NHS told to shape up or lose out

13 Jul 00
The government's favourite stick-and-carrot approach to public services is to be applied to the NHS with a vengeance. To the best, a bundle of cash; to the worst, the black spot.

14 July 2000

Health Secretary Alan Milburn's plans to hand out cash bonuses of between £2.5m and £5m a year to the best performing hospitals, health authorities and GP practices were immediately condemned by NHS managers this week.

Milburn is to build incentives totalling £250m a year into the National Plan for the English health service, due to be published in two weeks' time. Eligibility for the new cash will be determined by a number of performance indicators, including those – dubbed league tables – published on July 14.

These include statistics on waiting lists and times, accident and emergency trolley waits and survival rates for breast, colon and lung cancers.

The tables will reveal that in some trusts two in five patients wait more than two hours to be admitted to a ward from the casualty department. In the best, two hours is the maximum waiting time.

The cash bonus proposal was attacked by the NHS Confederation. 'If you have a hospital that is not doing very well then you put patients in double jeopardy,' said Andrew Foster, a Confederation policy director. 'Not only have you got a bad service but you are also not going to get that new MR scanner, for example.'

'Hit squads' made up of public and private sector managers could also be sent in to take over failing NHS organisations, which, like schools, might face closure if they fail to smarten up.

Foster added that while it would be appropriate for health service managers to take over the reins in a failing hospital, private sector managers could have little to offer because the NHS was a more complex organisation than those in commerce.

Some £60m of the extra £660m initially allocated to the English NHS this year has been held back in a performance fund which is being used to reward health authorities and trusts that meet local targets.

A Department of Health spokesman said it wanted the public to appraise local NHS organisations using the new league tables. 'The service must take these numbers away, see how they compare with others and improve their performance,' he added.


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