18 July 2003
NHS financial discipline must be tightened and deficits eradicated, Welsh Health Minister Jane Hutt warned this week after a far-reaching review claimed that demand could overwhelm services in the principality.
In May, Sir John Bourn, auditor general for Wales, forecast that the NHS would be between £39.61m and £44.08m in the red by the end of the 2002/03 financial year. In 2001/02 NHS Wales was £16m in deficit, compared with a surplus of £23.7m the previous year.
The 2001/02 debt would have been greater but the Welsh executive gave the NHS an extra £11.2m in strategic assistance funding.
This week's report, The review of health and social care, said the executive must stop handing out extra funding in this way – a move already backed by Hutt.
The review was compiled with the help of Derek Wanless, the former banker whose 2002 study of future UK health needs prompted the current sharp increase in national health spending.
'There is no denying the review provides some hard messages for the future delivery of the service,' Hutt said. 'As resources increase, so financial disciplines have to be tightened. Deficits have to be squeezed out of the system.'
Successful NHS bodies would be given more freedom from central control and those that underperformed less.
Hutt added that local government must also play its part in modernising services and this must include alternatives to hospital care.
Hospital activity has grown by more than 33% over the past ten years – but demand still outstrips supply and the system is in danger of being overwhelmed.
Emergency admissions are very high and adversely affect the delivery of elective services. As a result of these pressures, waiting lists and waiting times at some hospitals have become unacceptably long.
Welsh NHS Confederation director Richard Thomas agreed that the current position was unsustainable. But he warned that change could lead to difficult decisions.
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