Intended for healthcare professionals


Turning around NHS deficits

BMJ 2006; 332 doi: (Published 19 January 2006) Cite this as: BMJ 2006;332:131
  1. Chris Ham, professor of health policy and management (
  1. Health Services Management Centre, University of Birmingham, Birmingham B15 2RT

    It will be hard for the private sector to succeed where the NHS has failed

    When the department of health's director of finance invokes Rudyard Kipling to urge NHS directors of finance to “keep your head when all about you are losing theirs and blaming it on you” (Richard Douglas, speech to the Healthcare Financial Management Association, December 2005) it is a sure sign that the NHS is in trouble. With the NHS in England overspending by £250m in the last financial year and projected to be in deficit by around £650m in this, finance directors have taken much of the blame for the deterioration in NHS budgets. Ministers and civil servants have also been criticised for failing to cost properly the new contracts for NHS staff. The problems of the NHS mirror those confronting British schools three years ago, when extra funding led to deficits because the impact of pay awards for teachers had not been fully allowed for.

    For the public and patients the failure of the NHS to achieve a balanced budget in the …

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