Published: 13/10/2005 Volume 115 No. 5976 Page 12
Cambridgeshire primary care trusts have proposed cutting£3m from mental health services to pay for overperformance by Cambridge University Hospitals foundation trust, a former local MP has claimed.
Anne Campbell, who was Labour MP for Cambridge until she lost her seat in the May general election, told HSJ: 'We are in a position where the PCTs have huge debts caused in part by the open-ended contract with the foundation trust. They have to pay for everything the foundation trust does for them, so now mental health services are being cut to cover it.' Ms Campbell, who expects to be appointed chair of Cambridgeshire and Peterborough Mental Health Partnerships trust in December, voted in favour of foundation trusts when she was an MP.
She added: 'This is not the only case I have heard where services are being cut because PCTs have to pay the foundation trust's bill.' The cuts package, which went out to consultation on Monday, include the loss of 22 inpatient beds for adults and another 20 for older people as well as permanent closure of a 13-bed rehabilitation hospital and a day centre for adults with severe mental health problems.
But South Cambridgeshire and Cambridge City PCTs chief executive Derek Bray denied that overperformance by CUHFT (which includes Addenbrooke's Hospital) was directly linked to a£3m cuts programme in mental health services just put out for consultation.
He said: 'There is a serious financial position here. Last year we spent£4m more than was allocated on mental health and that would have had to be tackled whether or not Addenbrooke's was over-performing.' South Cambridgeshire and Cambridge City PCTs face a projected overspend of£23m this year. They have received£15m brokerage, leaving an£8m shortfall.
Board papers considered in September reveal that CUHFT has significantly over-performed on its£40m contract with the PCTs. In the first quarter of 2005 it added£1.8m to its bill after carrying out 5-8 per cent more elective activity and 10 per cent more non-elective activity than originally contracted.
The PCTs are challenging CUHFT's elective over-performance, saying it is not affordable.
They are also challenging other aspects of the bill, including a 28 per cent increase in obstetric admissions and an increase of a third in consultant-to-consultant referrals.
In a statement, CUFTH said: 'It is a requirement that we are paid for work carried out. We are currently involved in negotiations with the PCTs regarding payments for services already provided and their request for us to reduce levels of activity.' A number of finance directors contacted by HSJ said they were aware of PCTs elsewhere in the country making cuts to pay foundation trust bills.
Stockport PCT chief executive Richard Popplewell said that some community services were cut to achieve financial balance in 200405 after Stockport foundation trust over-performed. Activity this year was 'broadly in line' with planned activity, he added. 'By investing in demand management we have been able to turn the corner, ' he said.
Cheshire West and Ellesmere Port and Neston PCTs are in dispute with the Countess of Chester Hospital foundation trust over its over-performance while simultaneously tackling overspends of£7.6m and£5.67m respectively.
Managers were not prepared to comment directly on links between foundation trust activity and cuts in other services although board papers from Cheshire West say: 'Difficult measures to reduce expenditure across all budget areas will need to be implemented, which will inevitably impact on the services we commission and provide and also on the PCT staff.' Others are in a borderline position. John Dowell, financial director at East Devon and Exeter PCTs, which are in negotiation over payments with Royal Devon and Exeter foundation trust, said: 'We are not yet in a position where we are looking at making cuts from other services.' The PCT has a£30m contract with the trust so an increase of 1 or 2 per cent would 'create problems' he added.
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