Welfare Reform on the Web (August 2005): National Health Service - Funding

Budget crisis 'may hit patient care'

J. Meikle

The Guardian, July 27th 2005, p.10

A third of NHS hospital trusts in England failed to balance their books last year, a crisis that could soon jeopardise patient care, the health inspectorate said last night. Nearly a quarter of the bodies responsible for services outside hospitals, including GPs, opticians and dentists, also showed a deficit despite big increases in public spending. Overspending in healthcare trusts amounted to £499m, according to the Healthcare Commission. The financial problems together with tougher targets, particularly on cutting accident and emergency waiting times, meant fewer hospitals achieving three stars for high performance in the final annual star ratings.

(See also The Independent, July 27th 2005, p.4; The Times, July 25th 2005, p.20)

DoH will be 'sympathetic' to the plight of some indebted trusts

H. Mooney

Health Service Journal, vol.115, June 30th 2005, p.5

Reports that there is pressure on the government to cancel the historic debt of some struggling NHS trusts so that they can move to foundation status. The Department of Health has signalled that it is prepared to look sympathetically at the plight of some indebted trusts.

Financial management in the NHS: NHS (England) summarised accounts 2003-04

National Audit Office and Audit Commission.

London: TSO, 2005 (House of Commons papers, session 2005/06; HC60)

Report shows that in 2003/04 the Department of Health achieved financial balance across the 600 local NHS bodies. However, the number of individual NHS bodies failing to achieve financial balance increased from 12 to 18%, with more incurring significant deficits. The position deteriorated in 2004/05. The Department estimates that in that year the NHS as a whole incurred a small deficit. At least 12 strategic health authorities ended 2004/05 with a deficit compared to seven in the previous year. NHS bodies are facing major financial challenges as a result of reforms such as the new GP and consultant contracts, the National Programme for IT and the introduction of payment by results. The report makes a number of recommendations on how financial management could be improved, including better oversight at Board level, better financial forecasting, and greater transparency of reporting.

Patient enthusiasm for private sector threatens hospitals

H. Mooney

Health Service Journal, vol.115, July 21st 2005, p.5-6

A Mori poll for Birmingham and Black Country Strategic Health Authority has shown that patients believe the private sector to be superior to the NHS and most would be very happy to be treated in independent hospitals. Mass defections to the private sector under patient choice could cause NHS hospitals serious loss of income.

Programme budgeting is better for the health service than PbR

P. Brambleby and J. Dixon

Health Service Journal, vol.115, July 21st 2005, p.18-19

Brambleby argues that programme budgeting is transformational where payment by results is merely transactional. Dixon responds by making the case that payment by results incentivises commissioners to seek out greater quality and efficiency.

The slice is right

J. Hacking

Health Service Journal, vol.115, June 30th 2005, p.18-19

Analysis of primary care trust (PCT) funding allocations for 2005-06 and 2007-08 shows that the Department of Health has, in response to pressure, given a large funding increase to highly under-target PCTs, encouraged public health initiatives, provided extra cash for growth areas, and partially solved the problem of census under-count for some trusts.