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Durham University

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New health funding proposal is “misguided”

(16 October 2013)

Professor Clare Bambra

A new formula to allocate money for health services could promote “substantial” inequality, say policy experts in a letter to the British Medical Journal.

Professor Clare Bambra, Executive Director of the Wolfson Research Institute for Health and Wellbeing and colleague Dr Alison Copeland contend that under such a formula, “the more affluent, healthier south east will benefit most and the poorer, less healthy north will lose out substantially.”

NHS funding is currently allocated to areas on the principle of providing equal opportunity of access for equal need. To help achieve this, the current NHS allocation formula incorporates a deprivation related measure, known as the “health inequality weighting.” NHS England is now consulting on a new “weighted capitation formula.” This removes the health inequality weighting and thereby increases the emphasis given to age.

Using the data provided by NHS England, Professor Bambra and Dr Copeland mapped the difference in funding per person between the current formula and the new formula for clinical commissioning groups (CCGs) and NHS area teams. This showed that the more affluent, healthier south east will benefit most and the poorer, less healthy north will lose out substantially.

For example, Prof Bambra and Dr Copeland explain that in CCGs like South Eastern Hampshire, where healthy life expectancy is 68 years for women, NHS funding would increase by £164 per person (an increase of 14%). This would be at the expense of CCGs such as Sunderland, where healthy life expectancy is 58 years for women and where NHS funding will decrease by £146 per person (a decrease of 11%).

Professor Bambra and Dr Copeland continue: 

“Although these changes are not on the scale that a purely ‘age only’ allocation formula would produce, they are still sufficient to undermine the principle of equal opportunity of access for equal need. They are also potentially a first step towards an age only allocation, and they could widen the north-south health divide by reducing NHS services in the north.”

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