It seems that Roy Pearce has come up against a number of policy changes in the NHS.
There is now something called “procedures of limited clinical value”, including varicose veins, which are no longer available on the NHS. I think there is also a distinction to be made between chiropody and podiatry; chiropody is no longer NHS.
The problem is that the primary care trusts (PCTs) cannot pass any losses on to the clinical commissioning groups. Thus various activities will have to cease or be postponed.
Similarly there is acute pressure on the finances of the Royal Hospital. It looks as if there will be a loss for the financial year 2011/12, of one or two per cent of turnover.
Monitor is taking a hard line on this.
It is necessary to maximise income under the tariff, which I suspect is why the 12-week rule has been introduced. With the PCTs lack of funds they cannot send patients to the Royal Hospital as this has to be paid for.
Considerable progress is being made with ‘efficiency savings’ at the hospital, but they are not quite enough to balance the books.
Overall, NHS spending is being held constant, but it should really increase in real terms. Historically, the figure has been around 3 per cent per annum.
This is why finances are very tight, although there are no actual cuts in overall funding.
There is a general move away from district general hospitals to treatment ‘in the community’. This includes both doctors’ surgeries and patients’ homes. This should be both cheaper and better for patients.
I attended the meeting in Wirksworth, but the public debate about the Health Social Care Bill, has had many shortcomings. Included in that is the Liberal Democrats. I was at the Sheffield conference a year ago, but I have not really got involved.
It is a complex matter and quite difficult to understand. It must be an attempt at back-door privatisation.
Otherwise the Secretary of State could just have appointed some GPs and nurses to the PCTs.