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| NHS financial failure regime 'made up on the hoof' | NHS financial failure regime 'made up on the hoof' |
| (about 7 hours later) | |
| By Nick Triggle Health correspondent, BBC News | By Nick Triggle Health correspondent, BBC News |
| The way financially-troubled parts of the NHS are being dealt with appears to be done "on the hoof", MPs say. | The way financially-troubled parts of the NHS are being dealt with appears to be done "on the hoof", MPs say. |
| The Public Accounts Committee also expressed concern that ministers could not offer adequate assurances that access to good quality care would be maintained when trusts had problems. | The Public Accounts Committee also expressed concern that ministers could not offer adequate assurances that access to good quality care would be maintained when trusts had problems. |
| And the MPs also suggested the reforms being introduced next year could make the situation worse. | And the MPs also suggested the reforms being introduced next year could make the situation worse. |
| It comes as a number of NHS bodies in England are struggling with debt. | It comes as a number of NHS bodies in England are struggling with debt. |
| The cross-party group of MPs said that while overall the NHS finished last year with a £2bn surplus, the figure masked the problems developing in a number of trusts. | The cross-party group of MPs said that while overall the NHS finished last year with a £2bn surplus, the figure masked the problems developing in a number of trusts. |
| A total of 34 organisations - nearly one in 12 - failed to balance their books in 2011-12. | A total of 34 organisations - nearly one in 12 - failed to balance their books in 2011-12. |
| It represents a significant rise on the year before and would have been even higher if local health chiefs and the Department of Health had not provided bailouts | It represents a significant rise on the year before and would have been even higher if local health chiefs and the Department of Health had not provided bailouts |
| 'Short-term decisions' | 'Short-term decisions' |
| But despite this growing problem the MPs said the government was unable to explain what would trigger action in a trust with serious financial problems and how essential services would be maintained while this happened. | But despite this growing problem the MPs said the government was unable to explain what would trigger action in a trust with serious financial problems and how essential services would be maintained while this happened. |
| One trust - South London Healthcare - has already been put into administration. A report published on Monday recommended the trust be dissolved, paving the way for a radical reorganisation of services across the area. | One trust - South London Healthcare - has already been put into administration. A report published on Monday recommended the trust be dissolved, paving the way for a radical reorganisation of services across the area. |
| But the committee said there were no clear rules or thresholds that trigger such steps. | But the committee said there were no clear rules or thresholds that trigger such steps. |
| Committe chairman Margaret Hodge said: "It very much looks like the department [of health] is inventing the rules and processes on the hoof rather than anticipating problems and establishing risk protocols." | Committe chairman Margaret Hodge said: "It very much looks like the department [of health] is inventing the rules and processes on the hoof rather than anticipating problems and establishing risk protocols." |
| The committee said keeping control of finances was only going to get more difficult as the NHS was in the middle of a £20bn savings drive. | The committee said keeping control of finances was only going to get more difficult as the NHS was in the middle of a £20bn savings drive. |
| And it said the introduction of clinical commissioning groups - the GP-led organisations that will take charge of the NHS budget next year - could lead to short-term decisions being taken that could make the problems worse. | And it said the introduction of clinical commissioning groups - the GP-led organisations that will take charge of the NHS budget next year - could lead to short-term decisions being taken that could make the problems worse. |
| The MPs also criticised the impact of the private finance initiative (PFI). | The MPs also criticised the impact of the private finance initiative (PFI). |
| Under the programme, private money was used to fund building schemes which NHS trusts then paid back over time - similar to a mortgage on a house. | Under the programme, private money was used to fund building schemes which NHS trusts then paid back over time - similar to a mortgage on a house. |
| But the committee said there was a number of trusts where those repayments were so high that they were struggling to break even and priorities were being "distorted". | But the committee said there was a number of trusts where those repayments were so high that they were struggling to break even and priorities were being "distorted". |
| Mike Farrar, chief executive of the NHS Confederation, which represents trusts, said he agreed there needed to be greater clarity for dealing with financial failure. | Mike Farrar, chief executive of the NHS Confederation, which represents trusts, said he agreed there needed to be greater clarity for dealing with financial failure. |
| "We need the government to accept that financial pressures are the biggest facing the NHS at the moment. We cannot deal with these issues on a piecemeal basis. We need a frank conversation with the public about how we deal with these problems. | "We need the government to accept that financial pressures are the biggest facing the NHS at the moment. We cannot deal with these issues on a piecemeal basis. We need a frank conversation with the public about how we deal with these problems. |
| "Propping up struggling trusts with short term solutions is not the answer. We need to take action before we reach crisis point." | "Propping up struggling trusts with short term solutions is not the answer. We need to take action before we reach crisis point." |
| But Health Minister Lord Howe denied there were problems on the scale being described, adding: "This NHS is in robust financial health." | But Health Minister Lord Howe denied there were problems on the scale being described, adding: "This NHS is in robust financial health." |
| He said the government was working with NHS trusts and regulators to ensure where financial problems developed they were dealt with properly. | He said the government was working with NHS trusts and regulators to ensure where financial problems developed they were dealt with properly. |
| "To be clear - we are not 'making these rules' up," he added. | "To be clear - we are not 'making these rules' up," he added. |
| Shadow health minister Andrew said: "Ministers must get a grip on the turmoil and put staff and patients first." |