NHS trusts urge caution over BMA finance surveyBMJ 2005; 331 doi: http://dx.doi.org/10.1136/bmj.331.7519.716-d (Published 29 September 2005) Cite this as: BMJ 2005;331:716
The NHS Confederation, which represents NHS trusts and health authorities, has urged caution over the results of a BMA survey on NHS funding, which found that three quarters of trusts were in financial difficulty.
The survey claimed that most trusts faced funding shortfalls—but the confederation's policy director, Nigel Edwards, said the survey covered only a minority of trusts and, although not inaccurate, does not give a complete picture.
“Anecdotal evidence we have been receiving from our members suggests that the minority of NHS trusts are examining a full range of options to balance their books,” he said. “Some NHS trusts are undoubtedly having to make tough decisions because of financial pressure, although any measure which could have a direct impact on patient care, such as recruitment freezes and even redundancies, will always be a last resort.”
The BMA survey was sent to 530 medical directors, of whom only 120 responded—less than a quarter. Half of those responding were from acute trusts and a quarter were from primary care trusts.
Of those who responded 73% said their trust was facing a funding shortfall in the current financial year. They predicted shortfalls ranging from £0.2m ($0.4m; £0.3m) to £25m, and the average predicted shortfall was £6.2m.
A third of respondents reported that their trust was intending to reduce services as a result of a shortfall. This included staff redundancies, bed closures, and a freeze on recruitment.
One in seven respondents said medical staff posts would be included in recruitment freezes.
Paul Miller, chairman of the BMA's Central Consultants and Specialists Committee, wrote to the secretary of state for health, Patricia Hewitt, in August outlining his concerns at the apparent funding shortfalls in a growing number of trusts.
“There is a significant threat to patient care and innovation from the widespread freeze on consultant and other recruitment,” he warned.
Although Dr Miller had a reply from the health minister Lord Warner, he says that the government is denying the problem. He hit out at the policy of funding private providers at the expense of the NHS: “If the government persists with the introduction of a market based system for health care there must be a level playing field for all providers. It is financial madness to guarantee private providers huge volumes of work, often at a higher cost than the NHS, while NHS hospitals are deprived of essential funding and their facilities are being left idle.”
Mr Edwards said the NHS Confederation was confident that any cost cutting measures would be done in a way that safeguarded the quality of frontline care.
Where tough decisions did have to be made “they will be taken collectively by staff, including doctors and nurses,” he said.
He added that Department of Health statistics for NHS annual accounts' surplus and deficits for 2004-5 show that the NHS deficit at the end of the last financial year represented just 0.4% of its budget of £67.4bn.
The BMA was due to raise its concerns at a fringe meeting at the Labour party annual conference, in Brighton, on Tuesday, after the BMJ went to press.