Is healthcare funding distributed fairly?

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Unfair system could see some services underfunded

A report by the National Audit Office has revealed that some local healthcare services across England have been underfunded, as the government use an unfair system to allocate £79 billion to resources.

The NAO claims that many funding decisions are being made on individual civil servants’ judgments rather than evidence, causing struggling areas to receive not enough money while wealthier commissioners are being given too much. The review identifies Corby in Northamptonshire as being the worst hit, with underfunding of £186 per person, whilst West London is the most over funded area, with each patient receiving £508 over the target amount.

The report set out to examine how money is distributed to the three different sets of commissioners – CCG’s, NHS England area teams and local authorities, which receive separate funding allocations to commission services for their local populations. Currently, Jeremy Hunt – the health secretary – dictates how much budget should be allocated to the NHS and public health. NHS England decides centrally how much should be allocated to primary care and how much to hospital, community and mental health services.

Funding differences

In 2014/15 over three-quarters of local authorities and nearly two-fifths of CCG’s are more than five percentage points above or below their fair share of funding per person. Auditors found “a clear relationship” between the financial position of clinical commissioning groups and their distance from target funding allocations.

Margaret Hodge, chair of the public accounts committee, told The Guardian “It is outrageous that 104 clinical commissioning groups received more than their fair share of the available funding in 2013/14. These bodies had a combined surplus of more than half a billion pounds at the end of the year. This is all the more ridiculous when you learn that 19 of the 20 CCG’s with the tightest financial position received less than their fair share.”

A Department of Health spokesperson said “As the NAO recognises, there is a judgment to be made about how quickly areas can be moved to their target allocations without destabilising services. NHS England has taken steps to ensure every CCG benefits from protected health spending.”