 22nd 2011, p. 4-5

Chief executives of Britain's elite teaching hospitals have warned that the failure of the payment by results tariff to take into account the complexity of the treatments they provide could damage their finances. This would undermine their ability to work with industry on new treatments.

Can general practice dig deeper for savings?

N. Plumridge and P.Stevenson

Health Service Journal, Sept. 8th 2011, p. 14-15

General practices in the NHS are run as private business owned by doctors and paid a fixed annual fee for each patient registered with them. The authors debate whether this business model would allow practices to contribute efficiency savings of 4% per year to cost reduction targets in the NHS.

FTs step closer to diluting national pay deal

C. Dowler

Health Service Journal, Sept. 15th 2011, p. 4-5

Foundation trusts were found to be showing an unprecedented willingness to publicly consider moving away from nationally negotiated staff pay arrangements. An analysis of the most recent three year plans of England's 138 foundation trusts found that organisations in at least three of the ten strategic health authority regions had admitted to considering moving away from Agenda for Change.

Lansley's alarm over hospitals' debt challenged by NHS data

D. Campbell and P. Curtis

The Guardian, Sept. 23rd 2011, p. 8

Andrew Lansley's claim that 22 hospital trusts are at risk of collapse over their private finance initiative (PFI) debts has been laid open to question by NHS performance data rating most of them as financially sound. The health secretary said 22 trusts in England were 'on the brink of financial collapse' because they had been 'landed with PFI deals they simply cannot afford' by the Labour government. But the Department of Health's own latest quarterly assessment of the NHS's performance rated 17 of them as 'performing' financially between January and March 2011. Only four were deemed 'underperforming', while the performance of one, South London Healthcare, is 'under review'.

(See also The Independent, Sept. 23rd 2011, p. 1+2)

Legal bills could 'wipe out' CCGs

S. Lewis and D. West

Health Service Journal, Sept. 15th 2011, p. 10

Analysis has revealed that a typical clinical commissioning group could be allocated as little as 1.6m to cover the ring-fenced running costs of commissioning after fixed costs have been taken into account. There are concerns that this allocation is insufficient to cover contingencies such as legal challenges made by providers, or resulting from service reconfigurations, treatment decisions and contract awards.

Medics resist plan to attach pay to PROMS

S. Lewis

Health Service Journal, Sept. 1st 2011, p.4-5

The Department of Health has revealed that it is working on plans to link a 'small proportion' of payments for hip and knee surgery to patient reported outcome measures. The measures are based on a series of questionnaires, which include condition-specific questions as well as others covering general health. They are answered by patients before and after surgery. However, there is concern that the move could discriminate against patients with general health problems and incentivise 'cherry-picking' of healthier patients.

Midwives warn cuts put women in danger

O. Wright

The Independent, Sept. 29th 2011, p. 18

The Royal College of Midwives (RCM) has warned that, notwithstanding Britain's rising birth rates, senior midwives expect to reduce staff in 2012. This is because of the anticipated cuts to NHS funding. According to the RCM, the staff reductions will put women in danger because of the decreased ability to provide essential services they will cause.

Ministers row back on FT finance reform

C. Dowler

Health Service Journal, Sept. 8th 2011, p. 4-5

The government has pulled back from plans to stimulate a market for private sector lending to foundation trusts, under which they would have been cut off from all finance except commercial loans. Proposed changes to the Health Bill before Parliament would retain the secretary of state for health's power to provide injections of investment or 'public dividend capital' to foundation trusts in financial distress. They would also give the regulator Monitor the power to allow foundation trusts to raise their prices above the nationally set tariff for NHS services, if they could demonstrate that it would be impossible for them to deliver efficient services at the usual tariff rates.

NHS leaders say salary bill is unsustainable

D. Campbell

The Guardian, Sept. 21st 2011, p. 11

Leaders of 1.5 million NHS staff are poised for confrontation with health service employers and ministers over proposed pay and pensions changes that unions claim would seriously damage their incomes. The NHS already faces the prospect of more than 500,000 staff taking industrial action on 30 November 2011 as part of the national day of action against government plans to overhaul public sector pensions. But the organisation NHS Employers has increased the prospect of another money wrangle by declaring that the NHS salary bill is unsustainable and that local pay deals are needed to bring down costs. It claims that, despite the pay freeze for all NHS staff earning over 21,000, the cost to its members - such as hospital and mental health trusts - of employing staff is rising by 2.4% a year.

NHS must close units to avoid going bust - trusts

D. Campbell

The Guardian, Sept. 27th 2011, p. 1

The NHS's cash crisis is so great that it will have to either cut services to patients or close accident and emergency and maternity units if it is to avoid going bust, ministers have been warned. Resolving the service's deepening financial worries will involve decisions that will be politically unpalatable as any efforts to save money will arouse controversy, according to a senior NHS leader. Mike Farrar, chief executive of the NHS Confederation, writes in the Guardian that longer waiting times and worsening balance sheets at foundation trust hospitals show that the NHS is facing an 'unprecedented financial challenge' that has not yet been widely recognised.

NHS needs extra 5bn to save 40 hospitals, says ex-Blair adviser

R. Ramesh

The Guardian, Sept. 15th 2011, p. 5

The government will have to spend an extra 5bn on the NHS to prevent 40 hospitals closing by 2013, says Tony Blair's former health adviser Paul Corrigan. The professor warns that there are at least 30 failing NHS trusts unlikely to become foundation trusts, and another 10 foundation trusts that will face a cash crisis during the course of this Parliament. Writing in a paper for the think tank Reform, Corrigan says: 'As many as 40 hospitals may have to change radically or close . the old model and concept of the hospital are failing. Currently, hospital failure is averted by granting a variety of forms of interim financial support, yet if the government is to continue to protect all of England's hospitals from closure or reconfiguration [this would] mean the chancellor would have to find an extra 5bn to bail out the NHS by 2013.'

Overseas patients owe health service 60m

J. Ensor and M. Beckford

Daily Telegraph, Sept. 26th 2011, p. 17

According to figures released under the Freedom of Information Act, overseas patients owed the NHS nearly 60m in unpaid medical bills for non-urgent treatment in 2011. Embassies and foreign governments had run up debts of nearly 6m at two London hospitals. While much of the debt was still being chased, more than half had been abandoned or written off.

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