News / 12m payout to ease cross-border tensions

Welsh commissioners will receive £12m from the Department of Health in England in 2009/10 to allow them to pay tariff prices for the treatment of patients referred to providers in England.

The Department revealed the figure in its response to the Commons Welsh affairs committee’s report on the provision of cross-border health services for Wales.

In March the committee reported that different funding and commissioning arrangements between the Welsh and English NHS had raised tensions between commissioners and providers over pricing.

The different systems could lead to adverse financial impacts – one English trust told the committee it charged Welsh commissioners £16m for activity that would have cost an English-based commissioner £18m.

The Department of Health in Whitehall will pay £12m this year to support a new protocol agreed with its counterpart in Cardiff. The financial arrangements will be revised each year. One finance manager told Healthcare Finance the funding was ‘probably about right’, though the number of referrals would affect the final figure.

In addition, as more people who live in England have a GP based in Wales than people in Wales who have a GP based in England, the Department pays the net difference of the cost of referrals to secondary care. In 2008/09 this was £5.8m.

The funding will go to a Welsh NHS that faces a significant efficiency programme. An HFMA conference in June heard NHS Wales needs to deliver efficiencies of more than 6% in 2009/10. The other devolved systems also face major efficiency programmes.

Delegates discussed common solutions to problems, including best practice in efficiency drives and mergers.

Northern Ireland’s health service has just completed restructuring. In a report, also in June, the Northern Ireland Audit Office comptroller and auditor general John Dowdall said it must build on its success in maintaining financial balance in the newly merged health and social care trusts in 2007/08.

In a general report on the health and social care sector, he said the Department of Health, Social Services and Public Safety and health and social care trusts continued to improve services.

However, he warned that financial stability was a critical issue and that a number of organisations had reported significant spending pressures that could jeopardise their financial positions.