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

ALTERNATIVE MEDICINE FOR NHS

P. Minford

Daily Telegraph, Dec. 3rd 2001, p.31

Written from an economic view point, the author looks at the government's taxation and economic policy and discusses Minford's law: 'the better you make a public service, the more the demand for it'. Article goes on to weigh up the political and economic aspect of putting more money into the NHS,

BANKING CHIEF TO EVALUATE FINANCING IN THE NHS

F. Kapner

Financial Times, Nov. 27th 2001, p.5

Discusses Gordon Brown's choice of Derek Wanless to report on how to finance the health service during the next 20 years. He has been asked to examine trends in health care, and identify the key factors which will determine the financial and other resources available for a publicly funded health service. Article goes on to discuss his track record of identifying long-term problems.

BLAIR AND BROWN CLASH ON SEPARATE TAX TO FUND NHS

A. Grice

Independent, Nov. 30th 2001, p.2

Reports on the different view points of Tony Blair and Gordon Brown on whether there should be a special health tax in order to get people to contribute more to fund the National Health Service. The article goes on to discuss the need for people to see a direct link between what they are paying more in taxation for and what it's going into. It goes on to discuss Mr Wanless' report and the Chancellor's interpretation of it, and the differences of opinion. Mr Wanless has said he will continue to study other countries' systems before completing his final report in April 2002 and that he will not bury anything.

(See also: Financial Times, 30th Nov. 2001, p.1; Times 30th Nov. 2001, p.4; Guardian, 30th Nov. 2001, p.1 and 3; Daily Telegraph, 30th Nov. 2001, p.1 and Daily Telegraph 3rd Dec. 2001, p. 1 and p.34).

CAN HEALTHY DEBATE RESURRECT THE TORIES?

A. Kaletsky

Times, Nov. 29th 2001, p.22

Argues that centralised financing of the NHS is incompatible with efficient management; that provision of health care free at the point of use is incompatible with patient choice; and that voters may not be willing to tolerate the tax rises required to support a massive injection of funds to improve the NHS.

CHANCELLOR HAS THE POLITICAL AMMUNITION TO DEFEND TAX INCREASES

D. MacIntyre

Independent, Nov. 28th 2001, p.13

The Wanless report argues in favour of a publicly funded health service but admits that the NHS is under-resourced. This gives the government the ammunition it needs to justify tax rises in the last two years of the current Parliament.

COUGHING UP FOR HEALTH

P. Mandelson

Guardian, Dec. 6th 2001, p.19

The NHS is in need of a massive injection of funds sustained over a long period of time. Possible funding sources to be debated include a dedicated health tax and social insurance.

DECENTRALISATION DREAM

C. Deeming

Public Finance, Nov. 23rd - 24th 2001, p.28-29

The government appears to be sincere in its wish to devolve health spending decisions down to local areas. However, in practice 83% of health spending is centrally determined by pay and price inflation, costs of meeting National Institute for Clinical Excellence guidelines, and health modernisation initiatives. There is very little scope for local initiatives.

THE ECONOMICS OF THE PRIVATE FINANCE INITIATIVE IN THE NHS

J. Sussex

London: Office of Health Economics, 2001.

This report aims to assess the costs and benefits of the PFI scheme, 'relative to conventionally financed alternatives' and to draw out the important lessons already learned. It looks at how important capital is in the NHS and how investment and deinvestment decisions are made. It goes on to examine the origins and nature of the Private Finance Initiative and the barriers to it. It looks at PFI ascendant; its ambiguity; benefits and costs; the cost of borrowing; and the value for money aspects. It weighs up whether PFI is overall a net benefit or cost to the NHS and the implications for future policy and practice.

AN END TO A GREY DEFENCE

D. Walker

Guardian, Dec. 3rd 2001, p.15

Article analyses the extent to which an ageing population may be a burden on health spending and to what extent predictions may have been exaggerated in the past.

EXTRA CASH FOR NHS HAS HAD 'LIMITED EFFECT'

A. Grice

Independent, Nov. 27th 2001, p.1

Article discusses the Chancellor's pre-budget report on the need for more money to be pumped into the NHS. It also discusses the Treasury-ordered study that highlights the extra pressures facing the NHS. Article goes on to discuss the financial and taxation options available to make the improvements needed to the NHS.

EXTRA PUBLIC CASH "CANNOT SAVE NHS"

P. Wintour

Guardian, Nov. 23rd 2001, p.16

The Conservatives are arguing that extra public spending will not solve the problems of the NHS. Based on European practice, they suggest that increased private funding, possibly including social insurance schemes, is needed to turn the service around and arrest its decline.

HEALTH AND HYPOTHECATION: A NEW WAY FOR PAYING FOR PUBLIC SERVICES?

S. Webb

New Economy, vol. 8, 2001, p. 235-241

Advances the controversial argument that the yield from national insurance contributions should be used to pay for the health service as a way of reinforcing the link between what taxpayers are paying and what they are getting in terms of improved services.

HEALTH MAY PROVE MORE EXPLOSIVE THAN ROW OVER EURO

R. Sylvester

Daily Telegraph, Nov. 29th 2001, p.9

Although the Chancellor of the Exchequer is totally committed to continuing to fund the NHS out of general taxation, other influential Labour advisers, including some close to the Prime Minister, are attracted to alternatives such as social insurance or a hypothecated health tax.

(See also Times, Nov. 29th 2001, p. 1 and 4; Guardian, Nov. 29th 2001, p.26)

HEALTH SPENDING MUST RISE BY £45BN TO HIT TARGET, THINK-TANK TELLS BLAIR

A Grice

Independent, Dec. 10th 2001, p.1 and 4

The King's Fund says that a new survey of the rise in health spending in Europe shows that the EU average will be 10.7% of GDP by 2005/06. To equal this level, the UK would need to be spending an extra £45 bn a year on health care; the equivalent of 15p on the basic rate of income tax.

HOW BROWN GOT THE ANSWER HE WANTED ON THE NHS

R. Sylvester

Daily Telegraph, Nov. 29th 2001, p.8

Derek Wanless in his interim report on NHS funding found in favour of continuing to pay for the health service out of general taxation. This is not surprising as he was specifically forbidden by the Chancellor, who commissioned the report, to look at alternative ways of raising money.

NHS FINANCES "TO WORSEN" DESPITE EXTRA CASH

N. Timmins

Financial Times, Dec. 6th 2001, p.2

Figures produced by the Healthcare Financial Management Association indicate that a significant part of the extra money promised by the government will have to be spent on sustaining existing services and paying for developments already planned.

NHS HAS GONE BACKWARDS UNDER LABOUR, ADMITS CLARKE

P. Webster and L. Paterson

Times, Nov. 27th 2001, p.1

Discusses Gordon Brown's pre-budget report which emphasised the need for increases in spending in the NHS, in the light of the massive new demands it faces due to an ageing population, new technology and rising expectations. Article goes on to discuss possible ways forward.

NHS TO OFFER SERVICES TO PRIVATE COMPANIES

R. Bennett

Financial Times, Nov. 20th 2001, p.3

Announces the launch of NHS Plus, which will market occupational health services on the Department of Health web site. Profits will be ploughed back into the individual health trusts offering the service.

OVERSEAS DOCTORS TO BE PAID FOR GP TRAINING

R. Bennett

Financial Times, Nov 23rd 2001, p. 2

Reports government plans to give foreign doctors state funding to train as GPs. Under present rules government will only pay for foreign doctors without right of residence to complete their training to practice in hospitals. The move is part of a wider plan to recruit 2000 extra GPs by 2004.

PRIVATEERS ON THE MARCH

A. Pollock

Guardian, Dec. 11st 2001, p.14

Argues that the government's growing enthusiasm for private sector involvement in healthcare delivery is a threat to universal access. Markets limit the ability of the public sector to pool the costs of expensive patients and areas and spread them across the whole of society. The switch to markets also leads to increased administrative costs, and a drain of staff from the public to the private sector.

PUTTING MONEY IN THIS NHS IS LIKE PUTTING WATER INA COLANDER

I. Duncan Smith

Daily Telegraph, Dec. 5th 2001, p.26

Argues that putting extra public money into an unreformed NHS is pointless. Calls for decentralisation and extension of patient choice to improve the efficiency of the system.

RAISING TAXES IS THE WRONG WAY TO MAKE PEOPLE PAY MORE FOR HEALTH

C. Powell

Independent, Dec. 3rd 2001, p.4

Article discusses Derek Wanless' report findings and how the healthcare system in Britain could be funded. It discusses how voters' and patients' attitudes and expections have changed since the establishment of the National Health Service (NHS). The author concludes that we need an NHS for the 21st century which provides a standard of customer orientation that we are used to today in other aspects of our lives. He goes on to say that we will not get it unless we can be persuaded to pay for it and calls for more debate on the matter.

(See also The Times, Nov. 30th 2001, p.22)

RUNNING AWAY FROM THE PRIVATE SECTOR RISKS ALL TOO PUBLIC DISASTER

P. Wheatcroft

Times, Nov. 27th 2001, p.16

Looking at the financial and management structure of the NHS, this article discusses how it will swallow all the extra Treasury funding without any guarantee that the service will improve. It argues that the most pressing problem is not cash but management.

SECOND OPINION? MOVING THE NHS MONOPOLY TO A MIXED SYSTEM

S. Lawlor

London: Politeia, 2001

Calls for the scrapping of the NHS as a publicly owned and provided, tax-funded health service. It should be replaced by a system with competing providers mainly reliant on public funding but able to attract the additional voluntary sums on which successful universal healthcare depends. Such a system would also be responsive to demand instead of run for the convenience of suppliers.

SECURING OUR FUTURE HEALTH: TAKING A LONG-TERM VIEW: INTERIM REPORT

D. Wanless

London: Treasury, 2001

Report presents emerging views about the key factors that drive NHS costs: catching up to world class standards in the quality of service provided; rising patient and public expectations; technological advance; population ageing; and staff recruitment and retention. Supports continued funding of the NHS out of general taxation and argues that the impact of an ageing population on costs is not as large as is often thought.

(For comment see Financial Times, Nov. 28th 2001, p.11)

STUFF SOCIALISM, NURSES NEED A MARKET WAGE

B. Johnson

Daily Telegraph, Dec. 6th 2001, p.27

At present, nurses' pay is negotiated nationally, making it difficult to recruit in areas where the cost of living is high. Calls for nurses' pay and conditions to be negotiated locally.

TAX AND SPEND ISN'T GOING TO MAKE THE NHS BETTER

J. Daley

Daily Telegraph, Nov. 28th 2001, p.29

Advocates funding the NHS from private health insurance rather than general taxation.

THERE IS A BETTER WAY TO RUN OUR HEALTH SERVICE

S. Pollard

Independent. Review Supplement, Nov. 29th 2001, p.4

Argues that relying solely on public funding is not the best way to support the NHS. More successful European health systems supplement public funding with private, non-compulsory insurance spending and foster competition between providers. Most European systems are based on social insurance in which compulsory contributions are paid to independent sickness funds directly responsible to their members.

UNION DEAL "THREATENS" PRIVATE FINANCE INITIATIVE

C. Adams

Financial Times, Nov. 23rd 2001, p.2

Reports a deal between the government and Unison that would allow lower grade NHS staff to be seconded to the private contractor, but to remain health service employees, under three pilot PFI schemes. The arrangement is likely to become a model for private investment in hospitals.

(See also Guardian, Nov. 22nd 2001, p.16)

WANTED: A NEW PRESCRIPTION FOR NHS DRUGS

S. Brown

Public Finance, Nov. 9th - 15th 2001, p.12

The introduction of a new price control mechanism for generic drugs has failed to cut prescription costs. This is because prescription rates are continuing to rise as services strive to meet targets set in the National Service Frameworks which lay down treatment standards for conditions such as coronary heart disease and mental illness.

WILL WE LOVE THE HEALTH SERVICE TO DEATH?

A. Miles

Times, Nov., 28th 2001, p.18

Argues that consumer demand for health care is set to rise exponentially and indefinitely to levels which cannot realistically be supported by public funding.

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