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Genetic tests and staff are cut to save money

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.39059.421852.DB (Published 14 December 2006) Cite this as: BMJ 2006;333:1238
  1. Andrew Cole
  1. 1London

    The UK government's plans to make genetic testing more widely available in the NHS are being thrown into reverse by financial cutbacks, a survey by its own advisory body shows.

    The Human Genetics Commission's survey of 14 of the United Kingdom's 18 regional genetics centres shows that most are being forced to make cuts, which vary from 3% to 9% of their total budget. Five have had to cut staff or leave vacancies unfilled and most anticipate the situation being worse next year.

    This has led to restrictions in the number of genetic tests as well as longer waits at a time when referrals are rapidly increasing, thanks to the extra investment introduced by the 2003 genetics white paper. The government is reviewing the impact of the white paper.

    The commission's chairwoman, Helena Kennedy, will present the findings of the survey to health minister Andy Burnham when they meet early next year.

    According to Baroness Kennedy, the cuts are threatening the long term growth of the genetics service. “At a time when services are being criticised for not quite or not always making the ambitious white paper targets (for example, in laboratory reporting times), the capacity of the service to meet these changes is being eroded,” she says.

    The cuts are hitting genetics centres disproportionately hard because they are often so small and non-staff costs so minor that the only way of making savings is to reduce staffing, says the commission. One centre says that it may need to cut salaries to meet its target.

    Other centres have had to restrict the number of tests being sent to outside laboratories or, in one case, the number of tests for breast cancer it does each month. Another has had to make a 15% cut in molecular genetics and a 5% cut in clinical genetics, with further cutbacks expected next year.

    Several centres say that although they are breaking even, they still face cuts to help the host trust deal with its debts. One claimed its trust was now spending part of the money allocated for genetic testing on other services.

    Speaking at the commission's December meeting, Frances Flinter, clinical director and consultant clinical geneticist at Guy's and St Thomas' NHS Foundation Trust, said that primary care trusts were artificially restricting the number of referrals to centres through demand management. “It's frustrating to know there are things we could and should be doing but know we're not allowed to in order to balance the books.”

    A London GP, Iona Heath, said that enormous amounts of money were being spent to try to stop patients accessing expert services. “It means the trust gets a balance this year but the cost of that in the long term hasn't begun to be estimated.

    “The problem is you're stopping people accessing the service [they] need at the very initial point. If you invest in a whole load of testing mechanisms and then stop people accessing it, you really have thrown money away.”

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