UK pounds away at health problems
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* Mary Helen Spooner

Britain is set to boost spending on its National Health Service (NHS) by 40 billion pounds over the next 5 years, a 43% increase that will be funded largely by tax increases.

The recent announcement, part of Chancellor of the Exchequer Gordon Brown's budget presentation, followed a series of scandals involving botched operations, overcrowded emergency wards and patients who died while awaiting treatment. The increased funding will cover the hiring of 7500 consultant specialists, and at least 2000 GPs, 20 000 nurses and 6500 therapists by 2004. Health authorities also plan to build 40 hospitals and 500 primary care centres.

New targets for the NHS include reducing mortality rates for heart disease by 40% and for cancer by 20% in patients under age 75. Other goals, to be met by 2004, include guaranteeing access to a health professional within 24 hours and to a primary care doctor within 48 hours. In addition, by 2005 waiting times for hospital admissions are to be reduced to 6 months or less, while outpatient appointments with a specialist are to be available in 3 months or less.

The government missed this year's target of a maximum 6-month wait for specialist appointments, but officials noted that the number of people waiting for these appointments had been reduced to 500, down from 80 000 a year ago. Current waiting times for operations are as long as 15 months.

The King's Fund, a research organization, warned that expenses related to pay and inflation will drain billions from the new investments. Its director of health systems told members of Parliament that the planned 43% increase will be reduced to 35% in real terms, and noted that the spending increases will likely cause health care unions to demand higher pay. “Unions and the BMA will see much more money going into the system, and they will perhaps want to see a share of it.”

Meanwhile, Britain's cancer researchers say there is little use pumping money into the NHS “if we are going to fill the cancer and heart wards with smokers who have no price incentive to quit.” They said tobacco taxes should have been raised by more than the rate of inflation.

Overall, the National Audit Office says financial management of the NHS is improving, but it is still losing millions of pounds to fraud, some of which is being committed by physicians.— *Mary Helen Spooner*, West Sussex, UK