Managers accuse ministers of spin over money for NHSBMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7240.960 (Published 08 April 2000) Cite this as: BMJ 2000;320:960
The health secretary's announcement last week that he was going to use his powers of direction to ensure that £600m ($960m) of new NHS money went to front line services has angered representatives of health authorities.
Alan Milburn told the House of Commons last week that £600m of the extra £2bn which the chancellor of the exchequer announced in the budget for the next financial year (1 April, p 889) would “put local hospital and GP services on to a sound financial footing.” The health secretary said that the money had to be spent on real services: “That is why I am using my powers of direction to make sure these new resources go straight to the family doctors and community nurses who run [primary care groups]. They will then be able to make most of it available to hospitals and NHS trusts.” The Department of Health later clarified that the money would go to health authorities in the usual way with a statutory instruction to pass it on for specific purposes. The chief executive of the NHS Confederation, Stephen Thornton, said that the powers were always implicit in spending allocations, and he accused the government of putting a damaging spin on the announcement. Mr Thornton said that the government needed to be careful not to undermine its plans for the NHS by using misleading spin about bypassing bureaucracy. Mr Milburn said that he wanted the money to be used for a variety of purposes. He wanted intermediate care services to beset up to bridge the gap between hospital care and home for elderly people and he wanted waiting times and waiting lists to be reduced. He also wanted to see the recommendations of the National Institute for Clinical Excellence put into effect to prevent the lottery of care whereby patients in one authority receive a treatment denied to those in another authority. An additional £60m will be made available to reward good performance. This will be given in quarterly tranches of £15m to trusts and primary care groups that meet local targets. They will have to produce an action plan setting out how they will meet the targets. Trusts and primary care groups that fail to meet their targets will receive support from the NHS Executive's regional office. Mr Milburn wants the regional director to report weekly to the chief executive of the NHS on progress in resolving problem areas.