Editor's blog Tuesday 5 October 2010: Where's the new NHS money coming from?

Party conference = spending announcements. This is, after all, the sacred NHS.

The announcement of new money for healthcare always seems like a good thing. In the case of the £70 million for “reablement” after hospital treatment, we are told that the money is coming from from savings from central Department of Health budgets, and that PCTs will get the money from November.

It will be spent across health and social care this financial year, and the press release states that it will “enable local areas to help thousands of people and ensure services are in place by the time the NHS picks up new responsibilities in April 2011 for patients' first 30 days at home after hospital discharge”.

Mmmm.

The editor’s notes of the DH press release point out that “In the ten years from 1998-99 to 2007-08 emergency readmissions increased by 50 per cent from 359,719 to 546,354 (source ‘Compendium of clinical and health indicators’, NCHOD October 2009)”. The release says that "re-ablement" packages give people who are leaving hospital after illness or injury help and support for six weeks”.

The release says that 35,000 people will benefit from the £70 million, making each six-week package worth £2,000, or £333 a week. That will of course be very good value if it prevents readmissions. Torbay Care Trust (one of three Kaiser beacon sites in the English NHS) made amazing progress in preventing emergency admissions in its population. But Torbay has been doing with since 2003, forming its Care Trust in 2005.

But 35,000 people are not causing 546,354 emergency readmissions. It's a good idea. It will help. It's no cure.

The provenance of the new funding for cancer detection, prevention and drugs is less obviously apparent.

The £50 million for the Cancer Drugs Fund has already been announced, and as we have discussed before, will not go very far. It also sends utterly the wrong signals to phrama companies about price of new drugs.

The Cancer Drugs Fund itself is of course a political invention to buy off mid-market tabloid anger at rationing. Its effect is to undermine NICE. It’s a deeply bad idea.

The early signs and symptoms campaign (an excellent idea), which will start next January, has a budget of £9 million.

Flexible sigmoidoscopy (also excellent, and very well-evidenced - kudos to Cancer UK's long-term funding support) represents a £60 million investment over the next four years - £15 million a year.

Proton beam therapy (yes, excellent too) means “£43 million more over the Spending Review period (of three financial years) so that all high-priority patients with a need for proton beam therapy get access to this cutting edge treatment - benefitting 400 patients per year by the end of the Spending Review period”.

And as for “Delivering more specialist staff, by committing the funding needed to deliver an additional 1200 consultants with a major input into cancer services by 2012 (over and above the 2009 baseline)”, why are there no numbers attached?