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

ALLOCATING RESOURCES FOR HEALTH AND SOCIAL CARE: THE SIGNIFICANCE OF RURALITY

S. Asthana and others

Health and Social Care in the Community, Vol. 11, 2003, p.486-493

The paper considers the case for a rural premium in health resource allocation in England. First, there is evidence that the current NHS funding formula introduces systematic biases in favour of urban areas in the way it expresses "need" for healthcare. Secondly, the system takes insufficient account of the additional costs of rural service provision. Thirdly, with the growing emphasis on attainment of national quality standards, rural primary care trusts and social services departments can no longer tolerate lower levels of services. Finally, England is the only country in the UK that does not make an adjustment for rurality in its NHS funding formula. Concludes that the English NHS resource allocation system has done little to counter service deprivation in rural areas.

CLARITY BEGINS AT HOME

P. Smith

Health Service Journal, Vol. 113, Nov. 20th 2003 p.10-11

Introduces the programme budgeting initiative in the NHS. In essence, programme budgeting maps spending on healthcare on self-defined categories such as blood disorders, mental health, dental conditions, and skin problems. The categories will capture the totality of NHS expenditure across both primary and secondary sectors. So far this work has been carried out across a handful of pilot sites. Guidance will be issued in the New Year on roll-out across the NHS.

NHS WALES: BACK FROM THE BRINK?

S. Brown

Primary Care Report, vol.5, no.17, Oct. 29th 2003, p.8, 10-11

The NHS in Wales is afflicted by long waiting times for treatment, enormous pressure on acute hospital beds, and an under-resourced primary care sector. In spite of a significant rise in health spending since the Welsh Assembly came to power, NHS Wales suffers from chronic overspending and a lack of incentives for performance improvement.

OUT FOR THE COUNT

N. Plumridge

Health Service Journal, Vol. 113, Nov. 13th 2003, p.38

The article argues that the new NHS payment by results scheme for acute care will offer no financial incentives to keep chronically ill patients out of hospital beds. On the contrary, it will bolster the current perverse incentives to admit patients to hospital, which increases recorded activity, with a direct payment to the hospital for each spell.

PUBLIC - PRIVATE PARTNERSHIPS IN HEALTHCARE: THE MANAGERS' PERSPECTIVE

J. E. Field and E. Peck

Health and Social Care in the Community, Vol. 11, 2003, p495-501

Study found that the attitude of public sector managers towards the private health care sector was typically pragmatic. There was little emphasis on ideological issues or matters relating to accountability, equity or access. This pragmatic outlook stands in contrast to the more ideological viewpoints expressed by Labour politicians. Amongst the managers, there was a growing awareness of both positive and negative consequences of purchasing services in the market place. However, in the context of the ongoing debate within government regarding the role of the private sector in health care, public sector managers are unlikely to receive the practical advice that will enable them to reap the benefits of public-private partnerships or avoid the pitfalls.

SPELL IT OUT

B. Dredge

Health Service Journal, Vol. 113, Oct. 30th 2003, p.35

The article discusses the process of introducing payment by results in NHS acute hospitals. From 2008 hospitals will be paid for treatments provided according to a national tariff system. There will be no competition on price, but they will compete for business on grounds of quality of care.

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