NHS spending variation revealed9th August 2006
A new King’s Fund briefing shows stark variations in how much the NHS spends locally on different diseases. The briefing analyses new Department of Health data from 2003/4-2004/5 that shows how much money is being spent by primary care trusts (PCTs) in England on different diseases.
It reveals that some PCTs spend much more than others on particular diseases, such as mental health, cancer, and coronary heart disease, even after differences in the health needs of local populations and other factors have been taken into account.
For example there are large variations with a two-fold difference in mental health spending per head across 90 per cent of PCTs with similar variations for other diseases. The proportion spent on cancer care ranges from three per cent to over 10 per cent of PCTs’ budgets.
The National Programme Budget Project started in 2002, with PCTs reporting their spending on 21 different disease areas, such as mental health problems, cancers and tumours and respiratory diseases, for the first time in 2003/4.
Professor John Appleby, King’s Fund Chief Economist, said that the new data raises serious questions about the consistency of decisions PCTs make about how much they spend on different diseases. He added, however, that "a proportion of the variation in PCT spending will not be a result of deliberate choices by PCTs. Variations in clinical decisions about who and when to treat, and what treatment to provide, and differences in the efficiency of hospitals, contribute to the variations in PCT spending."
The figures show that spending is reaching the government’s three clinical priorities of cancer, mental health, and coronary heart disease. The largest share of spending (over £7 billion - 11 per cent) was devoted to mental health services - twice as much as spent on cancer care.
Nigel Edwards Director of Policy at the NHS Confederation, commenting on local variations in NHS spending priorities said that “Variation in the delivery of health services or the ‘postcode lottery’ as it’s often called is frequently seen as a problem by politicians and the public. Yet at the same time they say that they want less central control in health and more decisions to be taken locally - there is a direct trade off between them."
He added that it is right that local health services meet the needs of local patients and therefore important to understand that a consequence of this will always be variations in spending.
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Title: NHS spending variation revealed
Author: Sue Knights
Article Id: 621
Date Added: 9th Aug 2006