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End foolish contractual point-scoring

From Dr John Havard, Saxmundham, Suffolk

Ipswich Hospital is being punished for being too efficient, according to recent reports in the national press. Apparently £2.5m of surgical work was not paid for at all by the PCT because it was done before the contractual four-month minimum wait.

If Ipswich had the capacity to do the work early then clearly this would please patients and local GPs alike.

Failure of the PCT to pay for work done too quickly cannot be right but we do have to accept that they have finite budgets and other responsibilities. Why on earth is the payment not simply delayed for up to four months instead of being totally forfeited because of a clever contractual clause?

Do we really want new managers appointed to make sure patients have done their time and earned their operation? Surely the SHA and Department of Health cannot stand by and watch Ipswich Hospital plunge deeper into debt for being too efficient?

It is pertinent to contrast this contractual issue with one affecting another PCT in its recent contract with an independent sector treatment centre. In Portsmouth, the PCT did not succeed in getting enough cataracts done by the ISTC and ended up wasting nearly £300k of badly needed public funds. This meant the average cost of the operation was more than six times tariff!

Local GPs are pursuing several practice-based commissioning projects and trying to change the way primary and secondary care work for the benefit of patients.

Recent events impede progress immensely and it is no surprise that short-term financial fear paralyses a hospital trust like a rabbit in headlights.

Surely we should be looking at the wider health economy and not getting embroiled in foolish contractual point-scoring? While the NHS arms are busy punching each other, the foreign private sector is marching on.

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