NHS financial crisis: signs of crisis or hope?

doi:10.1136/bmj.332.7546.914-b

BMJ 2006;332:914 (15 April), doi:10.1136/bmj.332.7546.914-b

Letter

NHS financial crisis: signs of crisis or hope?

The first 150 words of the full text of this article appear below.

EDITOR—The current financial crisis in the NHS may bethe birth pangs of real reform and not a cause for panic.¹

Historically NHS trust accounts have contained little usefulinformation. They existed more to tick a statutory reportingbox than to provide useful guidance on performance or the stateof the hospital. To declare surpluses (which will be taken away)has never been good, and deficits smack of poor control. Sotrusts, primary care trusts, and strategic health authoritiesexpended great efforts to achieve the political goal of "balance"and none to reporting something relevant to management decisionmaking.

In the private sector, company accounts have a role (supplementedby private management information for managers only) in informingmanagers, investors, and governments about the real state ofthe business. Regulation and audit prevent serious manipulationby unscrupulous managers.

The current deficits may be a welcome sign that NHS . . . [Full text of this article]

Stephen Black, management consultant

London SW1 W9SR stephen.black@paconsulting.com