NHS shift may hit local health schemes

21 Oct 99
Local health schemes, such as the development of diabetes care or minor injuries units, face the axe as a result of the government's change of direction on funding.

22 October 1999

NHS managers claimed this week that the new priorities of cancer, mental health and coronary heart disease would increase financial pressures to such a degree that many local initiatives would have to be postponed.

Health Secretary Alan Milburn announced on October 18 that £50m would be spent increasing the number of heart operations by 10% over the next two years – an extra 3,000 operations. He added that the number of heart specialists would rise by more than 400 in the next six years. This could cost between £300m and £400m.

A National Service Framework (NSF) on cardiac services, which will include targets for treating heart patients, is expected soon. A similar programme to combat cancer is scheduled for launch next week.

Milburn insisted that downward pressure on waiting lists would be maintained, but the attempt to broaden objectives will cause NHS managers severe financial problems.

Stephen Thornton, chief executive of the NHS Confederation, said the £50m was only enough to keep up with the usual year-on-year increase in demand for cardiac surgery. 'We anticipate the NSF for coronary heart disease will have further significant cost implications. Just one example will be the cost of drugs to reduce cholesterol,' he added.

'This will inevitably increase pressure on the NHS because the money will have to be found from other areas.'

NHS managers complain that cash allocations for the current year are already too restrictive. There are fears that the new policy direction signals even greater restrictions when next year's allocations are announced in around four weeks, although the Confederation maintains this will not happen.

'In the settlement for next year, there are going to be a number of givens,' said Eric Morton, chairman of the Healthcare Financial Management Association.

He added: 'Resources will be used to maintain access to emergency services, hitting targets on inpatient and outpatient lists and delivering outcomes on the three national service frameworks. 'It is clear that even with the resources available, it is not going to be an easy year.

'Apart from these pressures, there is also the 1% increase in pension contributions, the impact of the Working Time Directive and the junior doctors' pay settlement. If there aren't any new resources next year will be a difficult act to pull off.'


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