The Department of Health stands accused of reneging on a pledge to provide extra money for cancer drugs after admitting the £200m pot will be mainly funded by clawing back primary care trust budgets.
A letter from NHS medical director Sir Bruce Keogh to strategic health authority medical directors and finance chiefs says cash for the fund in 2011-12 will come from a “a non-recurrent clawback of £140m nationally from PCT allocations to fund SHA level budgets of the same value.”
The £200m fund, announced last autumn by health secretary Andrew Lansley, is intended to stop regional disparities in access to medication.
The cash will be held by SHAs for clinicians to apply for on behalf of their patients.
Mr Keogh’s letter, dated 1 March, said the remaining £60m would be provided from funds held centrally by the DH.
The method for allocating the cash will build on arrangements for distributing the £50m interim fund announced in-year for 2010-11.
SHA shares of the £140m sum have been calculated according to the national weighted capitation formula, and Mr Keogh said he “anticipated” the £60m from the DH would be distributed the same way.
However, he added, the DH cash could be used to weight the fund differently, depending on the results of a public consultation.
The DH’s consultation paper on the fund, published in October, said the £200m is “intended to be additional to that already included in PCT allocations”.
Mr Stout told HSJ: “On the face of it, it’s reneging on what they said in their consultation paper. They’re saying it’s not going to be additional. That’s a significant change in direction from a funding point of view.”
He estimated that the fund would cost PCT approximately £1m each in 2011-12.
He said: “PCTs are incredibly hard pressed. This will make a material difference to their budgets if they haven’t planned on this basis… they will have to find £1m worth of savings somewhere else. That is not minor.”
A DH spokesman said: “We have made £200m additional funding available next year to support the cancer drugs fund. This is money ring-fenced to support funding for improved access to cancer drugs. Already, through our interim cancer drugs fund, more than 1,300 patients have got access to the drugs they need.
“Technical details on the administration of the cancer drugs fund in 2011-12 were set out in Sir Bruce’s letter. Funding in 2011-12 is additional funding within PCT allocations.”