NHS ‘Must Make Surplus Next Year’

The government is to tell the NHS in England it must achieve a £250m surplus next year. The service ended the last financial year £512m in deficit, but Health Secretary Patricia Hewitt has pledged to balance the books this year. However, the latest predictions are that there will be a £94m shortfall. The government will also set out new targets for tackling hospital infection and on meeting the 18-week target for waits from GP appointment to operation.

In November, Ms Hewitt told the Health Select Committee she would take “personal responsibility” for bringing the NHS out of deficit. However hospitals and primary care trusts – in charge of community services such as GPs – in particular have already been found to be building up big debts.

There are concerns from health unions that the need to drive down deficit levels, rather than a desire to improve services, are fuelling some of the service re-organisations which are currently being planned, such as closing or downgrading some A&E units.

Professor Chris Ham, a health policy expert at the Health Services Management Centre in Birmingham, said the £250m surplus target was “very ambitious”. He said it might be achieved by following an Audit Commission recommendation for NHS trusts to write off “inherited deficits” from previous years.

Keith Baron, chair of the Commons Health Select Committee which is set to publish a report on NHS deficits later this week, said: “The government is being very brave in setting this target.” He raised concerns that those trusts who were performing well could be penalised by having budgets “top-sliced” to address deficits.

NHS trusts will also be told on Monday that 85% of inpatients must receive treatment within 18 weeks by March 2008. All patients should be treated within that time by the end of the year. The Department of Health will also announce hospitals can bid for a share of £50m to help control infection rates, particularly Clostridium difficile. In addition, hospitals will have to set local targets which they must achieve.

If its infection rate is high, a trust will have to set a reduced target while if it is low, the target may be to maintain that level. C. difficile is a common hospital-acquired infection which usually causes diarrhoea but can lead to fevers or more serious infections. Older people are particularly at risk. Cases of C. difficile are increasing, rising by 17% in the over-65s from 2004 to 2005.