Report highlights health spending variations

Stark variations in local NHS spending on different diseases have been revealed in a new report.

The King's Fund report analysed new Department of Health data from 2003/04 - 2004/05 that showed how much money was being spent by primary care trusts (PCTs) in England on different diseases.

The report found that some PCTs spent much more than others on particular diseases such as cancer, mental health and coronary heart disease, even after differences in the health needs of local populations and other factors had been taken into account.

The report found that Islington PCT was spending four times as much on mental health as Bracknell Forest PCT, after accounting for needs and other factors.

King's Fund said that, aside from the most extreme contrasts, there were still large variations with a two-fold difference in mental health spending across 90% of PCTs.

The report found similar variations on spending for other diseases. It was found that the proportion spend on cancer care ranges from 3% to over 10% of PCTs' budgets. For example, Daventry and South Northamptonshire PCT was spending four times more than Heart of Birmingham Teaching PCT after accounting for needs and other factors.

The report also showed the areas where the extra money allocated for the NHS in 2004/05 has been spend. The largest share of spending - over £7 billion or 11% - was devoted to mental health services - twice as much spent on cancer care.

King's Fund Chief Economist Professor John Appleby said: "This new data is very revealing and raises serious questions about the consistency of decisions PCTs make about how much they spend on different diseases."

Commenting on the report, Joanne Rule, Cancer Backup Chief Executive, said: "What people will want to know after seeing this research, is will I receive good cancer care in my area if I need it? How can we end the postcode lottery of cancer care, but still say local decision making comes first? Making decisions locally is important, but in order to get the best outcomes for people with cancer, we need to work regionally."

Nigel Edwards, Director of Policy at the NHS Confederation, said: "Variation in the delivery of health services or the 'postcode lottery' as it's often called is frequently seen as a problem by politicians and the public. Yet at the same time they say that they want less central control in health and more decisions to be taken locally - there is a direct trade off between them.

"The healthcare priorities of the people of Brighton will be different to the priorities of those living in Bradford. It is right that local health services meet the needs of local patients and therefore important to understand that a consequence of this will always be variations in spending."

(KMcA/SP)