Socialist Resistance

An archive of socialistresistance.org, 2002–2022

NHS drops "double deficit" system

 |  Socialist Resistance no44  |  page 6

This is scanned newsprint, not web text. The original PDFs carried no text layer at all, so every word here was read off the page by OCR. Expect dropped opening letters, run-together words and wrong characters. There was no contents page to cut the paper up by, so the articles were found from the size of their headlines: a headline may carry its kicker, and where an article ran beside a boxed panel a few lines of the neighbour can appear. The scanned issue is the authority; this text is here so the words can be found at all.

Patricia Hewitt promised that if she failed to balance the books of the NHS in 2006-7 she would resign as Health Secretary. Everyone was hoping for the best.

But by the time she made that pledge she must already have known that the figures have been fiddled to ensure that the NHS as a whole appears to be running at a small surplus: just £13m on a budget of £80 billion.

Of course many Trusts and Primary Care Trusts (the local bodies which commission and provide health services) have only got their books into balance or reduced their deficits by driving through cutbacks in jobs and services.

In many cases the PCTs were facing even larger targets for cash savings because - as in London's 31 PCTs - they had already had a lump of their allocated money "topsliced" by the Strategic Health Authority as a reserve against deficits.

Only in the final stages of the financial year - after waiting times had been driven back up, services had been excluded from the NHS and thousands of jobs left vacant to save money at the expense of quality care - did health chiefs reveal that this money "Give it to us straight. How long have we got?" would then be shared back out to give the impression of a balanced overall budget.

And then as a bonus Hewitt announced that the controversial system of "Resource Allocation Budgeting" (RAB, which had been imposed on the NHS at Gordon Brown's insistence and led to massive and worsening deficits for 28 Trusts which fell foul of its regulations, is to be scrapped, and any current deficits arising from it will be written off.

The Department of Health is handing out a total of £178m in amounts varying from £69,000 to £24 million, with the refunded money sufficient in the case of six Trusts to wipe out a projected deficit or put it on course for a small surplus.

However dozens of Trusts and PCTs still face alarming deficits this year and next, and for them there is little consolation in the fact that the NHS as a whole and even their Strategic Authority may be in overall balance: each organisation has to balance its own books.

Under these pressures the brief respite from cutbacks and rationalisation of hospital services which has arisen in the run-up to the May elections seems certain to be short-lived. cranked up through amendments or later notice motions to include a call for strikes - would have run the risk of defeat by angry delegates.

The union's national leadership in England has been reluctant to engage in confrontation with Gordon Brown, who they see as the inevitable successor to Blair -or to take a stand which might further undermine Labour's crumbling support in the May to a ballot, UNISON could find that the new line of policy uncovers a reservoir of latent millitancy.

Let's hope so, because whatever the end result on pay UNISON members are going to have to fight much more strongly over the next twelve months if they want to defend their jobs and working conditions along with vital NHS services against a new wave of rationalisation likely to be unveiled after the May election results have been counted.