Welfare Reform on the Web (February 2004): National Health Service - Funding

DO TARIFFS STACK UP?

A. Street and K. Lowson

Health Service Journal, Vol. 114, Jan 8th 2004, p.31

The introduction of payment by results means that English acute trusts will face a fixed price for specific treatments. In order to survive under the new regime they will have to improve the accuracy of their activity coding and costing procedures, as well as increasing efficiency.

FRANCHISING 'LAST RESORT FOR NHS'

N. Timmins

Financial Times, January 16th 2004, p.3

Moves to hand over the management of failing National Health Service hospitals to the private sector have become a policy of last resort, the Department of Health has confirmed. Only in "extreme cases of under-performance" will the hospital management be franchised out - either to the private sector or to another NHS trust, said the Department.

PILING ON THE POUNDS

N. Plumridge

Health Service Journal, vol.114, Jan. 22nd 2004, p.34

Discusses the constant struggle faced by NHS acute trusts to balance their books using a range of familiar "quick fixes" such as recruitment freezes, and stopping building maintenance. More effort needs to be invested in strategic solutions.

THE PURSUIT OF EQUITY IN NHS RESOURCE ALLOCATION: SHOULD MORBIDITY REPLACE UTILISATION AS THE BASIS FOR SETTING HEALTH CARE CAPITATIONS?

S. Asthana and others

Social Science and Medicine, Vol. 58, 2004, p.539-551

The article presents a critical review of NHS resource allocation and assesses the feasibility and effect of using direct health estimates as a basis for setting health care capitations. Target allocations for inpatient treatment of coronary heart disease were compared in 34 primary care trusts. Results showed that a morbidity based model would result in a significant shift in hospital resources away from deprived areas into rural areas and areas with an older demographic profile. In conclusion, the paper calls for a greater clarity between the goals of health care equity and health equity.

PUTTING A PRICE ON HEALTH

B. Corby

Community Care, Jan.15th-21st 2004, p.34-35

Using provision of therapy for sexually abused children as a case study, article discusses the tensions between the demands of cost effectiveness and patient choice in treatment provision. Offering a range of treatments will always be more expensive that a "one size fits all" approach.

RECOVERY POSITION

M. Gould

Health Service Journal, Vol. 114, Jan. 15th 2004, p.10-11

The article reports opposition, on practical and ethical grounds, to government plans to charge foreign nationals for primary care services as well as hospital care.

SPENT FORCE

G. Clews and H. Mooney

Health Service Journal, vol.114, Jan. 29th 2004, p.14-15

Discusses pressures on NHS budgets as the financial year 2003/04 draws to a close. Cost pressures are arising from:

• increased elective and emergency activity;
• the implementation of the new consultants' contract;
• use of expensive agency staff;
• compensation claims from patients wrongly charged for continuing care.