Magazine article Public Finance

Hugs Aren't Enough

Magazine article Public Finance

Hugs Aren't Enough

Article excerpt

Last week, five I ,abour MPs wrote to Health secretary Patricia Hewitt to complain. While that might not be unusual, the fact that they were criticising the financial effects of payment by results ratherthan long waiting times or nursing shortages speaks volumes for the growing concern about the initiative.

The MPs claimed that the Wrightington, Wigan and Leigh trust was being short-changed, as it did not receive extra cash for performing complicated orthopaedic procedures. Under the new national tariff, neighbouring hospitals are paid the same for straightforward operations such as hip replacements.

Although this problem ought to be sorted out as a more sophisticated system develops, there are many other opportunities for payment by results to destabilise the finances of both acute and primary care trusts.

PCTs have accused acute trusts of 'gaming' the system to get more cash. Meanwhile, trusts worry that PCTs could send their finances into a tailspin by treating more patients outside hospital. With so much at stake, disputes are inevitable.

The Department of Health wants to minimise the potential for disagreements and financial instability by implementing a code of conduct for PBR. …

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