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Welfare Reform on the Web (March 2000): National Health Service - Funding

BMA TO LAUNCH REVIEW ON HEALTH SERVICE FUNDING

C. Hall

Daily Telegraph, Dec. 10th 1999, p. 1

Reports that the British Medical Association has commissioned a comprehensive review of NHS funding. In spite of the injection of extra money by government, the resources available for health care cannot meet the needs and expections of patients.

BROWN PRESENTED £9bn NHS rise as £18bn

C. Hall

Daily Telegraph, Nov. 15th 1999, p. 1 and 2

Reports allegations that the government used a method known as 'double counting' to calculate spending rises on the NHS, so that an actual increase of £9bn after three years was presented as £18bn. These apparently exaggerated government claims about funding are at the heart of NHS financial problems.

DOH ACCUSES DRUG FIRMS OF PROFITEERING

L. Whitfield

Health Service Journal, vol. 109, Nov. 11th 1999, p. 4-5

In a hearing before the Health Select Committee, representatives of the generic drugs industry attributed price rises to the closure in December 1998 of Regent - GM Laboratories, the move from bulk supplies to patient packs, and the operation of a listing of drugs in short supply that allows pharmacists to dispense more expensive alternatives. The Department of Health however hinted that it believes manufacturers and wholesalers to have been profiteering from the situation.

ECONOMY AND FINANCE: A PROSPECTIVE VIEW OF FINANCING HEALTH CARE

P. Kanavos

London: Nuffield Trust, 1999 (Policy futures for UK health: 1999 technical series; no. 5)

The NHS has not changed its funding arrangements since its establishment in 1948. Report draws attention to factors that may change this tradition. These include the internationalisation of health and the development of health and health care as a commodity, rising pharmaceutical expenditure, pressures on expenditure that have led to the exclusion or restriction of some services from the NHS, and demographic projections that show a smaller working population supporting an ever-larger dependent population.

MAKING SENSE OF THE PRIVATE FINANCE INITIATIVE: DEVELOPING PUBLIC-PRIVATE PARTNERSHIPS

C. A. Smith

Radcliffe Medical Press, 1999

Gives useful summaries of guidance on the PFI process: business cases, approvals, procurement and output-based specifications are covered. Includes two case studies of PFI projects and discusses future directions, such as cross-trust, health and action zone-wide and inter-sectoral projects.

MILBURN HINTS AT REAL-TERM INCREASE IN NHS SPENDING

N. Timmins

Financial Times, Dec. 9th 1999, p. 3

In an attempt to reassure the pharmaceutical industry, Alan Milburn has hinted at larger real-term increases in NHS funding when the next comprehensive spending review is concluded next year.

NHS ADVISER TO SEEK COSTS DATA FOR NEW DRUGS

N. Timmins

Financial Times, Dec. 10th 1999, p. 5

Reports that the National Institute for Clinical Excellence will be looking to see if treatments referred to it offer sufficient gains over existing products to justify their costs to the NHS, and will be looking at wider issues of cost-effectiveness.

NHS 'IS HEADING FOR £250 m DEFICIT'

N. Timmins

Financial Times, Nov. 12th 1999, p. 4

NHS finance officers have called for on the government to reopen the comprehensive spending review for the NHS as they warned it was heading for a £250m overspend this year. This is due to an increase in prescribing costs, the impact of the working time directive, the drive to cut waiting lists and the cost of dealing with the millennium bug.

(See also Health Service Journal, vol. 109, Nov. 11th 1999, p. 2)

PROTECTING THE PUBLIC PURSE: ENSURING PROBITY IN THE NHS

Audit Commission

Abingdon: Audit Commission Publications, 1999

Detected fraud rose from £2.6m in 1997/98 to £4.7m in 1998/99. Fraud in payments for medical services rose from £900,000 in 1997/98 to £3.3m in 1998/99. Report makes specific recommendations about tackling contractor fraud and calls for: the 'Red Book' on GP fees to be scrapped and replaced by a simplified system of reimbursement; a review of the fundamental lack of control on dental claims; and the creation of a central record of optical patients to check opticians' visits and prescriptions.

'PRUDENCE, DON'T LEAVE ME'

M. Gould

Health Service Journal, vol. 109, Nov. 18th 1999, p. 11-13

Reports predictions by the Healthcare Financial Management Association that year-end deficits in the NHS are set to top £200m. The deficit is set to grow despite attempts to cap appointments or transfer capital money into the revenue budget. The main problems for trusts are overactivity due to government modernisation initiatives, staff pay rises and the impact of the working-time directive. HAs are facing massive rises in the prescribing budget for both branded and generic drugs.

UNION RIGHTS IN PFI HOSPITAL DEALS OUTLINED

N. Timmins

Financial Times, Dec. 15th 1999, p. 8

Reports that trade unions are to be given a clear right to be consulted on private financing of NHS hospitals and to interview prospective bidders.

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