NHS 'should be fairer to cities'

Inner-city health authorities should be given millions more at the expense of those in the Home Counties, a cross-party committee of MPs recommended yesterday.

The changes would result from making the formula used to allocate NHS cash fairer, the Commons Health Committee said. It also recommended a reworking of the element in the formula which adjusts for higher pay and recruitment costs in London and the South-east. A change to that - on which the Department of Health is already working - would have more diverse effects. But it could also benefit some city authorities.

The MPs on the Tory-dominated committee called for the cash shift to inner cities despite its broad effect being to benefit Labour-voting areas at the expense of traditionally Tory ones. Ensuring that patients receive equal treatment for equal need is an important NHS principle, the committee said.

Its call follows a decision by the Department of Health in 1993 not to make any adjustment to allow for differing local needs to the 24 per cent of the hospital budget which covers administration, mental handicap, some community services and other items. That has left deprived inner- city areas worse off to the advantage of more-affluent ones, the MPs say.

The sum used to be adjusted, and should be again from next April, either under the old formula or a newer one suggested by consultants at York University. Under the more radical option, 2 to 3 per cent would be cut off the budgets of a string of Home Counties authorities. East and West Surrey would lose about pounds 20m each. Authorities in Cambridgeshire, Oxfordshire, Hertfordshire. Berkshire, Buckinghamshire, West Sussex and parts of Hampshire would lose pounds 14m to pounds 17m. The biggest gainers would be Manchester and Liverpool, with an increase of around 3.5 per cent, or pounds 34m and pounds 27m, respectively.