Controversial plans to change the way NHS spends its £100bn budget being considered


Senior health service managers are considering controversial plans to change the way the NHS spends its £100bn annual budget across different parts of England.

Click HERE to view graphic

The move would result in vast amounts of NHS money being shifted from some of the poorer parts of England, with young populations, to richer areas with older populations.

Currently the poorest areas of the country receive significantly more money per head of population than richer areas as part of efforts to reduce long-term health inequalities.

But under the new plan, supported by Health Secretary Andrew Lansley, NHS managers are considering changing the formula so that the age of the local population rather than deprivation would be the main factor in determining funding.

Critics say the shift is being backed by the Government because the areas which would benefit are primarily Conservative strongholds while those which would lose out vote Labour.

However, senior health economists argue that deprivation is a poor indicator of the health needs of an area and that Britain’s growing elderly population makes it imperative to rethink the health funding formula.

Currently NHS funding is weighted by looking at a range of factors including age, a range of deprivation indicators and the standardised mortality rate – the number of deaths each year by age above or below what might be expected nationally.

Thus Tower Hamlets – one of the most deprived areas of the country – has an NHS spend per head of £2,084, while Dorset,  with a large number of elderly residents, has a spend per head of £1,560.

This reflects the amount of money local health authorities have available to spend on their patients. Last year Dorset spent £4,075 on each of its cancer patients compared to Tower Hamlet which spent £13,087.

Answering questions from health professionals recently, Mr Lansley suggested it was time to change the formula to reflect the higher burden on the NHS of elderly populations with bigger health needs.

“Wherever you are in the country you should broadly have resources equivalent with access to NHS services,” he said.

“They (commissioners) should be looking at what it is that is likely to give rise to a demand for NHS services. What is likely to make the biggest difference? Actually it’s elderly populations who are not in substantial deprivation.”

But his comments have outraged the Labour Party and a number of health economists who argue the new policy will result in a massive redistribution of NHS “wealth” from the poorest parts of England to the richest.

Clare Bambra, Professor of public health policy and acting director of the Wolfson Research Institute at Durham University, said focusing on age and severing the current link with deprivation and health needs would shift funding 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”.

In a letter to the British Medical Journal, which included a chart showing her projections for which areas of the country would lose out, she added: “It means more money for areas voting Conservative and less for those voting Labour.”

Critics also point out that areas with large elderly populations may be that way because they have better standards of living in the first place.

Labour’s Shadow Health Secretary, Andy Burnham, said age must not be a dominant factor in determining health spending. “Proceeding with a system of that kind would siphon resources out of the areas where life expectancy is shortest and the health challenges greatest. It would be immoral and indefensible.”

But Sheena Asthana, Professor of Health Policy at the University of Plymouth, described the current system of allocating money to different parts of the NHS as a “mess” which was unfair on those people who needed the service most.

“What we know is that current health funding formula does not give sufficient weight to the age of the population and the demands they put on local NHS services,” she said. “It has been mess for many years and it is not a party political point to say that it needs to be reformed.”

A Department of Health spokesman said: “We are making sure that funding is given to areas that need it most. The Secretary of State has asked an independent body of experts for advice on how best to achieve this. No decisions have been made.”

Alexis Sanchez has completed a £35m move to Arsenal, the club have confirmed
sportGunners complete £35m signing of Barcelona forward
Poor teachers should be fearful of not getting pay rises or losing their job if they fail to perform, Steve Fairclough, headteacher of Abbotsholme School, suggested
voicesChris Sloggett explains why it has become an impossible career path
world cup 2014
Popes current and former won't be watching the football together
Life and Style
ebookA wonderful selection of salads, starters and mains featuring venison, grouse and other game
Wayne’s estate faces a claim for alleged copyright breaches
newsJohn Wayne's heirs duke it out with university over use of the late film star's nickname
Arts and Entertainment
Celebrated children’s author Allan Ahlberg, best known for Each Peach Pear Plum
peopleIndian actress known as the 'Grand Old Lady of Bollywood' was 102
Mick Jagger performing at Glastonbury
Germany's Andre Greipel crosses the finish line to win the sixth stage of the Tour de France cycling race over 194 kilometers (120.5 miles) with start in Arras and finish in Reims, France
tour de franceGerman champion achieves sixth Tour stage win in Reims
Life and Style
beautyBelgian fan lands L'Oreal campaign after being spotted at World Cup
Arts and Entertainment
Chocolat author Joanne Harris has spoken about the financial struggles most authors face
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Business Analyst Consultant (Financial Services)

    £60000 - £75000 per annum: Harrington Starr: Business Analyst Consultant (Fina...

    Systems Administrator - Linux / Unix / Windows / TCP/IP / SAN

    £60000 per annum: Harrington Starr: A leading provider in investment managemen...

    AVS, JVS Openlink Endur Developer

    £600 - £700 per day: Harrington Starr: AVS, JVS Openlink Endur Developer JVS, ...

    E-Commerce Developer

    £45000 - £60000 per annum + competitive: Progressive Recruitment: Exciting opp...

    Day In a Page

    A History of the First World War in 100 Moments: Peace without magnanimity - the summit in a railway siding that ended the fighting

    A History of the First World War in 100 Moments

    Peace without magnanimity - the summit in a railway siding that ended the fighting
    Scottish independence: How the Commonwealth Games could swing the vote

    Scottish independence: How the Commonwealth Games could swing the vote

    In the final part of our series, Chris Green arrives in Glasgow - a host city struggling to keep the politics out of its celebration of sport
    Out in the cold: A writer spends a night on the streets and hears the stories of the homeless

    A writer spends a night on the streets

    Rough sleepers - the homeless, the destitute and the drunk - exist in every city. Will Nicoll meets those whose luck has run out
    Striking new stations, high-speed links and (whisper it) better services - the UK's railways are entering a new golden age

    UK's railways are entering a new golden age

    New stations are opening across the country and our railways appear to be entering an era not seen in Britain since the early 1950s
    10 best women's sunglasses

    In the shade: 10 best women's sunglasses

    From luxury bespoke eyewear to fun festival sunnies, we round up the shades to be seen in this summer
    Siobhan-Marie O’Connor: Swimmer knows she needs Glasgow joy on road to Rio

    Siobhan-Marie O’Connor: Swimmer knows she needs Glasgow joy on road to Rio

    18-year-old says this month’s Commonwealth Games are a key staging post in her career before time slips away
    The true Gaza back-story that the Israelis aren’t telling this week

    The true Gaza back-story that the Israelis aren’t telling this week

    A future Palestine state will have no borders and be an enclave within Israel, surrounded on all sides by Israeli-held territory, says Robert Fisk
    A History of the First World War in 100 Moments: The German people demand an end to the fighting

    A History of the First World War in 100 Moments

    The German people demand an end to the fighting
    New play by Oscar Wilde's grandson reveals what the Irish wit said at his trials

    New play reveals what Oscar Wilde said at trials

    For a century, what Wilde actually said at his trials was a mystery. But the recent discovery of shorthand notes changed that. Now his grandson Merlin Holland has turned them into a play
    Can scientists save the world's sea life from

    Can scientists save our sea life?

    By the end of the century, the only living things left in our oceans could be plankton and jellyfish. Alex Renton meets the scientists who are trying to turn the tide
    Richard III, Trafalgar Studios, review: Martin Freeman gives highly intelligent performance

    Richard III review

    Martin Freeman’s psychotic monarch is big on mockery but wanting in malice
    Hollywood targets Asian audiences as US films enjoy record-breaking run at Chinese box office

    Hollywood targets Asian audiences

    The world's second biggest movie market is fast becoming the Hollywood studios' most crucial
    Grindr founder Joel Simkhai: 'I've found love on my dating app - and my mum keeps trying to hook me up!'

    Grindr founder Joel Simkhai: 'I've found love on my dating app'

    Five years on from its launch and Grindr is the world's most popular dating app for gay men. Its founder Joel Simkhai answers his critics, describes his isolation as a child
    Autocorrect has its uses but it can go rogue with embarrassing results - so is it time to ditch it?

    Is it time to ditch autocorrect?

    Matthew J X Malady persuaded friends to message manually instead, but failed to factor in fat fingers and drunk texting