NHS hospitals told to delay operations to ease Labour's debt underfunding
The New Year has only just begun but it is clear that the next three months are not a good time to become ill as the NHS can not cope with Labour's underfunding of the health services as patients in some parts of the National Health Service are for the first time facing minimum waits to be seen and treated as managers attempt to balance their books. Suffolk, Hertfordshire, North Yorkshire and Kingston are all imposing various forms of minimum wait, with some primary care trust chiefs saying their organisations may follow suit as the NHS battles to recover from last year's £536m plus overspend.
Hospitals treating patients from north, east and west Hertfordshire have been told not to book them in for non-urgent operations until the start of the new financial year in April. Similar restrictions will apply to new outpatient appointments from the end of January.
Patients in Suffolk are having to wait a minimum of 14 weeks for routine surgery and York NHS Trust has been told by its local primary care trust not to operate on non-urgent cases until they have waited a minimum of 20 weeks - six weeks short of the government's guarantee that patients will not wait more than six months for an operation.
Kingston primary care trust is operating a standard 10-week wait for outpatient appointments - three weeks short of the13-week maximum wait.
Michael Dixon, chairman of the NHS Alliance, which represents primary care trusts, said: "This is a direct effect of payment by results. In the old days of cost and volume contracts it wasn't an issue because hospitals didn't get paid any more if they treated more patients than planned."
Now that they are paid for each patient they treat, "if a hospital brings its waiting list down rapidly it will do an awful lot of extra work and blow the primary care trusts' budget", he said.
A spokesman for the Hertfordshire PCTs said it had only enough funding "to treat patients in line with national targets". It was, it said, "crucial that referrals are managed to ensure we achieve our financial plan".
The Tories said patients were having their treatment artificially delayed because trusts were under orders from Patricia Hewitt, the Health Secretary, to ensure that they break even.
The instructions to delay treatment for as long as possible are made in two separate letters sent by health managers in the East of England, which has the worst performance in the NHS.
The first letter was sent by the East of England's strategic health authority to the chief executives of the region's primary care trusts, which run GP clinics and pay hospitals if a patient needs treatment.
The letter, written in November by Dr Paul Watson, the strategic health authority's director of commissioning, underlined the pressing need to get a grip on budgets.
"The current end of year projections for PCTs are simply unacceptable," he said, before going on to set out his plans to ensure hospital operations were "restricted to the minimum required to meet required access targets.
"PCTs should ensure that elective activity is limited to patients on the 20-week [patient targeting list] and clinically urgent cases only."
There is a similar message in a separate letter sent to the Queen Elizabeth Hospital in King's Lynn by Hilary Daniels, the chief executive of the Norfolk primary care trust.
In her letter, she said her PCT was having to impose limits on the number of patients it could pay to be treated at the hospital in the final few months of the financial year.
"We have previously indicated that we expect you not to treat earlier than 17 weeks from 1 December. We expect that by 1 February this wait will have risen to not less than 18 weeks," she wrote. "Please can you quantify how many cases can be deferred into 2007/08 by not operating on patients where treatments can be deferred into the new financial year without breaching 20 weeks on this basis."
The delays were condemned last night by Andrew Lansley, the shadow health secretary, who was sent the leaked documents anonymously.
"These patients are being deliberately obstructed in accessing the treatment they need, despite hospitals having paid for the staff who can treat them," he said.
"There is no point in paying these NHS staff to do nothing in the last quarter of the financial year solely because Patricia Hewitt has put her own job on the line by promising to get the NHS back into the black by April. Even the Department of Health must realise this is false economy."
No one from the East of England strategic health authority or the Norfolk primary care trust could be contacted for comment yesterday.
Reproduced from:
http://www.ft.com/cms/s/d62fca08-9a05-11db-8b6d-0000779e2340.html
http://www.telegraph.co.uk/news/main.jhtml;jsessionid=VIGNMCTEKE2KPQFIQMFSFFWAVCBQ0IV0?xml=/news/2007/01/02/nhospital02.xml
Hospitals treating patients from north, east and west Hertfordshire have been told not to book them in for non-urgent operations until the start of the new financial year in April. Similar restrictions will apply to new outpatient appointments from the end of January.
Patients in Suffolk are having to wait a minimum of 14 weeks for routine surgery and York NHS Trust has been told by its local primary care trust not to operate on non-urgent cases until they have waited a minimum of 20 weeks - six weeks short of the government's guarantee that patients will not wait more than six months for an operation.
Kingston primary care trust is operating a standard 10-week wait for outpatient appointments - three weeks short of the13-week maximum wait.
Michael Dixon, chairman of the NHS Alliance, which represents primary care trusts, said: "This is a direct effect of payment by results. In the old days of cost and volume contracts it wasn't an issue because hospitals didn't get paid any more if they treated more patients than planned."
Now that they are paid for each patient they treat, "if a hospital brings its waiting list down rapidly it will do an awful lot of extra work and blow the primary care trusts' budget", he said.
A spokesman for the Hertfordshire PCTs said it had only enough funding "to treat patients in line with national targets". It was, it said, "crucial that referrals are managed to ensure we achieve our financial plan".
The Tories said patients were having their treatment artificially delayed because trusts were under orders from Patricia Hewitt, the Health Secretary, to ensure that they break even.
The instructions to delay treatment for as long as possible are made in two separate letters sent by health managers in the East of England, which has the worst performance in the NHS.
The first letter was sent by the East of England's strategic health authority to the chief executives of the region's primary care trusts, which run GP clinics and pay hospitals if a patient needs treatment.
The letter, written in November by Dr Paul Watson, the strategic health authority's director of commissioning, underlined the pressing need to get a grip on budgets.
"The current end of year projections for PCTs are simply unacceptable," he said, before going on to set out his plans to ensure hospital operations were "restricted to the minimum required to meet required access targets.
"PCTs should ensure that elective activity is limited to patients on the 20-week [patient targeting list] and clinically urgent cases only."
There is a similar message in a separate letter sent to the Queen Elizabeth Hospital in King's Lynn by Hilary Daniels, the chief executive of the Norfolk primary care trust.
In her letter, she said her PCT was having to impose limits on the number of patients it could pay to be treated at the hospital in the final few months of the financial year.
"We have previously indicated that we expect you not to treat earlier than 17 weeks from 1 December. We expect that by 1 February this wait will have risen to not less than 18 weeks," she wrote. "Please can you quantify how many cases can be deferred into 2007/08 by not operating on patients where treatments can be deferred into the new financial year without breaching 20 weeks on this basis."
The delays were condemned last night by Andrew Lansley, the shadow health secretary, who was sent the leaked documents anonymously.
"These patients are being deliberately obstructed in accessing the treatment they need, despite hospitals having paid for the staff who can treat them," he said.
"There is no point in paying these NHS staff to do nothing in the last quarter of the financial year solely because Patricia Hewitt has put her own job on the line by promising to get the NHS back into the black by April. Even the Department of Health must realise this is false economy."
No one from the East of England strategic health authority or the Norfolk primary care trust could be contacted for comment yesterday.
Reproduced from:
http://www.ft.com/cms/s/d62fca08-9a05-11db-8b6d-0000779e2340.html
http://www.telegraph.co.uk/news/main.jhtml;jsessionid=VIGNMCTEKE2KPQFIQMFSFFWAVCBQ0IV0?xml=/news/2007/01/02/nhospital02.xml
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