Update: The new NHS Commissioning Board announced this week it was proceeding with scrapping the existing formula from next April – by adopting a flat rate increase for funding this year. It also announced it will ” conduct an urgent fundamental review of the approach to allocations, drawing on the expert advice of ACRA and involving all partners whose functions impact on outcomes and inequalities.” This will come into force in 2014-15.
In fact this will mean a redistribution to areas with large numbers of elderly people at the expense of poorer areas like the North East of England, Central Manchester and Salford and the London borough of Tower Hamlets. All this will be in place for the run up to the next general election.
Fresh from creating chaos as part of his so-called NHS ” reforms” Andrew Lansley has let slip another dastardly plan to cope with the genuine burgeoning costs of a growing elderly population.
Basically it’s very simple: Take away the NHS cash from the poorest parts of England and give to the relatively affluent seaside resorts and the suburbs.
I am indebted to hawk-eyed reporter David Williamson at the Health Services Journal ( behind a pay wall at http://bit.ly/K7dceG ) for spotting a virtually unreported speech in London during the Parliamentary recess to new commissioning bodies who will be spending the NHS cash from next year.
He told them they “should be looking at what is in… population data that is likely to give rise to a demand for NHS services”.
“What is likely to make the biggest difference, therefore? Actually it’s elderly population, who were not in substantial deprivation”.
He added :“Some of the lowest spending on stroke and cancer services were in areas with high elderly populations such as Fylde and Eastbourne, places where there were quite a lot of older people who weren’t poor”.
What Lansley is proposing – and the Department of Health is helpfully not making his speech available on its website is seismic in NHS terms. Ever since Clement Attlee set up the NHS, its main aim has been to improve the life chances of the poor most of them die long before affluent and middle classes.
The Royal College of Nursing in the North East and Newcastle MP former Labour minister, Nick Brown, have spotted exactly what it means.
As Glen Turp, regional director of the RCN put it: “It is well-known that in areas of social disadvantage, local populations experience higher incidents of heart disease, cancer, emphysema, diabetes, as well as a range of other diseases caused in part by our industrial history and the work that our communities undertook. Health outcomes are directly linked to poverty and inequality, and to use age as the measure rather than inequality is simply the wrong thing to do. “
To ram home his point: “The shocking truth is that if you live in Chelsea and Westminster in London, a man can expect to live to 86 years of age. However, in Hendon, in Sunderland, male life expectancy is only 69. That’s a 17 year difference. It’s nothing short of obscene, and frankly that is what the NHS funding formula should be all about.”
For those interested in more details Tom Gorman has tweeted me a map – showing some of the changes – the link is http://goo.gl/dyuGe .
Lansley plans to be even nastier in the way he plans to implement it. He intends to deny the government is doing it by tipping the wink to a quango - the Advisory Committee on Resource Allocation which recommends how NHS budgets should be split up.
At the Conference, Lansley gave the game away: “The advisory committee will do this, I won’t— the number crunching should get progressively to a greater focus on what the actual determinants of health need” and that “Age is the principal determinant of health need”.
But there is also a cynical political side to this. By withdrawing money from poor areas, he can halt the trend of living longer among mainly Labour voters, save the pension bill by ensuring that if they die off at 69 or even younger, they will in future not even need to receive a state pension.
But in the sunlight uplands of mainly Tory areas, the cuts that will inevitably come will be blunted or services improved in time for the 2015 election. And it won’t cost him an extra penny, all the money will be taken from Labour areas.
The formula is almost a Tory right winger’s wet dream. Ed Miliband’s supporters dying off as they wait for operations in Labour seats, and the prospect of Tory and Liberal Democrat voters living longer and longer in Chelsea, Bournemouth, Eastbourne and Torquay.
Perhaps Mr Lansley should be told what we think of this. His emails are: firstname.lastname@example.org and email@example.com. If that fails perhaps the faceless people who sit on this quango, the Advisory Committee on Resource Allocation, should be contacted. Interestingly, the Department of Health, has not updated their membership since 2008 and archived the list. Perhaps Mr Lansley doesn’t want us to know.
After all , should Mr Lansley be allowed to get away with literally killing off the opposition.