Health Service Journal, Nov. 3rd 2011, p. 23
Twenty-two trusts which contacted the health secretary in September 2011 with serious concerns about their financial position blamed the costs of private finance projects. This article outlines two ways of cutting PFI costs, either to reduce the scope of services or to relax performance standards or maintenance regimes.
Daily Telegraph, Nov. 24th 2011, p. 1 + 2
An OECD report found that, despite record spending on healthcare, cancer survival rates in the UK were worse than in Slovenia and the Czech Republic in 2011. The health secretary, Andrew Lansley, laid the blame for the NHS' poor performance on the previous Labour government's failure to make sure that investment reached the front line. He claimed that too much of the extra funding injected into the NHS under Labour was spent on inflated salaries for managers, failed computer systems and unsustainable PFI schemes.
Committee of Public Accounts
London: TSO, 2011 (House of Commons papers, session 2010/12; HC 1469)
In the past three years, NHS trusts in England have spent around £50 million annually on buying three specific types of high value capital equipment - Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scanners - used mainly for diagnosis - and Linear Accelerator (Linac) machines for cancer treatment. The current value of these three types of machines in the NHS is around £1 billion. Patient demand for services from these machines has increased significantly in the last decade and continues to grow. Since 2007, the Department of Health has devolved responsibility for procuring and managing these machines to individual trusts but this structure is not conducive to delivering value for money. The Committee is concerned that the NHS is failing to optimise its purchasing power, crucial at this time when £20 billion of savings in the NHS are required by 2015. The NHS needs to make high quality, comparable data available on machine use and cost. The procurement and management of high value equipment is fragmented and uncoordinated, leading to wasted resources and variable standards of services. Trusts have three main ways to purchase high value equipment: by dealing directly with suppliers, through framework agreements, managed by NHS Supply Chain, or by joining up with other trusts in collaborative purchasing arrangements. The Committee believes there is a lost opportunity to use collective buying power to get lower prices and the Committee expects NHS Supply Chain and other collaborative procurement bodies to work with trusts to share plans about future needs and get better prices and value for money.
Daily Telegraph, Nov. 14th 2011, p. 1 + 4
A report from the NHS Co-operation and Competition Panel found that delaying treatments to save money had become endemic as the health service struggled to make savings of £20bn per year. The health secretary responded by banning the practice and said that from March 2012 any primary care trust chair whose organisation was still using the technique would be sacked.
(See also The Independent, Nov. 14th 2011, p. 6; The Guardian, Nov. 14th 2011, p. 2)
Health Service Journal, Nov. 10th 2011, p. 16-17
An investigation by the National Audit Office in 2011 concluded that NHS procurement systems were fragmented, complex and wasteful, with trusts being charged different prices for the same goods. However, the government's response was light on immediate remedial action and promised long term savings through the use of improved information and web-based tools. It is concluded that the status quo is likely to remain undisturbed.
Daily Telegraph, Nov. 22nd 2011, p. 18
In November 2011, the All-Party Pharmacy Group of MPs announced an inquiry into the practice of exporting drugs intended for British patients to take advantage of favourable exchange rates in a legal but ethically questionable trade. The practice was found to be causing shortages of medicines in 2010, but evidence suggested that the situation had not improved in 2011.
Health Service Journal, Nov. 24th 2011, p. 4-5
In April 2011, the government introduced measures aimed at reducing the number of patients readmitted after discharge by barring payment for many emergency readmissions. However at least 54% of commissioners reported an increase in readmission rates in the first three months after the rules took effect. Many commissioners also appeared not to have followed government instructions to reinvest all the fines in measures to reduce readmissions.
Health Service Journal, Nov. 24th 2011, p. 10-11
An investigation in 2011 by consultants McKinsey found that six hospital trusts needed government financial support to meet their PFI obligations and achieve foundation trust status. The findings meant that other trusts needing help would probably have to obtain any outside financial assistance required from primary care trust or strategic health authority clusters.
The Independent, Nov. 15th 2011, p. 9
The head of the NHS confederation, Mike Farrar, said that Andrew Lansley's ban on rationing treatments would make it difficult for PCTs to balance their books. He said that the trusts would find it very difficult to make £20bn of efficiency savings unless they were free to make decisions about which procedures to offer.