Financial meltdown for the NHS?BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7044.1432 (Published 08 June 1996) Cite this as: BMJ 1996;312:1432
- Jennifer Dixon,
- Sean Boyle,
- Anthony Harrison
- Fellow in health policy analysis Fellow in health policy analysis Fellow in health policy analysis King's Fund Policy Institute, London W1M 0AN
Rising demand, increasing costs, and perverse incentives may all be to blame
Last month, Britain's Guardian newspaper ran two articles about financial problems in the NHS. The first reported that chief executives of NHS hospital trusts had met the secretary of state for health, Stephen Dorrell, and warned of severe financial difficulties facing trusts, including the prospect of financial “meltdown.”1 A second reported that the Department of Health had found £25 million to ease financial pressures in nine health authorities: four inner city authorities undergoing “reconfiguration” of services, three undergoing “structural change,” and two experiencing “market management changes.”2 More recently, three letters in the BMJ made headlines as consultants warned that the drive for efficiency was in danger of harming patients.3 4 5 But is this all a familiar exercise in shroud waving by doctors and managers or is there a new problem? If so what should be done about it?
The reasons for these apparent problems are complex and are likely to vary …