My understanding about PBC was that the **total** budget ot the PCT was
devolved to individual practice level, and practices then devolved
elements of this back to the PCT - often without much consultation or
detail.
Does anyone know what the position is on the budgets awarded to SHAs and
devolved to PCTs?
Is it the same system: total budget notionaly devolved and elements
passed back? Or are there elements which are retained automatically -
and if so, what are these supposed to cover, and how are they calculated
and by whom?
I am really disturbed by the enormous projected underspends in deprived
areas: were these SHAs funded above the national average in order to
correct health inequalities, and the funding has not been used for this
purpose, or was their funding the same as the national average, and the
original distribution to PCTs less than in other SHAs?
The result of all of this would appear to be that PCTs are being forced
to make slashing cuts in areas that are actually under their control (my
impression is that this is basically DNs and HVs) to achieve the
obligatory "financial balance" by 1.4.08.
Burning question ***** WHAT IS NOT BEING FINANCED TO PROVIDE THE SHA
SURPLUSES****
I had hoped someone on his list ( a knowledgable lot! ;->>) would
know...
MaryH
In message
<[log in to unmask]>, Russell
Brown <[log in to unmask]> writes
>Yes, I do. The fact that so many PCTs have been on "turnaround" and
>yet their SHA's have generated massive surpluses (which , lets not
>forget, are actually underspends, not surpluses) is appalling.
>
>On 23/11/2007, Mary Hawking <[log in to unmask]> wrote:
>> Does anyone else find the situation to be obscene?
>> The HSJ has extracted data from the House of Commons library and SHA
>> Board papers for September, and come up with the figures in the table.
>> What I find obscene is that the SHAs in the areas known to have the
>> worst health inequalities are predicting really massive underspends:
>> even if they return the funds topsliced from PCTs (have they ever been
>> known to do this?) to the PCTs, many of whom are still in turn-around
>> and cutting front line services, Yorkshire and the Humber, East
>> Midlands, North East and North West - the old industrial areas - and
>> South West will still be in significant surplus.
>> What services was this money supposed to supply, and are those services
>> being provided? Or has someone in the DH got their sums wrong when
>> calculating allocations?
>> MaryH
>>
>> Http://shorterlink.co.uk/13275
>>
>> Projected surpluses
>>
>> SHA
>>
>>
>> Topsliced from PCTs
>> Total predicted surplus
>> London £268m £135m
>> Yorkshire and the Humber £85m £280m
>> West Midlands £74m £102m
>> South Central £68m £80m
>> South East Coast £58m £60m
>> East of England £57m £46m
>> South West £46m £149m
>> East Midlands £38m £114m
>> North East £26m £142m
>> North West £9m £350m
>> Totals £729m *£1,458m
>>
>> Sources: House of Commons library Nov 07 (topslices); SHA board papers,
>> Sept-Nov 2007
>>
>> *Based on data to September, estimates since risen
>> --
>> Mary Hawking
>>
>
--
Mary Hawking
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