GPs to get more cash but nothing for trusts

Family doctors will be allocated an extra pounds 100m today for their budgets for next year to expand the range of services they can offer their patients, including small operations, but there will be no help from the Government for hospital trusts struggling to get out of the red.

The money is being allocated to general practitioners in the run-up to the election as part of the drive to develop "cottage hospitals" in GPs' surgeries.

A White Paper setting proposals for expanding GP services to patients will be published next month by Stephen Dorrell.

It will include a wider role for nurses in GP practices to take over some of the prescribing from family doctors. It precedes the Primary Care Bill enabling GPs to run pilot schemes in 1998 for new services.

The Health Secretary today also will allocate the extra pounds 800 million for the health service announced in the Budget. But he will rule out any emergency injection of cash to get hospitals out of the red this winter.

Hospital trusts are being told to use accounting "flexibility" to make ends meet before the additional money for the health service becomes available in the next financial year in April 1997.

The refusal of ministers to bow to Labour's demands for extra spending this year will leave the NHS trusts threatened with going into the red, in spite of a statutory duty to break even at the end of the financial year.

Labour sources claimed last night that hospital trusts were unofficially being told to delay paying their bills in order to meet their costs. "Regional offices of the NHS have told the trusts to break the 30-day rule on paying their bills. There is nothing written down, because it would be a scandal," said a Labour source.

Ministers privately denied the allegations, insisting that the hospitals will be expected to pay their bills on time. "They will be expected to ask their creditors to pay up more quickly," said one ministerial source.

But ministers tacitly accept that the hospitals will be allowed some accounting flexibility to get through the winter. The Government has denied there is a crisis facing the NHS this winter but officials fear that more routine operations could be postponed, if there is a repeat of last year's unexpected increase of six per cent in demand for emergency services.