Welfare Reform on the Web (December 2001): National Health Service - Funding

NHS STAFF ENTICED TO MEET TARGETS

J. Carvel

Guardian, Oct. 11^th 2001, p. 15

Reports the launch of pilot incentive schemes offering team bonuses to frontline NHS staff who meet performance targets.

THE PRIVATE FINANCE INITIATIVE: A PUBLIC FINANCE ILLUSION

D. Dawson

Health Economics, vol. 10, 2001, p. 479-486

An important political decision has been taken that an increase in major NHS investment will take place, but only if financed by PFI. Problems with PFI schemes arise from:

• bundling of services;
• the cost of new investment;
• the risks for the NHS of very long term contracts;
• lack of transparency.

TAX INCREASES LIKELY AS NHS COSTS RISE

C. Denny

Guardian, Oct 10^th 2001, p. 27

The terms of reference for a Treasury review of NHS funding reveal that the government is committed to maintain access based on clinical need, not ability to pay. The Review team are expected to conclude that spending on the NHS will have to rise faster than economic growth to keep pace with an ageing population and advancing medical techniques.

(See also Independent, Oct. 10^th 2001, p. 12; Financial Times, Oct 9^th 2001, p.1)

WRONG SIGN, NICE MESS: IS NATIONAL GUIDANCE DISTORTING ALLOCATION OF RESOURCES

R. Cookson, D. McDaid and A. Maynard

British Medical Journal, vol. 323, Sept. 24^th 2001, p. 743-745

NICE considers cost effectiveness but has been reluctant to advise against funding many costly new pharmaceuticals in the NHS in England and Wales. NICE must devise politically acceptable ways of refusing to spend taxpayers' money on costly new drugs and devices that lack demonstrable incremental cost effectiveness. Otherwise, new and often inefficient technologies will continue to fuel the widening gap between public expectations and public willingness to pay for the NHS. NICE should prioritise new national guidance within a fixed growth budget for the net cost of new technologies and in relation to incremental cost effectiveness. If reducing postcode rationing would compromise more important goals of equity or efficiency, NICE should sometimes refuse to issue definite national guidance.