NHS spending variations `unchanged`

The wide variations in how much NHS trusts spend on diseases like cancer and heart disease have remained practically unchanged for three years, a report has said.

Even after the different health needs of local people are taken into account, there still remains a huge difference in how much primary care trusts (PCTs) spend on certain illnesses.

Some of this could be down to decisions by individual doctors about who to treat while some hospitals may not being as efficient as others.

Professor John Appleby, chief economist at the King's Fund, who compiled the report, said more research was needed but the study did raise questions about the "consistency of the decisions PCTs make about how much they spend on different diseases."

He added: "This latest analysis reveals that the widespread variations in PCT spending on different diseases have remained relatively unchanged over the past three years.

"Even when local need and other legitimate reasons for variations in spending are taken into account, PCTs continue to spend varying amounts on cancer, coronary heart disease, mental health and a range of other diseases.

"Some of the variations we have highlighted will not solely be as a result of deliberate choices by PCTs. Other factors, such as variations in decisions by clinicians about who and when to treat, and what treatment to provide, and differences in the efficiency of hospitals, will also contribute to these variations."

Prof Appleby's study, into spend in 2006/07, took account of the different health needs of local populations. For example, people in some parts of the country have far more need for mental health services than in other parts.

But even when is was acknowledged, wide variations in spend still remain, the report found.

Islington PCT in north London spent £332 per head of population on mental health but this figure was just £114 in the East Riding of Yorkshire PCT - a 2.9 fold gap.

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