Government plans to allocate NHS resources by age only would disproportionately benefit areas of England that are the most healthy, most affluent, and most likely to vote Conservative, argues a senior researcher in a letter to this week’s BMJ.
In a speech last month, health secretary Andrew Lansley promised that when the new clinical commissioning groups are up and running, areas with lots of old people will no longer be penalised by the way the NHS allocates resources.
At present, funds are allocated to primary care trusts by a complex formula that takes account of age, deprivation, health need, and the local cost of providing care.
Clare Bambra, Professor of Public Health Policy and Acting Director of the Wolfson Research Institute at Durham University warns that focusing only on age and severing the link with deprivation and health need “will lead to a considerable shift of healthcare funding away from the neediest, poorer areas of the north and the inner cities towards the least needy, most affluent, and most elderly areas of the south.”
It also means more money for areas voting Conservative and less for those voting Labour, she adds.
She examined the impact of age only allocation by recalculating the 2011-2 NHS resource allocation by English strategic health authorities and found that, if an age only allocation approach had been taken, there would have been a 14.9% and 12.0% loss of resource in the poorer north east and north west regions (£265 and £209 per head).
The regional winners would have been the more affluent south east coast and south central areas, with increases of 12.6% and 15.8% (£188 and £220 per head), she shows.
She concludes: “These data suggest that age only NHS resource allocation, which ignores the important link between deprivation and health, would disproportionately benefit areas of England that are the most healthy, most affluent, and most likely to vote Conservative.”
Clare Bambra, Professor of public health policy, Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton on Tees, UK