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Hospital loses £8.5m in NHS fines
11:09am Wednesday 19th February 2014 in News
York Hospital has lost £8.5 million of vital funding in NHS fines because of controversial Government targets, it has been revealed.
A total of £6 million of the loss was due to the so-called marginal tariff set by the Labour Government due to concerns about A&E departments becoming swamped over the last ten years.
The surge in admissions is believed to be due to the growing elderly population and increasing frustration at GPs’ new out-of-hours arrangements.
The tariff lays down that for every patient the trust admits beyond the figure in 2008, the hospital will only be paid 30 per cent of the cost of looking after that patient.
The other 70 per cent of the cash stays within the NHS – which decides how it should be spent through its new Clinical Commissioning Groups.
Last year, York lost £6 million under the marginal tariff, plus £2.5 million in fines for readmitting patients it had discharged, but who then needed further treatment.
Health bosses have admitted than rather than going to help patients, the money has simply disappeared in settling NHS debts.
York hospital staff are up in arms that the hospital is being docked money simply for looking after a growing number of people.
Chief executive Patrick Crowley said: “The £6 million would pay for six wards’ worth of nurses. In any one year, that would pay for 50 to 60 consultants. It would pay for some desperately needed capital investment.”
The CCGs are supposed to spend the money on initiatives to prevent patients landing up at hospital in the first place.
But Mr Crowley said that because of the state of local NHS finances he understood why the money was not being invested.
He agreed that in the York area, the 70 per cent was “just disappearing”.
“But I don’t say that in any way critically,” he added.
“We have commissioning groups which are working in deficit with financial difficulties and therefore choices are incredibly limited. The inability to invest that 70 per cent is a function of the environment we are working in.”
The claims were made in a Channel 4 Dispatches programme which featured York Hospital as a typical A&E.
The night before the recording, York Hospital had been forced to turn away patients to other casualty departments in Leeds, Hull and Scarborough for the first time in its 30-year history.
The programme claimed that hospitals nationwide had missed out on £1 billion over the past three years due to the tariff and other missed targets.
Dr Steve Crane, a consultant in York A&E, said: “You try to juggle as many patients as you can in a system which is broken. It has been broken for a very long time because there has not been enough investment in it either financially but also investment from the point of view of thinking clearly about what patients’ care and out-of-hours care needs may be."
An NHS Vale of York CCG spokesman said: “The programme discussed the marginal rate tariff. This Government policy gives healthcare systems an incentive to prevent admissions.
“The CCG can confirm that if it was able to ring-fence funds under the marginal rate policy, it would primarily be invested in out-of-hospital care projects to prevent hospital admissions, leading to funds being channelled to other areas of healthcare.
"The CCG acknowledges that to date it has not yet been able to invest in this way but it sees its work to deliver services closer to where patients live as a positive step forward in helping to alleviate pressures on the hospital.