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Thursday, December 17, 1998 Published at 17:36 GMT


Health

NHS told to tighten its belt

Hospitals will have to make efficiency savings

The government has set a series of long-term performance targets for the health service.

Chief Secretary to the Treasury Stephen Byers launched the initiative in a White Paper on Thursday.

Ministers are determined that the NHS should meet the new targets in return for the £21bn cash injection promised by Chancellor Gordon Brown in the Comprehensive Spending Review this summer.

The targets are laid down in a Public Service Agreement (PSA), one of 28 covering departments across government.

Most controversially, health authority bosses will be expected to make efficiency gains of three per cent a year for the next three years.

They have also been told to cut sickness absence, and fraud.

Other specific targets include:

  • A thirty-three per cent reduction in death rate from heart disease and stroke-related illness among people under 65 by 2010;
  • A twenty per cent reduction in accidents which require a hospital visit or GP consultation by 2010;
  • A twenty per cent reduction in the death rate from cancer amongst people aged under 65 by 2010;
  • A reduction in inpatient waiting lists by 100,000 over the lifetime of the parliament from the position in March 1997;
  • Ensure everyone with suspected cancer is able to see a specialist within two weeks of their GP deciding they need to be seen urgently;
  • Reduce the proportion of children who are re-registered on the child protection register by 10% by 2002;
  • Cut the growth in emergency admission of people aged over 75 to an annual average of 3% of the total by the year 2002-03, compared to the current average rate of 3.5%.

The broad objectives of the NHS are defined in the PSA as:

  • To reduce the incidence of avoidable illness, disease and injury in the population;
  • To treat people with illness, disease or injury quickly, effectively and on the basis of need alone;
  • To enable people who are unable to perform essential activities of daily living, including those with chronic illness, disability or terminal illness, to live as full and normal lives as possible;
  • To maximise the social development of children within stable family settings.

In total, Mr Byers has laid down more than 500 targets to be met by Whitehall departments.

The aim is to increase the efficiency of public services, so that more than £8bn a year is released for re-investment by the year 2001-02.


[ image: Stephen Byers: Standards must be raised]
Stephen Byers: Standards must be raised
Mr Byers said: "For too long people have focused on how much money is spent on public services. It is now time to move on and consider the more important issue - how the money is spent and what people get in return for their money.

"The old days of throwing money at a problem and hoping that it goes away have gone.

"Our approach is to ensure that the extra investment we are putting into public services achieves real improvements, that standards will be raised and the quality of services enhanced."

The government's insistence on 3% a year efficiency savings was criticised by the Institute of Health Services Management.

Deputy director Suzanne Tyler said: "Finding savings of £1bn year on year from April 1999 will place unprecedented pressure on a health service that is having to maximise existing resources to implement the government's avalanche of initiatives.

"Staff time is already at a premium because of existing restrictions on our management costs. A good quality health service needs a well resourced professional approach and effective management.

"It is important that performance targets are made, as simply throwing money at the likes of waiting lists will not work. But the targets must not only be measurable but also realistic."

The ability of departments to meet their spending plans will be reviewed by the Cabinet's public expenditure committee, chaired by the Chancellor.

The next Comprehensive Spending Review in 2001 will take account of how successful departments have been in keeping to their targets.



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