Spending on health shows big variations

PATIENTS in Oldham are the victims of a postcode lottery according to a new report which reveals some London health trusts spend more than twice as much on certain diseases.

The top spender on mental health is Islington Primary Care Trust (PCT) at £332 per head.

On cancer it is Knowsley, Liverpool, at £118 per head; and on circulatory diseases it is Middlesborough at £167 per head.

The least money per head on mental health is spent in the East Riding of Yorkshire (£114). On cancer it is Ealing (£47) and on circulatory diseases it is Southwark (£76).

Oldham comes between the two, with £156 per head on mental health, £72 on cancers and £131 on circulatory problems, including heart disease.

Even after the different needs of populations are taken into account, there still remains a huge difference on the amount of money trusts spend.

Prof John Appleby, chief economist at the King’s Fund, said more research was needed, but the study raised questions about the consistency of decisions made by PCTs about how they spend their money.

The report reveals spending on mental health ranged from 8.7 per cent to 25 per cent of budgets.

It also showed spending on the Government’s three priorities of mental health, coronary heart disease and cancer was responsible for the largest three shares of the budget, at 12 per cent, 9 per cent and more than 6 per cent respectively.

Total spending on mental health was twice as much as that for cancer, and spending on cancer varied from 3.6 per cent to more than 9 per cent of budgets.

The King’s Fund’s chief executive, Niall Dickson, said the report raised questions rather providing answers.

He said: “It does not mean that any one PCT’s spending is necessarily wrong, but it does suggest that as well as unexplained variations in clinical practice, there are unexplained spending variations and some of these are almost certainly not justified.”

Steve Sutcliffe, interim director of finance for Oldham Primary Care Trust, said: “The PCT decides its spending priorities based on the health needs of people in Oldham.

“It has been holding a series of workshops to ask people and partners about where it should be concentrating its efforts.

“This is part of work to put together our strategic commissioning plan, which will outline the PCT’s priorities for the next five years.”