APPENDIX 5
Memorandum submitted by the NHS Confederation in Wales
PURPOSE
To set out the basis of the response by the NHS Confederation
in Wales to the extra non-recurring allocation of £9.5m made
available by Mr. Win Griffiths, Parliamentary Under Secretary
of State for the winter of 1997-98.
INTRODUCTION
In October 1997, ministers announced an additional £9.5m
for the NHS in Wales to:
- ease the pressures on the health and social care system
during the winter period; and
- restrain the growth in waiting lists and waiting times.
The money was allocated to health authorities according to
1997-98 weighted capitation shares and authorities were asked
to submit copies of their plan for utilising the money to Welsh
Office by 30th November 1997.
BASIS OF
RESPONSE TO
£9.5M
- The NHS Confederation in Wales wishes to acknowledge
the minister's achievement in securing extra funding, as any additional
money for the hard-presssed NHS is welcome.
- The NHS faces severe resourcing problems year on year
and there is concern at the non-recurring nature of this extra
money. The NHS in Wales is already facing considerable financial
difficulties in 1997-98 and whilst the additional money will assist
in the short term, it will not help the underlying financial position
unless made available as a recurring basis. To assist members
of the Committee in gaining an appreciation of the resource position
within the Welsh NHS, a copy of the submission made by the Confederation
in response to the Secretary of State's consultation on spending
priorities for 1998-99 is attached.
- The lateness of the announcement is problematic and
could cause difficulties in utilising the money as effectively
as possible. This is because of issues associated with the lead
time for the planning of schemes, the recruitment of temporary
staff, etc. The Confederation suggests that the potential for
"earmarking" such resources at the start of a financial
year be explored, so that all parties involved can work towards
the most effective application of funds.
- As was stated in the introduction, the money has been
allocated for two separate sets of priorities. It is the Confederation
in Wales' view that it might have been preferable to concentrate
on the one priority of easing the emergency demand pressures on
the health and social care system over the winter period, in the
knowledge that this would have a beneficial impact on the service's
ability to restrain waiting lists and waiting times.
- The Confederation supports the channelling of the resource
through the NHS as being the most appropriate organisation for
co-ordinating the necessary action; there is, however, an issue
relating to the development of a truly intersectoral approach.
The NHS would be interested in exploring the potential to "block
back" some of the resource in future years for specific purposes
that cross departmental boundaries-the funding of "heating
vouchers" for the elderly is one such purpose, as many elderly
patients are admitted to hospital during the winter months due
to hypothermia. The timing of the allocations this year has prevented
this approach being explored fully yet the NHS believes that there
is merit in developing the concept further in the future.
CONCLUSION
It is the view of the NHS Confederation in Wales that the
receipt of the additional income is welcome, given the considerable
pressures facing the service. There are real concerns relating
to the non-recurring nature of the money and the lateness of the
allocation. The Confederation wishes to emphasise the need for
the resource to be recurring and to be "earmarked" accordingly
early in the financial year. Members are also interested in exploring
the development of a broader intersectoral approach to the issue
to ensure that all agencies are involved in determining the most
appropriate actions to be taken.
8 December 1997
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