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Hospitals take short term measures to meet targets
BMJ 2003; 326: 1054 [Full text]
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[Read Rapid Response] Bristol - the penalty for success
Nigel Dudley   (16 May 2003)

Bristol - the penalty for success 16 May 2003
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Nigel Dudley,
Consultant in Elderly Medicine
St James's University Hospital, LEEDS. LS9 7TF

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Re: Bristol - the penalty for success

There is also a penalty to be paid for successfully delivering Department of Health targets as evidenced by the £44 million financial blackhole that has opened up in North Bristol.[1] The Trust's 2001/02 annual report indicated the trust overspending by £4.1 million to buy treatment in the private health care sector to ensure no patient waited longer than 15 months. The trust financial papers in September 2002 indicated that holding targets at 15 months would cost between £3 to £5 million and to achieve a 12 month target would cost an additional £5 to 7 million - £8 to 12 million in total. Even as far back as April 2002 the board minutes show that the finance director was concerned about the apparent loss of financial control. The external auditor PricewaterhouseCoopers signed off its opinion for 2001/02 on trust finances and internal financial control on 6 September 2002.

Targets that the Department of Health have felt to be important may have been successfully delivered but at what cost to the overall health services around Bristol and in the Avon, Gloucestershire and Wiltshire SHA area? Surely this financial blackhole could have been avoided with proper executive leadership in relation to internal financial control measures and notice being taken of mounting nursing cost deficits and unfunded activity warnings? Hopefully the Avon, Gloucestershire and Wiltshire report on this matter will be placed in the public domain in the spirit of open and transparent government and management of health services so that the public and those who work locally in the NHS can learn why financial control systems failed.

[1] Mark Gould. Bristol deficit chair opts to go. Health Serv J 2003;113(5855):10-11

Competing interests:   None declared