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Welfare Reform on the Web (February 2003): National Health Service - Funding

CONSULTANTS SET FOR SHOWDOWN

J Carvel

The Guardian, December 27th 2002, p.9

Alan Milburn, the Health Secretary, was last night set on a collision course with hospital consultants in a battle over pay that could make or break his attempt to deliver key NHS waiting list targets. He wants doctors to negotiate locally with hospital managers in England on a range of bonus payments to reward those doing the most work for the NHS.

HOW NUMBERS FAIL TO PAINT TRUE PICTURE OF THE NHS

N Timmins

Financial Times, Dec 13th 2002, p.4

Figures released by the Department of Health suggest that hospital productivity is plummeting. This article discusses the issues and suggests that money is not disappearing into a black hole but is simply being used in different ways.

MILBURN SETS OUT RISE IN NHS SPENDING

N Timmins and K Guha

Financial Times, Dec 12th 2002, p.2

The Health Secretary announced details of a 30% rise in cash spending on the NHS as official figures showed that a 20% increase since 2000 had produced only marginal improvements in hospital activity. The figures show that finished consultant episodes rose only by 1.6%, while hospital admissions actually fell. These statistics may disguise shifts in care from in-patient to outpatient procedures, and from outpatient treatment to care in general practice.

MILBURN TO PAY SURGEONS FOR EXTRA OPERATIONS

N Timmins

Financial Times, Dec 13th 2002, p.4

The Health Secretary, Alan Milburn, has announced that surgeons and anaesthetists are to be paid extra for each patient they operate on in an attempt to hit the governments waiting time targets. This is just part of a new package which will allow physicians and other hospital staff to earn more in recognition of their workload.

MORE THAN A THIRD OF EXTRA NHS MONEY SPENT ON PAY

A Grice

The Independent, December 26th 2002, p.2

More than a third of the extra money being pumped into the NHS is being soaked up in higher pay for existing staff, the Department of Health has disclosed.

PAY REBUFF THREATENS NHS REFORMS

P Wintour

The Guardian, December 31st 2002, p.1

The Health Secretary, Alan Milburn, faces a set back to his programme for NHS change after it emerged that plans to restructure the pay of more than a million NHS workers are in "deep trouble" with the health unions. Some of the hostility stems from the Labour government's plans to allow a small group of foundation hospitals to set their own pay rates. The Unions, and many labour MPs, regard foundation hospitals as an elite.

PRESCRIBING COSTS: A BITTER PILL FOR PCTs

S Prestwood

Primary Care Report, vol. 4, Nov 27th 2002, p.6-15

The NHS in England is predicted to be heading for a £300 million overspend in 2002/03 largely due to rises in prescribing costs. Many primary care trusts attribute these rises to pressure to implement National Institute for Clinical Excellence guidance which requires expensive drugs to be made available.

RATES AND PILLAGE

A Moore

Health Service Journal, vol. 112, Dec 5th 2002, p.10-11

The NHS drugs bill has doubled from £3bn in 1992/93 to £5bn in 2001/02. This is partly due to the impact of the National Service Frameworks and National Institute for Clinical Excellence recommendations of new and expensive treatments. There is little scope for reducing costs through use of generics until more drugs come out of patent.

REDUCING AVOIDABLE INEQUALITIES IN HEALTH: A NEW CRITERION FOR SETTING HEALTH CARE CAPITATION PAYMENTS

K Hauck, R Shaw and P C Smith

Health Economics, vol. 11, 2002, p.667-677

Traditionally, most health care systems have sought to allocate their limited funds in order to secure equal opportunities of access for equal need. The UK government is implementing a profound change in resource allocation philosophy towards "contributing to the reduction of avoidable health inequalities". Health inequalities may arise due to variations in the quality of health services, variations in access to them and variations in the way people produce health. Resource allocation consequences differ depending on which source of health inequality is being addressed. Paper shows that an objective of reducing health inequalities is not necessarily compatible with achieving equal access, or with the maximisation of health gain.

WHY PCTs SHOULDN'T BANK ON A NEW SOURCE OF FINANCE

S Brown

Primary Care Report, vol. 4, Nov 27th 2002, p.16-17

Discusses the role of the NHS Bank in providing special assistance to strategic health authorities in severe financial trouble. The Bank could also provide funds for capital investment and set up mechanisms to allow primary care groups and acute trusts to carry forward underspends.

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