Tuesday, November 04, 2008

Mental Health - Through The Valley Of Debt - And Treasury Vultures?

UK Government Walks Through The Valley Of Debt

Will The NHS Magical "Surplus" Be Raided ?

by silvisrivers | November 4, 2008

Well now, it does not take much to wobble a UK health planet made unstable with various contrary gravity forces around it - does it ?

The sudden deep gravity lurch towards recession has seen the UK Treasury eyeing up the NHS surpluses created by the Foundation Trusts . That is £2.5 Billion . Now there's a bit of rocket fuel for you ...

Of course locally, UserWatch is aware of the UK Birmingham and Solihull Mental Health Foundation Trust declaring its last financial year surplus as £3.9 million.

The Primary Care Trusts with whom the Trust's are supposed to have planning partnership (PCT's are the planners , local redesigners and commissioners of services ) are frankly chaosed with so many new Govt imperatives . For example : becoming Foundation Trusts themselves and also amalgamating and also reconfiguring services galore - and also - and also, because the "also's" just go on and on .. Yes you've understood, the PCT's are "also-rated"....From having to digest too much ..

But joking aside, this is dangerous for some people's health because some patients just do not get timely services .. And of course the £2.5 billion surplus will be put into buildings mainly (A Keynsian economic strategy) - at a time when patients are increasingly short bed stays and are pushed to be cared for in their own homes ... Oh ...at a time too when allowances for care will be means tested pretty severely ...In mental health, Service Users have for some time seen the great "you are on your own" push by the Dept Of Health - dressed up as a community care ..So this is nothing new to them .

But do not take our word for the problems we outline - have a look at what Bill Moyes (Regulator "Monitor" for the Foundation Trusts) says :

"The head of Monitor has warned it would be "completely bizarre" for the Department of Health to claw back foundation trust surpluses.

Executive chairman Bill Moyes' comments came after HSJ revealed the Treasury was considering holding on to all or part of the surplus to ease the financial crisis.

Mr Moyes told HSJ: "The surpluses are there mainly for capital investment. They have money and they are ready with specific plans.

"The chancellor is saying he wants to see capital investment brought forward. It would be bizarre for the Treasury to be saying that with one voice, and then to have the DH taking away the ability of foundation trusts to make those investments [with another]."

The Treasury has proposed a Keynesian-inspired strategy to stimulate the economy in the impending recession by bringing forward public investment in construction projects.

Mr Moyes said the foundation trust cash surplus, which reached £2.5bn in June, meant they were ready and able to play their part in that. He has already advised foundation trusts to bring forward any capital plans where they can.

"If David Nicholson and the Treasury think it would be helpful I am very happy to put that in writing to the foundations and to encourage them [further]. But my sense is they don't need encouragement; what they need is clarity from their commissioners."

Mr Moyes said the barrier preventing foundation trusts from investing their surpluses was that primary care trusts did not know what new services they wanted locally.

"My message for the DH is that instead of thinking about taking away foundation surpluses, encourage PCTs to focus on where they want new facilities so that foundations have a basis for spending money sensibly," he said. "

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