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Welfare Reform on the Web (August 1999): National Health Service - Funding

CANCER TARGETS 'USELESS WITHOUT EXTRA NHS CASH'

C. Hall
Daily Telegraph, May 21st 1999, p.5

The government has announced an action plan aimed at reducing cancer deaths by 60,000 in people under 75 in the next ten years. There will also be: a national survey of cancer patients' experiences, a cancer action team to raise standards, and new standards for treating different kinds of cancer. However there is no new money to implement the plans and experts have warned that ambitious targets are pointless without funding.

CONSERVATIVES PLAN FOR HEALTH TESSAS

P. Waugh
Independent, May 24th 1999, p.8

Ann Widecombe has announced that the Tories are considering plans for 'Health Tessa' savings accounts to boost private health care. The accounts would be used to fund medical care during a five-year period, but could be cashed in if no funds were called upon during its lifetime.

COVER STORY

Audit Commission
Abingdon: Audit Commission Publications, 1999

Report urges NHS Trusts to tighten up on their use of locum doctors, which now costs the NHS £214 million a year. Recommendations include ensuring a locum is needed and introducing more flexible working arrangements for permanent staff. A national code of practice should be used across the NHS.

NHS CANCER PATIENTS TOLD NEW DRUGS TOO EXPENSIVE TO PRESCRIBE

C. Hall
Daily Telegraph, May 5th 1999, p.5

Thousands of cancer patients are told every week they cannot have new drugs for their disease because they are too expensive for the NHS. In a campaign to double the NHS's £170 million per year spending on cancer drugs, doctors estimate that 47,000 patients would benefit from the extra cash and another 23,000 would be helped by new drugs being tested. Access to treatment is at present a lottery and dependent on where patients live. For many people the choice is to pay privately, rely on health insurance, go abroad or go without.

(See also Independent, May 5th 1999, p.6)

PFI: STILL A CASE TO ANSWER

J. Shaoul
Public Finance, May 7th-13th 1999, p.13

Disputes a defence of the Royal Infirmary of Edinburgh PFI scheme by John Owen in Public Finance, April 23-29 1999.

THE PFI CONTRACT FOR THE NEW DARTFORD AND GRAVESHAM HOSPITAL

National Audit Office
London: TSO, 1999.

House of Commons papers. Session 1998/99; HC 423

The first major private finance initiative deal to be signed is likely to prove as costly to build as traditional finance methods, and will eat up £4m more revenue per year than planned. Patient services also had to be cut to force down costs when the contractor increased its price estimate by 33% after being left as the sole bidder. However the NAO draws no conclusions as to the cost effectiveness of PFI generally, suggesting that many of the problems identified at Dartford and Gravesham Hospital may have been rectified in subsequent schemes.

PLUNDER AND PILLAGE

A. Earl-Slater
Health Service Journal, vol.109, May 6th 1999, p.18-20

The government has proposed a statutory scheme to regulate prices and profits on the sale of drugs to the NHS. Drugs companies which don't co-operate could be liable to heavy fines, but the government has failed to spell out the precise conditions under which such penalties would apply. Defining what constitutes excessive prices or profits is liable to present a number of practical problems. Experience overseas suggests that the scheme will fail to halt the inexorable rise in the NHS drugs bill.

THE PRIVATE FINANCE INITIATIVE: POLITICS OR PRAGMATISM?

British Journal of Health Care Management, vol.5 no.4, 1999. Supplement. 12p.

Looks at the advantages and disadvantages of the new public-private sector partnerships.

PROFITS FOR INDUSTRY

E. Knutt
Health Service Journal, vol.109, May 13th 1999, p.12-13

Reports that the £1.5bn first wave of private finance initiative hospitals are now under construction. No major problems have been reported in any project in turning 1:200 drawings into detailed designs, and all are reported to be on or ahead of schedule. Profits on the contracts for the construction industry are healthy.

SO THAT'S AGREED, THEN?

M. Crail
Health Service Journal, vol.109, May 20th 1999, p.11

Alan Milburn, chief secretary to the Treasury, has told a Select Committee Hearing that public service agreements under which cash is released to spending departments in return for progress towards agreed targets, may be extended to individual health authorities and trusts. Targets set by the Treasury may be toughened or augmented at any time.

'THREAT' TO SERVICES IN CONTRACTUAL SWITCH

K. McIntosh
Health Service Journal, vol.109, 20th May 1999, p.5

Acute and teaching hospitals face losing millions of pounds because of the switch to service agreements and out-of-area treatments. The old extra-contractual referrals system guaranteed payment for work done, while the new system is based on historic levels of funding. Health Authorities have insisted on using figures from up to two years ago as a baseline for funding regardless of what has happened since and have ignored increases in the numbers of patients treated.

WHY PFI PERFORMS IN PRACTICE

J. Owens
Public Finance, April 23rd-29th 1999, p.26-27

Rebuts criticism of the £180 million new Royal Infirmary of Edinburgh scheme. Argues that the new hospital represents a shift of resources from acute to primary care. Ultimately £11 million pounds will be transferred to primary care, thanks to the reduced running costs of the new hospital.

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