The Scrutiny Support Officer submitted a report the purpose of which was to introduce Professor Clare Bambra from Durham University and senior representation from the local NHS in order to address the Panel with regard to research undertaken around health care funding allocation policy and its possible implications for populations and local health services.
The Chair welcomed Professor Bambra and the local NHS representatives to the meeting who highlighted the key issues of recent research around health funding formulae which had recently received significant media attention.
As part of the research the 2011/2012 NHS resource allocation had been recalculated on the basis of English strategic health authorities which demonstrated that if an age only allocation approach had been taken there would have been a 14.9% and 12.0% loss of resource in the poorer North East and North West regions (£265 and £209 per head).Research showed that the more affluent areas of the South East Coast and South Central areas would gain increases of 12.6% and 15.8% (£188 and £220 per head).
Statistical data was provided which demonstrated that as a local authority, Middlesbrough in 2010/2011 spend per head was shown as £99.29 and the estimated budget per head based on the proposed formula would be £58.49, a reduction of £40.80.
Professor Bambra indicated that the data suggested that age only NHS resource allocation which ignored the important link between deprivation and health would disproportionately benefit areas of England that were the most healthy and most affluent.
The Panel was advised of current arrangements for NHS funding whereby funds were allocated to primary care trusts by a complex formula that took into account age distribution of population, deprivation, socioeconomic characteristics, population health need status and the geographical variations in the local cost of providing care.
Andrew Lansley, Health Secretary had stated that age was the principal determinant of healthcare need and could drive the allocation of funding to Clinical Commissioning Groups. He had also indicated that the current approach treated age as the primary factor, but it penalised regions with many older people but a low level of deprivation such as the Fylde coast around Blackpool and Eastbourne. The Secretary of State had asked an independent body of experts for advice on how best to achieve that funding was given to areas that needed it most.
An indication was given of the draft proposals for Public Health funding which included:
4.0 % of total health expenditure promised to be spent on public health
current NHS funding to improve public health was based on local consultation and prioritisation
above had resulted in much higher levels of spending in poorer areas where the health needs were greatest
new proposed formula would be based on SMRs under age 75 (pre-mature mortality) with no additional deprivation weighting.
The local NHS representatives referred to current funding arrangements with particular regard to the pace of change policy in those circumstances whereby growth was not as the same rate as other local authorities. It was reaffirmed that no decision had yet been made by the Department of Health of changes to the public health funding and that much depended on the weighting that was given to the poorest and more affluent areas in terms of the percentage funding based on SMR. The Panel acknowledged the extent to which Professor Bambras research had raised awareness to the potential impact of such changes on local health services.
It was noted that formal responses on the proposed public health formulae needed to be submitted to the Department of Health by 14 August 2012 and that amongst a number of other organisations the Association of Councils would be preparing and submitting a response.
Members suggested that a report should be formulated and brought to the attention of local Members of Parliament and the matter considered further by the Tees Valley Health Scrutiny Committee prior to submission to the Overview and Scrutiny Board and the Executive. The Panel also agreed the importance of the involvement of the Health and Wellbeing Boards both locally and at a regional level in this matter.
AGREED as follows:-
1. That Professor Bambra and the local NHS representatives be thanked for attending the meeting, the information provided and contribution to subsequent deliberations.
2. That a report be compiled as outlined and submitted to the Health Scrutiny Panel and Overview and Scrutiny Board.