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

£100,000 SALARIES FOR GPS ON NEW PAY SYSTEM

M. Frith

The Independent, May 29th 2003, p.5

Some NHS family doctors are earning more than £100,000 a year - up to 30 per cent higher than estimated by the British Medical Association. The findings raise concerns about how new "paid by results" contracts for GPs, which were designed to help deprived areas, are being implemented.

£81M OF CANCER CASH 'WENT ASTRAY' IN NHS

C. Hall

The Daily Telegraph, May 23rd 2003, p.6

Millions of pounds awarded to cancer services was spent on other areas of the NHS and an investigation has failed to discover where the money went.

(See also The Times, May 23rd 2003, p.4)

CUT TO THE CHASE

P. Smith

Health Service Journal, vol. 113, May 22nd 2003, p.12-13

Under the new system of financial flows in the NHS, the planned foundation trusts will be paid by primary care trusts for work done at prices fixed nationally by government. They will compete for business on grounds of quality, and will need to look for efficiency gains to reduce their internal costs to generate surpluses. These surpluses could then be used to finance loans from the private sector for capital investments. Surpluses (or profits) could also be generated through competition which would take revenue from other trusts or by a system of supplementary charges to patients for televisions, private rooms, etc.

GO WITH THE FLOWS

G. Clews

Health Service Journal, vol. 113, May 8th 2003, p.13

Briefly discusses the introduction of the new system of financial flows into the NHS. Under this, funding will follow the patient and primary care trusts will commission care on the basis of a national tariff system.

HOSPITAL TRUST £44M IN RED FOR ONE YEAR

S. de Bruxelles and N. Hawkes

The Times, May 9th 2003, p.4

An NHS hospital trust has run up debts of more than £44 million in a single year, while forecasting that this would double in the next few months. The overspend by the North Bristol NHS Trust is more than seven times higher than the previous deficit.

(See also The Daily Telegraph, May 9th 2003, p.10)

HOT AND BOTHERED

M. Gould

Health Service Journal, vol. 113, May 29th 2003, p.12-13

Hospital consultants, having rejected the government's proposed new national contract, are now opposing local incentive schemes. They are calling for the re-opening of negotiations on a national contract.

IT'S TIME FOR THE NHS TO COME CLEAN

S. Brown

Primary Care Report, vol 5, 14 May 2003, p.6,8-9

The government wants the NHS to account for how resources are used and to show their effect on performance. It is proposed that the Commission for Healthcare Audit and Inspection (CHAI) publish an annual report showing how resources are used and that Primary Care Trusts (PCTs) publish an annual patients' prospectus which would include resource spending. There is a political motivation to the need for accountability but NHS managers have welcomed the move. Showing the true cost of improvements, such as reducing junior doctors' working hours, will help them manage expectations.

LEARNING A NEW LANGUAGE: HEALTH CARE RESOURCE GROUPS

S. Brown

Primary Care Report, vol 5, Apr. 30th 2003, p.13-15

Health care resource groups (HRGs) are made up of clinically similar cases which consume similar levels of resources. There are currently 565 separate groups. It is now intended to pay hospitals according to the numbers of patients they treat and the complexity and costs of their care. From April 2003 average HRG costs are being used to create a national tariff for activity in 15 high volume/high expenditure HRGs that have been deemed critical to waiting times targets and the coronary heart disease strategy. At the same time, new requirements for cost and volume commissioning in six surgical specialities demand an understanding of expected activity levels in each HRG category within those specialities.

MAJORITY RULE

D. Carlisle and M. Gould

Health Service Journal, vol. 113, May 29th 2003, p.10-11

Discusses the action, or lack of it, by NHS managers, to implement the new consultant contract locally, and/or to launch fee-for-service incentive schemes in the teeth of clinician opposition.

REFORMS AT RISK AS GPs REJECT PAY DEAL

J. Carvel

The Guardian, May 15th 2003, p.5

GP's representatives might refuse to accept a contract negotiated by their leaders which would have increased the income of family doctors by 26% over three years. At a BMA Conference of local medical committee chiefs, the majority demanded a six-month delay to allow renegotiation.

(See also The Times, May 11th 2003, p.16)

REFUSE TO DO OVERTIME, BMA TELLS CONSULTANTS

J. Carvel

The Guardian, May 16th 2003, p.10

The British Medical Association advised hospital consultants to begin a work-to-rule against the unpaid overtime that is required by the NHS to meet the government's waiting-list targets.

WATCHDOG CHALLENGES NHS AUDIT PLANS

N. Timmins and C. Adams

Financial Times, May 15th 2003, p.4

The government's independent spending watchdog has written to Alan Milburn, the Health Secretary, challenging the audit arrangements for the new foundation hospitals, amid fears that they may not protect the public interest

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