NHS urged to drop plan to shift health funding to areas with more old people

NHS urged to drop plan to shift health funding to areas with more old people


A controversial plan that could mean almost £1bn is diverted from England's poorest areas to its richest will be finalised by NHS bosses on Tuesday.


Under the plan, the north of England and London would lose a significant chunk of their NHS funding, with the cash going to the south, Midlands and east of England. MPs from poorer areas of the country fear it will exacerbate already stark health inequalities between rich and poor.

The government claims the funding shift is necessary because older people are disproportionately heavy users of healthcare, so funding should be weighted towards regions where they make up more of the population.


Andy Burnham, the shadow health secretary, said the plan would mean taking health services from the poorest parts of the country. "They are going to be siphoning almost a billion pounds out of some of the poorest parts of England to give it to areas where healthy life expectancy is already the longest. This would be a kick in the teeth for the poorest parts of the country. How can that be justified? "This is a colossal shift in NHS resources and in NHS thinking. It's a dangerous road to be going down because [if age is prioritised and deprivation downgraded] it breaches a fundamental principle of the NHS that need is the prime consideration."


The historic shift in the weighting of the formula has been approved, although the exact implementation will be agreed on Tuesday. Research by the House of Commons library suggested the north would lose £721.6m from its allocation from the NHS from April, and the capital £222m – a total of £943.6m. The south of England would gain £283.3m, while the Midlands and east would receive an extra £660.2m to spend on NHS services.


NHS England said it would not use the formula the Commons library analysed to produce its figures but would consider a number of options for what the formula should be and choose one. The board of NHS England meets on Tuesday to discuss the best way to allocate funding as a result of coalition ministers deciding that deprivation should become less important – and the age of a population more important – in the allocation of funding to England's 211 GP-led clinical commissioning groups (CCGs).


Burnham has written to Professor Sir Malcolm Grant, chairman of NHS England, asking him to reject the switch and instead implement a fairer formula to avoid exacerbating wide health inequalities between poorer and richer areas.


If the changes go through as the House of Commons library expects, Wigan in Lancashire would lose £31 for each one of its patients while Windsor in Berkshire would gain £106 per head. Similarly, south eastern Hampshire, where healthy life expectance is 68 years for women, would gain £164 per head. However, Sunderland, where women can expect to live free of ill-health only until they are 58, would lose £146 per local patient.


CCGs leaders in the places which would lose money are "terrified by what this would mean", added Burnham. The shift from deprivation to age was first proposed by Andrew Lansley, the health secretary until September 2012. He claimed it was needed because Britain's population was ageing fast, and older people were disproportionately heavy users of health services. "Age is the principal determinant of health need in an area", he said.

In future, the NHS's formula for allocating the £65bn of its £95.6bn budget which goes to CCGs should ensure that "wherever you are in the country, you should broadly have resources equivalent with access to NHS services."


John Mann, Labour MP for Bassetlaw, Nottinghamshire, has written to NHS England's chief executive, Sir David Nicholson, warning: "The potential impact on health services and health outcomes will be devastating. We in the north appear to be paying for an increase in spending in the south." Shifting resources from poorer to better-off parts of England "is not only unfair, it is morally wrong", he added.


An NHS England spokesman said it would not be implementing the scheme studied by the Commons library, which had been suggested by the government's Advisory Committee on the Allocation of Resources (ACRA) because "it didn't take into account some key health indicators, [and] it would have meant some areas with worse health outcomes would have received less funding, relatively, than those with better health outcomes."

He added: "It is vital that we allocate funding in a way that ensures equal access for equal need across the country and addresses health inequalities. [A year-long] review [of NHS funding] has focused on ensuring that the future funding formula takes into account key indicators to ensure equal access for equal need including age, deprivation, population size and change over time and 'unmet' health need."



BY Denis Campbell


The Guardian, 16th December 2013

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