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Welfare Reform on the Web (January 2002): National Health Service - Funding

BLAIR SIGNALS DEMAND FOR EXTRA HEALTH SPENDING

N. Timmins

Financial Times, Nov. 15th 2001, p.5

Tony Blair has publicly supported increased public spending on the NHS in a speech to primary care trust staff.

BLEAK OUTLOOK FOR NHS AS FUNDING RISE FAILS TO DELIVER

J. Laurance

Independent, Nov. 5th 2001, p.11

Since 1997 spending on the NHS has risen by 30% in real terms, but the number of routine patients treated in England has remained stubbornly fixed at between 1.2 and 1.4 million per quarter. The money appears to have been spent on pay and price rises, reducing financial deficits and funding initiatives in government priority areas such as cancer and heart disease.

DON'T EXPECT A QUICK CURE

D. Walker

Guardian, Nov. 7th 2001, p.17

Extra state funding is being pumped into the NHS, but is not purchasing improvements visible to patients. Increments are going to fund increased costs of existing staff, drugs, treatment and pensions. Time spent on clinical audit should improve the quality of care but means less time spent with patients.

EXTRA TIME

J. Appleby and S. Boyle

Health Service Journal, vol. 111, Nov. 1st 2001, p.22-25

The government is committed to raising spending on healthcare in the UK up to the European average by 2006. There is debate about the exact target figure, but agreement that the key consideration is how the extra money will be spent. If the UK is to achieve the EU average, it will probably have to increase private as well as public spending. Some of the money will have to go on recruiting more clinical staff to close the yawning gap between the UK and the rest of Europe. Otherwise there is little evidence on where the extra spending should be targeted to improve health outcomes.

GPS OFFERED £5000 TO MOVE INTO CRISIS AREAS

C. Hall

Daily Telegraph, Nov. 2nd 2001, p.5

Reports government plans to offer incentives to attract doctors into family medicine in the face of a growing manpower crisis. These include: 1) ensuring that trainee GPs' pay increases in line that of trainee hospital doctors; 2) additional funds to pay locums to cover maternity, paternity and adoption leave; 3) provision of subsidised childcare; and 4) cash gifts of up to £5000 to encourage doctors to go and work in areas where there is a shortage.

HOW SPENDING COMES DOWN TO TRUST

R. Gandy

Public Finance, Oct. 26th - Nov. 1st 2001, p. 28-29

Health authorities have only the most rudimentary service/programme costing in their statutory accounts, and limited costing (of variable accuracy) in their annual planning returns. Neither would offer a reliable basis for comparison. Author calls for a statutory duty to be placed on health authorities and primary care trusts to complete detailed annual service costings for their relevant population, so that productive comparisons of differences in supply, use and costs could begin.

A LARGER ROLE FOR THE PRIVATE SECTOR IN FINANCING UK HEALTH CARE: THE ARGUMENTS AND THE EVIDENCE

C. Propper and K. Green

Journal of Social Policy, vol. 30, 2001, p.685-704

Article reviews the arguments and the evidence for increasing the role of private finance in the UK health care system. Concludes that 1) an increased role for the private sector in financing health care will increase overall spending; 2) increased private sector finance may lead to the system becoming less progressive; 3) there is no support for the theory that increased private finance will lead to the NHS becoming a poor, residual service for disadvantaged groups; and 4) it is unlikely that a marginal increase in private sector finance will erode general support for the NHS or the willingness of individuals to pay taxes to fund public care.

MILBURN TO BUY PRIVATE OPS TO FREE NHS BEDS

J. Carvel

Guardian, Oct. 25th 2001, p.15

The Health Secretary has promised to spend £40m over the next 18 months on procuring up to 25,000 operations in the private sector to relieve pressure on NHS beds. Another £40m will be used to recruit 600 extra accident and emergency nurses. A&E procedures are to be reformed to "stream" patients according to the gravity of their condition. Separate staff will run each stream and patients will be treated in the order in which they arrive. It is also proposed to have diagnostic services available round the clock.

(See also Financial Times, Oct. 25th 2001, p.12; Times, Oct. 25th 2001, p.14)

"NO CURE, NO FEE" PLAN TO CUT COST OF NHS DRUGS

J. Laurance

Independent, Nov. 1st 2001, p.10

In August 2001 the National Institute for Clinical Excellence (NICE) made a preliminary ruling that beta interferon and glatiramer acetate should not be available on the NHS to multiple sclerosis sufferers. The problem with these drugs is that they help some patients but not others, and it is impossible to tell in advance who will benefit. Under the "risk sharing" proposal put forward by government, the NHS would fund treatment with beta interferon or glatiramer acetate for up to 10,000 MS patients who would be tracked over several years. The government would seek to recover from the manufacturers the cost of drugs prescribed to those who had not progressed.

(See also Financial Times, Nov. 1st 2001, p.7; Times, Oct. 31st 2001, p. 13; Daily Telegraph, Oct. 31st 2001, p. 12; Financial Times, Oct. 31st 2001, p.6)

OUTCRY AS HOSPITAL PAYS £1000 FOR NURSING SHIFT

J. Laurance

Independent, Nov. 9th 2001, p.15

The Princess Royal Hospital in Haywards Health paid Thornburg Nursing Services £1000 for a specialist nurse covering a 12-hour shift during the August Bank Holiday. The trust chief executive has called for urgent measures to prevent commercial agencies from exploiting staff shortages in the NHS.

PUBLIC - PRIVATE RELATIONS IN HEALTH CARE

J. Keen, D. Light and N. Mays

London: King's Fund, 2001

Argues that past government efforts to kill off private health care in the UK have only fuelled its strength. Urges the government to put aside the ideological debate about health care funding, and accept the reality of the private sector by making it subject to the same standards as the NHS.

SCANNING THE NHS FOR PROFIT

S. Ward

Public Finance, Oct. 19th - 25th 2001, p. 22-23

Reports government plans to allow top performing hospitals to set up companies to market any technological innovations they have developed, so generating an income stream.

WATCHDOG INCREASES NHS DRUG BILL BY £200M

D. Walker

Guardian, Nov. 8th 2001, p. 10

Reports that the National Institute for Clinical Excellence (NICE) accepts more treatments than it vetoes, imposing a net cost of £200m to £250m this year.

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