Doctors' refusal to cut costs blamed for crisis

Doctors have refused to help NHS trusts cut their spending, leading to a massive cumulative deficit of more than £1bn, a committee of MPs says today.

The reluctance of the medical profession to consider the cost when proposing treatment is singled out by the Public Accounts Committee as a key reason for the poor financial performance of the NHS. The report's emphasis on the role of doctors signals rationing of care may be inevitable if the NHS is to balance its books.

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Hospital consultants control vast resources and their decisions can plunge a trust into deficit or help it claw its way back. Spending on the NHS has increased faster over the past five years than at any time in its history and is projected to rise to £92.6bn in 2007-08. But one in three NHS trusts is overspent, and some are so heavily in debt they have little hope of extricating themselves without outside help.

Of the 159 NHS organisations reporting a deficit in 2004-05, three quarters were still in deficit a year later. The committee found no single reason for the deficits, which it said were aggravated by overgenerous pay awards to GPs and consultants. Some trusts have had to cut posts - leading to 903 compulsory redundancies in the six months to September 2006 - close wards and postpone capital projects.

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