Published: 17/02/2005, Volume II5, No. 5943 Page 9
Primary care trusts have been left in limbo pending a decision on whether they will have to pay any 'above-tariff' costs attached to the next wave of the independent sector programme.
Last week, health minister John Hutton told HSJ that the funding allocations for PCTs included funds for any increases in independent healthcare provision required to increase NHS capacity.
He said the allocations 'include an amount for secondary care activity, so we have given every PCT enough to commission the activity that they say need to do to meet the 18-week target' [from referral to treatment by 2008]. He added that this would cover 'all the necessary secondary care activity...including their use of the independent sector'.
However, it remains unclear whether PCTs will have to pay for any extra costs of privately contracted work if a rate is set which is higher than the NHS tariff price.
The extra private sector contract costs in the first wave of the programme, which were up to 15 per cent above the NHS tariff price, were borne by the Department of Health.
However, a DoH spokesperson told HSJ that second-wave bidders would be 'expected to offer much greater value for money, which could be at tariff price [in the second wave]'.
The DoH said it would provide 'all details of the second wave will be announced when it is launched'. An announcement is expected later this month, although there is speculation that companies will only be invited to bid to take part in an expansion in diagnostics, with details of the expansion in elective capacity likely to be announced later this year, possibly after a general election.
Mr Hutton said the announcement on how the government intended to take the programme forward would 'deal with many of the concerns that the frontline of the NHS have been expressing to us about how that should be managed'.
The majority of those polled in an HSJ survey of NHS chief executives (news, pages 5-9, 20 January) described the government's handling of the programme so far as prescriptive and political.
Mr Hutton said that the programme would be taken forward 'in a way that is fully compatible with patient choice, because patients will decide who they go to'.
'It will not be for NHS planners, so to speak, to allocate blocks of patients to certain types of providers because that is not consistent or compatible with patient choice.' This month all strategic health authorities have had to submit proposals outlining how they intend to increase private sector capacity to the DoH.
'Public health needs more clout'
Public health 'spearhead' primary care trusts will have trouble protecting the extra money they have been allocated for white paper priorities unless stronger incentives are put in place, primary care leaders have warned.
Eighty-eight PCTS - first identified following the public health white paper last November - received an equal share of£500m extra funding in allocations unveiled by health secretary John Reid last week.
But the funding has not been specifically allocated to public health priorities as many PCTs had hoped.
National Primary and Care trust Development programme chief executive network chair Edna Robinson said public health targets must be given more clout if white paper priorities are to be realised.
'PCTs do not want to be parented by the centre, but there need to be stronger targets to support the health improvement agenda.' See news analysis, pages 16-17.