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

ARE DECISIONS BY PURCHASERS IN AN ENGLISH HEALTH DISTRICT EVIDENCE-BASED?

P Johnston and P Lacey

Journal of Health Service Research and Policy, vol. 7, 2002, p. 166-169

Article looks at how many decisions by one district health authority were based on evidence of effectiveness from randomised controlled trials (RCTs) and systematic reviews. It goes on to explore whether alternative quantitative and qualitative studies could be used as evidence to support commissioning decisions.

THE COMMISSIONING PROCESS IN THE NHS: THE THEORY AND APPLICATION

S Dopson and L Locock

Public Management Review, vol. 4, 2002, p. 209-229

In 1991 a purchaser-provider split was introduced into the NHS, with Health Authorities commissioning services from hospitals. Using obstetric services as a case study, article assesses how much leverage purchasers really had to enforce change in service delivery. Finds that their influence was minimal and barely dented the clinical autonomy of hospital doctors.

DOCTORS TOLD NOT TO PUT FAITH IN BROWN

J Carvel

Guardian, July 4^th 2002, p. 11

The new president of the British Medical Association has argued that economic and political difficulties will probably delay the extra money the government has promised the NHS. He therefore advocates the introduction of social insurance for health care, and the abandonment of an NHS funded out of general taxation.

(See also Daily Telegraph, July 4^th 2002, p. 10; Independent, July 4^th 2002, p. 1 and 6; Financial Times, July 4^th 2002, p.3)

NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE

Health Committee

London: TS0, 2002 (House of Commons papers, Session 2001/02; HC 515)

Calls for a comprehensive framework for setting healthcare priorities. Argues that because the National Institute for Clinical Excellence examines individual treatments and because its recommendations are mandatory, managers have had to cut back on other treatments to fund them. Treatments which may be equally valuable but have not been evaluated may be squeezed.

PRINCIPLES AND PRACTICE OF CANCER CARE

S Hawkett

Community Practitioner, vol. 75, 2002, p.245-247

As part of the NHS Cancer Plan, £6m has been set aside to fund additional education and support for district and community nurses in the principles and practice of palliative care.

SPLITTING THE DIFFERENCE

Z Morris

Health Service Journal, vol. 112, July 4^th 2002, p. 14-15

There are plans to rebuild the Royal London Hospital in Whitechapel and to redevelop St Bartholomew's as a cancer and cardiac centre of excellence using private finance. There has been fierce staff opposition to split site working and little interest in the scheme from private investors.