comment: But expect financial jiggery-pokery to see the service past this year-end

Published: 12/09/2002, Volume II2, No. 5822 Page 19

'Every year we say it, but this year we really mean it. There will be no money to bail out the service this Christmas'. So a senior source at the Department of Health told HSJ recently.

Others believe differently. Since summer, interested parties have tried to convince the DoH that the service needs more money before the year-end, but the official line remains: 'no more money'.

Let us not forget that one of the reasons why the English NHS is heading for a£300m overspend (news focus, pages 10-13) is that it is doing more work. Another is that staff are being paid more - even if too much money is ending up in the pockets of nursing agencies. That apart, increased activity and pay is surely cause for cheer.

There are also those who could say, 'told you so'. The government was warned in January that a 10 per cent increase in prescribing costs would be inadequate. The forecasters now believe the eventual overspend could be 15 per cent.

The government is caught between a rock and a hard place. It is pumping unparalleled amounts of cash into the system in the full knowledge that the funding is not sufficient to do everything that needs to be done. It is aware that historic deficits and its own targets, together with a plethora of cost pressures, are soaking up all but a tiny part of the NHS's 'disposable income'. Equally it cannot be seen to be simply shovelling more money into the furnace.

The likely outcome will be, as usual, some financial jiggery-pokery around the yearend. By then it is hoped that resources can be found to develop the service redesign, which is the only sustainable way costs can be better controlled. l