An audit report said that there were record levels of funding going into the health service in Scotland, and the National Health Service ended the 2005-06 year in surplus. But strong long-term planning was needed, as the service faced financial pressures.
Source: Overview of the Financial Performance of the NHS in Scotland 2005/06, Audit Scotland for Accounts Commission and Auditor General (0131 477 1234)
Links: Report | Audit Scotland press release
Date: 2006-Dec
A report said that although expenditure on drugs, staff, salaries, and training might have increased, the additional £6 billion per year being spent on healthcare was unlikely to transform the National Health Service.
Source: Stephen Martin, Peter Smith and Sheila Leatherman, Value for Money in the English NHS: Summary of the evidence, Health Foundation (020 7257 8000)
Links: Report | Health Foundation press release
Date: 2006-Dec
A report by a committee of MPs said that there was 'compelling evidence' of a failure of financial management within the National Health Service.
Source: NHS Deficits, First Report (Session 2006-07), HC 73, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report | NHS Alliance press release | BMA press release | Rethink press release | BBC report | Guardian report | Personnel Today report | Community Care report
Date: 2006-Dec
A report said that almost half of the £5.5 billion increase in health spending in England in 2005-06 went on higher pay for NHS staff.
Source: Public Expenditure on Health and Personal Social Services 2006: Memorandum received from the Department of Health containing replies to a written questionnaire from the Committee, HC 1692, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report
Date: 2006-Nov
A report by a committee of the National Assembly for Wales said that the National Health Service in Wales overspent by more than £30 million in 2005-06, and also had 'historic debt' totalling £82 million. The size of the debt, despite increased funding, called into question how well the service was managed.
Source: Is the NHS in Wales Managing Within its Available Financial Resources?, Audit Committee/National Assembly for Wales (029 2082 5111)
Links: Report | BBC report
Date: 2006-Nov
A think tank announced a review of healthcare spending, to be led by Derek Wanless (author of an official report in 2002 which recommended large increases in National Health Service spending). The review would consider how changes in the health of the population, demographics, productivity, staff pay, drug costs, and medical advances had influenced healthcare spending, as well as analyzing how the NHS had spent its extra resources. It would also look at progress made in health prevention strategies.
Source: Press release 19 October 2006, King s Fund (020 7307 2591)
Links: King's Fund press release | Guardian report
Date: 2006-Oct
A think-tank report examined the causes of the National Health Service deficit in 2005-06. It then considered three recent policy developments the 2006-07 system rules (operating framework); the new payment by results tariffs; and the commissioning framework and asked what the impact of these policy developments could be, and how they might be improved.
Source: Keith Palmer, National Health Service Reform: Getting back on track, King s Fund (020 7307 2591)
Links: Report
Date: 2006-Oct
The National Health Service recorded a financial deficit in 2005-06 of £547 million. This was higher than the £512 million which NHS trusts initially reported in June 2006, and well above the government's target of £200 million.
Source: House of Commons Hansard, Written Ministerial Statement 9 October 2006, columns 4-5WS, TSO (0870 600 5522)
Links: Hansard | Guardian report
Date: 2006-Oct
A report (commissioned by a private health insurance company) said that after 2008 the National Health Service faced the possibility of a significant and increasing funding deficit. It examined possible ways of bringing more funds into the healthcare system in general, and of improving the long-term financial stability of the NHS. Either a boost in private spending on health or new NHS charges would be needed if healthcare quality were not to decline after 2008.
Source: Edward Bramley-Harker and Tim Booer with Michael Ridge and Matthew, Mind the Gap: Sustaining improvements in the NHS beyond 2008, BUPA (020 7656 2491)
Links: Report | Summary | FT report
Date: 2006-Oct
A report said that more than a third of National Health Service trusts in financial deficit had withdrawn funding from services jointly agreed or funded with social care services in England. Two-fifths of social services departments were being forced to deal with increased referrals of cases that appeared to be the responsibility of the NHS.
Source: Social Care Finance Survey June 2006: The impact of NHS trust financial deficits on English local authorities, Local Government Association (020 7664 3000)
Links: Report | LGA press release | Community Care report | BBC report
Date: 2006-Jul
An audit report said that a minority of National Health Service trusts had been unfairly penalized by an accounting system which meant a deficit was effectively counted twice. Millions of pounds should be handed back to some of the trusts with the worst debts, as part of an overhaul of NHS accounting.
Source: Review of the NHS Financial Management and Accounting Regime, Audit Commission (0800 502030)
Links: Report | Audit Commission press release | BBC report | Guardian report
Date: 2006-Jul
A survey found that more than half of England's mental health trusts had seen money diverted away from them to pay for deficits in other local health services.
Source: Under Pressure: The finances of mental health trusts in 2006, Sainsbury Centre for Mental Health (020 7827 8300)
Links: Report | SCMH press release | Mind press release | Alzheimer's Society press release | BBC report
Date: 2006-Jul
The report was published of an independent review (led by John Lawlor) of the 'tariff' setting process in 2006-07 under the new payment by results system for acute and foundation National Health Service trusts. In response the government published an action plan showing how it would respond to the report's recommendations.
Source: Report on the Tariff Setting Process for 2006/07, Department of Health (08701 555455)
Links: Report | Preface | Action plan | DH press release | BMA press release | BBC report
Date: 2006-Jul
A paper examined the administrative costs of the new payment by results system in the National Health Service, and the reasons for the increases seen in both hospital trusts and primary care trusts.
Source: Giorgia Marini and Andrew Street, The Administrative Costs of Payment by Results, Research Paper 17, Centre for Health Economics/University of York (01904 433648)
Links: Paper
Date: 2006-Jul
An audit report said that ineffective management or inadequate board-level leadership, and sometimes both, had caused the serious financial problems seen in a small number of National Health Service bodies.
Source: Learning the Lessons from Financial Failure in the NHS, Audit Commission (0800 502030)
Links: Report | Audit Commission press release | NHS Alliance press release | BBC report
Date: 2006-Jul
An audit report said that there was a deficit across the National Health Service in England as a whole in 2004-05 for the first time since 1999-2000. The overspend for 2004-05 was ?251 million, compared to an underspend of ?65 million in 2003-04. Unaudited figures suggested that the year-end deficit for 2005-06 was in the region of ?536 million: more than two-thirds of this sum was accounted for by about one-tenth of all National Health Service organizations.
Source: Financial Management in the NHS: NHS (England) Summarised Accounts 2004-05, HC 1092 (Session 2005-06), National Audit Office and Audit Commission, TSO (0870 600 5522)
Links: Report | NAO press release | DH press release | Hansard | Kings Fund press release | Kings Fund briefing | LGA press release | FT report | BBC report | Guardian report
Date: 2006-Jun
A new book said that the steady transformation of the National Health Service into a management agency commissioning care through competing contractors had caused a higher percentage of total spending on healthcare to be absorbed by administration, transactions, legal support, and profit for contractors. In the pre- reform National Health Service these amounted to less than 6 per cent: but the figure had increased to 12 per cent by 2004, and more recently to nearly 20 per cent.
Source: Julian Tudor Hart, The Political Economy of Health Care: A clinical perspective, Policy Press, available from Marston Book Services (01235 465500)
Links: Summary | Bristol University press release
Date: 2006-Apr
An audit report said that the National Health Service in Wales was facing mounting financial problems, despite improvements in financial controls.
Source: Is the National Health Service in Wales Managing within its Available Financial Resources?, Wales Audit Office (029 2026 0260)
Links: Report | WAO press release | NHS Wales press release | BMA press release | BBC report
Date: 2006-Apr
A think-tank briefing said that in the financial year 2005-06 the National Health Service was likely to record a substantial overspend - in gross terms, around 900 million. The causes of the deficit were complex, and solutions were likely to take time to take effect.
Source: Deficits in the NHS, King s Fund (020 7307 2591)
Links: Briefing | Kings Fund press release | Guardian report
Date: 2006-Apr
The foundation trusts regulator expressed concern that cash shortages could result in National Health Service primary care trusts failing to honour their contracts.
Source: National Health Service Foundation Trusts: Nine-month Report for period 1 April 2005 to 31 December 2005, Monitor (020 7340 2400)
Links: Report | Monitor press release
Date: 2006-Mar
The Chief Executive of the National Health Service (and Permanent Secretary at the Department of Health) announced that he would be retiring early. He said: "not everything has gone well. I am particularly saddened by the difficulties we have had over the last few months and the financial problems we are grappling with".
Source: Press release 7 March 2006, Department of Health (020 7210 4850)
Links: DH press release | Guardian report
Date: 2006-Mar
An audit report was published on the accounts of the National Health Service in Wales for 2003-04.
Source: The Finances of NHS Wales 2005, Wales Audit Office (029 2026 0260)
Links: Report
Date: 2006-Mar
A think-tank report said that the government needed to be clear about the value of the benefits expected from spending on the health service before it committed itself to future investment.
Source: John Appleby and Anthony Harrison, Spending on Healthcare: How much is enough?, King s Fund (020 7307 2591)
Links: Report | King's Fund press release
Date: 2006-Feb
The new Conservative-Liberal Democrat coalition government published a previously confidential consultancy report (produced in March 2009) that set out ways in which the National Health Service in England could cut spending by £13-20 billion over a five-year period.
Source: McKinsey, Achieving World Class Productivity in the NHS 2009/10-2013/14: Detailing the size of the opportunity, Department of Health
Links: Report | DH press release
Date: 2006-Jan
A think-tank report said that the National Health Service funding formula gave some trusts twice as much money per head as others: it was constructed by dubious statistical methods from data that had no direct connection to medical need, and bore little, if any, relationship to that need.
Source: Mervyn Stone, Eye of Newt and Toe of Frog: A Good Formula for Health?, Civitas (020 7401 5470)
Links: Report | Civitas press release
Date: 2006-Jan
An article examined the hospital and community health service component of the formula for funding of England's 304 primary care trusts. It concluded that it might be better to put future resources into developing direct, rather than proxy, measurements of health needs.
Source: Mervyn Stone and Jane Galbraith, 'How not to fund hospital and community health services in England', Journal of the Royal Statistical Society: Series A, Volume 169 Issue 1
Links: Abstract
Date: 2006-Jan
The government said that although the National Health Service as a whole had been in broad financial balance, at local level a minority of organizations had been overspending. As a result of this assessment, 18 organizations would get immediate turnaround support to help them tackle financial problems.
Source: Press release 25 January 2006, Department of Health (020 7210 4850) | Financial Turnaround in the NHS, Department of Health (08701 555455)
Links: DH press release | Report | Guardian report
Date: 2006-Jan
The opposition Conservative Party said that it would reduce the level of National Health Service 'bureaucracy' by one-third from £4.5 billion to £3 billion a year by 2013-14. 'Substantial sums of money' could be saved by devolving decision-making closer to patients.
Source: Speech by Andrew Lansley MP (Shadow Secretary of State for Health), 5 October 2009
Links: Text of speech | Conservative Party press release | Telegraph report | Pulse report
Date: 2006-Jan
