The must-read stories and debate in health policy and leadership.


The NHS spent an estimated £4.3bn on generic medicines in 2016-17 so the news that a no-deal Brexit would likely result in increased drug costs will be a significant cause for concern.

Senior industry sources have warned that the industry’s cost base would increase and this could filter through to a number of products in this high volume, low complexity market.

Considering there was an unprecedented increase in the prices of certain generic medicines in 2017-18 (a surge clinical commissioning groups bore the brunt of), most will be unprepared for a further price increase after March 30.

The British Generics Manufacturers Association also revealed that companies are prioritising generics for which they are the sole supplier and those that are critical in terms of healthcare outcomes.

What remains to be seen is if the “rumblings” that government will help fund the extra storage needed for stockpiling turn into something more concrete.

Progress on PFI but questions remain

Nine months after Carillion was liquidated, the future of Royal Liverpool and Broadgreen University Hospitals Trust’s new hospital looks to be secured.

Work on the new Royal, one of two new acute hospitals left half built when the construction firm collapsed, proved harder to restart than was hoped.

But the government has now announced it will bail out the trust by paying for the rest of the construction, and allowing the trust to terminate its Private Finance Initiative deal.

In timing which was probably coincidental, but satisfying regardless for the government, the announcement was made just two days after shadow health secretary Jonathan Ashworth visited the site and described the lack of progress as a “shambles”.

While it is good news for the people of Liverpool, questions remain as to how much the trust will end up paying.

It will have to reimburse the lenders for the work completed to date, but the lenders will still incur significant losses.

As with the Midland Metropolitan Hospital in Birmingham, which was bailed out by the government last month, no details have been made public about the funding being provided by the Treasury.

Remember, if Carillion had finished the projects the trusts were set to pay the money back to their PFI providers for several decades.

It is unclear if the trusts must make similar payments to the Treasury, or if the money will be recovered in other ways – such as withholding funds from other budgets.