Doctors 'must take budget role'

MPs say clinical experience is key

Doctors must be more closely involved in budget decisions if the NHS is to solve its financial problems, say MPs.

The Public Accounts Committee has investigated the current financial problems of the NHS - which finished last year £547m in the red.

MPs blamed weak management, poor planning and lack of transparency - and said doctors and managers must join forces to ensure money was well spent.

Doctors said it was not true to suggest they had not played an active role.

There is also no excuse for clinicians to distance themselves from money matters as if the quality of healthcare delivered by an organisation has nothing to do with whether it has to dig itself out of a deficit Edward Leigh Public Accounts Committee

The PAC blamed the government for failing properly to cost the impact of pay rises for GPs, consultants and other health workers.

Flagging up lack of strong management, it said once an NHS body fell into debt, it often seemed unable to drag itself back into the black.

The NHS is projected to break even by the end of the current financial year - but this will only be achieved by using funds set aside for issues such as training.

The report said there was a need to bring more clinicians into senior management positions.

If high quality healthcare was to be delivered effectively and efficiently, it said, decisions needed to take account of both clinical need and financial implication.

Edward Leigh, PAC chairman, said: "There is no excuse for clinicians to distance themselves from money matters as if the quality of healthcare delivered by an organisation has nothing to do with whether it has to dig itself out of a deficit."

Reforms 'a mess'

Dr Jonathan Fielden, chairman of the British Medical Association's consultants committee, said the NHS had financial problems because reforms had been ill thought out and incoherent.

Doctors could not have been more vocal about the looming financial crisis Dr Jonathan Fielden British Medical Association

He said: "It is totally untrue to claim that clinicians show a lack of interest in financial matters.

"Doctors could not have been more vocal about the looming financial crisis and have become exasperated by the lack of funds and the devastating effect this has had on the patient care.

"Clinicians are being deliberately disengaged by trust managers who instead prefer to employ costly management consultants to come up with solutions already suggested by NHS staff."

Health Minister Andy Burnham said the government had introduced new rigour, discipline and transparency to NHS finances.

He admitted the pay bill was higher than first anticipated, but he said action had been needed to tackle low morale and recruitment problems.

"Staff are now getting paid more for doing more," he said.

Dr Gill Morgan, chief executive of the NHS Confederation, said deficits were concentrated in a relatively small number of organisations - with over 50% of the deficit in 6% of trusts.

She said it was right to invest in staff, but admitted the service still suffered from structural problems.

Andrew Lansley, shadow health secretary, said ministers had no idea bout the impact of their mismanagement on local NHS services.