Tough times ahead for NHS despite record investment

British Prime Minister Tony Blair yesterday met with the chief executives of sixteen Primary Care Trusts to discuss the financial crisis dogging the National Health Service (NHS).

The health service bosses discussed their experience of financial worries and how they had managed to resolve the problems, while others are still struggling with them.

Blair said despite record investments, the NHS faces a difficult and challenging year.

He says the meeting was to make sure that all the extra investment is being used properly in order to get the best benefit for the patient.

The attempts by the government to reform the National Health Service to make it more efficient have seen increased investment, but nevertheless a 623 million pounds deficit is expected to be reported.

According to reports as many as 7,000 job cuts have been announced across the service in recent weeks but the Department of Health says many of the job losses affected temporary or agency staff and reflected "natural wastage".

The meeting was to some extent an acknowledgement of the upheaval and anxiety being experienced by many organisations in the health service.

It appears three principles are proving to be increasingly important for good financial management in the health service - cutting hospital stays by treating patients with day surgery where possible - cutting back on temporary staff and taking a firm line with sickness and absence - and the way that hospitals purchase drugs and equipment.

In the meeting Blair and Secretary of Health Patricia Hewitt met the health bosses to discuss the service and the Prime Minister says although a year of challenge and difficulty lies ahead massive improvements are happening.

The health service bosses discussed their experience of financial worries and how they had managed to resolve the problems.

Blair says waiting lists are falling, cancer and cardiac care is improving, admissions are improving, and a huge hospital building programme is taking place.

Critics have said the money has been poorly spent on middle managers rather than frontline medical staff and query why so many hospitals are cutting jobs and delaying non-emergency treatment because of cash shortages when the government has been pumping record amounts of money into the service.

Early in the year Hewitt promised teams of financial specialists would resolve problems facing health trusts with the greatest financial risks.

Hewitt remains confident the financial problems can be solved.

The meeting coincided with a report by the Reform think tank which has said government changes to the NHS could lead to 100,000 job losses but would result in a more efficient system.

Leaner times clearly lie ahead financially and big hospitals could particularly feel the pinch with the government's aim to move more treatment outside hospitals.

It is clear that NHS managers should not expect any handouts if they run into trouble.

Any plans to close or slim down hospitals are politically difficult and always meet with opposition as was seen recently when hundreds of angry doctors protested about uncertainty over plans to redevelop the Royal London and Bart's hospitals in East London. The plans were later given the green light.

Hewitt has announced the go-ahead for two more redevelopment schemes in Birmingham and St Helens, under the Private Finance Initiative.