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

BITTER PILL

J Buchan

Health Service Journal. vol. 112, Aug 8th 2002, p. 24-26

Negotiations are continuing over a revised pay structure for NHS staff. The government's original plan of producing an integrated pay system for all NHS staff has been scuppered by the separate settlement for consultants. The new system will have to balance management needs for local flexibility and the unions' desire to sustain national pay. It could also be undermined by the new foundation hospitals which will be able to set their own pay rates and by the employment of foreign clinical teams.

THE CHANGING PUBLIC-PRIVATE MIX IN HEALTH CARE

D J Hunter and R Robinson

British Journal of Health Care Management, vol. 8, 2002, p. 301-304

The public-private mix in UK health care is changing rapidly, with the private sector destined to play a much bigger role in the NHS in future. The evidence base for this policy is, however, slender. The appeal of public-private partnerships lies in their providing a means of obtaining short-term increases in capacity. However, they are beset by a lack of information on cost-effectiveness, uneven quality assurance mechanisms, NHS managers' inexperience in dealing with the private sector, and great complexity in partnership working.

FEARS OVER NHS PATIENTS IN NEW-STYLE HOSPITALS

N Timmins

Financial Times, July 30 2002, p. 1

Plans to allow foundation hospitals to raise money by treating private and overseas patients have raised fears of NHS patients losing out to more lucrative customers. Although existing NHS hospitals can take private patients, the Treasury is concerned that over time foundation hospitals would have an incentive to take on more and more fee-paying patients to boost their business. This would in turn threaten capacity available to NHS patients.

MILBURN HINTS AT MORE PAY TO HELP RECRUIT NURSES

S Boseley

The Guardian, July 26th 2002, p. 2

Extra pay to help recruit and retain nurses and other hospital staff in areas where they are in desperately short supply could be on the cards. Alan Milburn, the Health Secretary, has recognised staff shortages are getting in the way of NHS reforms and has said an extra 35,000 nurses are wanted by 2008.

MINISTERS AT ODDS OVER FUNDING OF HOSPITALS

M White

Guardian, July 31st 2002, p. 8

Reports that the Chancellor of the Exchequer is opposing the Health Secretary's plans to allow the proposed foundation hospitals to raise funds on the open markets. There is concern that the hospitals could get into financial trouble, forcing the taxpayer to bail them out. The Treasury is also concerned that hospitals may seek to raise funds by treating large numbers of foreign and private patients.

PUBLIC SECTOR WORKERS TO BE OFFERED 10% PAY RISE

J Sherman and D Charter

Times, Aug 1st 2002, p.8

Reports that the Health Secretary is pressing NHS staff, including nurses, to accept a three year pay settlement worth 10%, linked to modernising career structures.

(See also Guardian, Aug 1st 2002, p. 1)

THIS LITTLE PIGGY...

J Appleby and others

Health Service Journal, vol. 112, Aug 15th 2002, p. 24-29

The government is proposing to introduce a new version of the internal market into the NHS from 2003. The prices acute trusts can charge for treatment will be fixed centrally on the basis of healthcare resource groups (HRG), with prices for each HRG pegged at, say, a required average to reflect uncontrollable geographical variations in costs. This system could mean many trusts making significant losses. Policy must balance the need to protect some trusts from the effects of fixed prices with the desire for financial incentives with "bite". The basis on which prices are struck is crucial, and quality will need careful monitoring.

TORY LEADER CASTS DOUBT ON FREE NHS

N Watt

The Guardian, July 26th 2002, p. 13

Iain Duncan Smith raised doubts about whether the Tories were committed to the founding principle of the NHS - that treatment should be free at the point of delivery. In an interview the Tory leader said that a Conservative government under his leadership would "probably" be committed to the idea.

USING HEALTH ECONOMICS IN HEALTH SERVICES: RATIONING RATIONALLY?

R McDonald

Buckingham: Open University Press, 2002

This book examines the impact of attempts to use 'rational' health economic analysis on local decision making in the National Health Service. It uses case studies to demonstrate the processes and contexts of healthcare resource allocation at local level.

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