speak out

Compensation for errors in the 2001 census have been forthcoming - but surprisingly not from the Department of Health. John Hacking explains

Last month, the Office for National Statistics released 'final corrected' population estimates for 2001. Corrections had been needed because of errors in the 2001 census, which led to large underestimates for some of the local authority district (LAD) populations. Both LAD and primary care trust financial allocations were based on these populations. The fact that PCTs had allocations set for three years has greatly exacerbated the effect of the errors, which are in effect compounded year on year.

About 60 PCTs lose out from the errors, and for some the amounts run into many millions of pounds. The largest losses are suffered by Manchester and London PCTs, although other urban areas are also badly affected. The table shows losses for the 10 PCTs worst hit. The final column shows the projected total losses for eight years caused by knock-on effects of the mistakes.

The Office of the Deputy Prime Minster has agreed to compensate losing LADs for 2003/04 and for knock-on effects in future years, and is tackling this task thoroughly and promptly, including consulting with LADs on technical issues.However, losing PCTs have, so far, been granted nothing by the Department of Health.

Losing PCTs, especially the biggest losers, are in some of the areas of poorest health. For the top 10 losers, the average acute health needs index is 31 per cent above average. Also, most losing PCTs already have allocations well below 'fair share'. These PCTs will be unable to afford the resources needed for effective public health measures when traditional services are already under financial pressure. This situation goes against the government priority to reduce health inequalities and will work against national targets.

The current lack of compensation is particularly odd in the light of the£40m special allocation for 2004-05 and 2005-06 granted to PCTs in 'growth areas'; most of these PCTs are in good health areas.

Manchester's PCTs stand to lose the most -£21m for three years or about£50m projected over eight years. This is particularly serious since Manchester is the LAD with the lowest life expectancy in England for both men and women. The Manchester Joint Health Unit and Manchester PCTs have been lobbying for compensation, with support from the SHA and the local strategic partnership.

Other losing PCTs are also starting to lobby in a similar way. One key deadline is the next round of allocations (for 2006-07 and 200708) at the end of 2004. A commitment by the DoH to compensating losing PCTs, in the way that the ODPM is compensating local authorities, would be a significant step forward for fairness.

John Hacking is senior research officer at Manchester Joint Health Unit.