24 December 2014
Last updated at 12:13
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"The plan is to pay a reduced fee to hospitals for each extra patient they take on", reports Hugh Pym
Hospital specialists have hit out at plans to reduce funding for specialised operations and treatments NHS trusts provide, including some cancer care.
Some 345 specialists have written to NHS England saying the changes could mean longer waiting lists and avoidable deaths, the Daily Telegraph reports.
Under the plans, centres treating more patients than expected would receive just half the extra treatment costs.
NHS England says these services have already seen a big increase in funding.
Lower income The body channels taxpayers' money to the select NHS trusts that provide specialist services for conditions such as uncommon cancers, burns and medical genetics.
Its proposals - due to come into force in April - aim to curb a growth in spending in this area.
NHS England says providers had seen their incomes rise by more than £1bn over two years.
Curbing this growth in spending would free up resources to be used on other services including care for mental health patients, ambulance provision, casualty departments and GP care.
Analysis: Hugh Pym, BBC Health Editor It's another illustration of a central question about the future direction of the NHS - what should priorities be at a time of rising demand for care and more sophisticated medical technology and treatment becoming available?
NHS England have taken a decision to shift some resources from specialised provision, including some complex cancer surgery, to areas which they feel are in need of more funding, such as mental health. In effect it has a cake, agreed with the Department of Health, and it has decided to slice it differently from next year. There is no plan to cut specialised services, rather to pay hospitals less for each new patient they take on.
Hospitals and their consultants are understandably upset that their income for new work will be lower than they expected. They warn that patients will suffer as waiting lists for treatment will get longer. Why, they argue, should people needing cancer treatment lose out at all?
No final decisions have been reached. The haggling will continue over the next few weeks. Whatever the outcome, the debate about a health service with finite resources but ever-increasing demands on it won't go away.
However, the letter quoted by the Daily Telegraph says the proposals will leave hospitals with a choice of treating patients and incurring a financial loss, or not treating them at all.
"The clinical consequences of these longer waiting times and a lower quality service to patients with conditions such as heart disease, liver disease, leukaemia, complex cancers etc will be severe," it reportedly says.
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Each patient should get the treatment they need where and when they need it, instead of essentially robbing one part of the system to pay for another"
End Quote Dr Mark Porter British Medical Association council chair "There will inevitably be avoidable deaths as patients die on waiting lists or find that their disease has progressed during the wait for treatment, to the point that it is no longer curable."
A consultation period ends on Wednesday with a final decision expected early next year.
NHS England said in a statement: "We will listen carefully to all consultation responses on these proposals, while recognising that providers of specialised services have enjoyed income increases of over £1bn over the past two years."
Dr Mark Porter, of the British Medical Association which represents doctors, said: "This is a way of putting into action the latest round of NHS cuts, but the funding changes ignore the underlying problem that those hospitals facing unprecedented levels of demand are being forced to provide patient care at a loss, pushing more and more into deficit and collapse.
"The BMA believes that each patient should get the treatment they need where and when they need it, instead of essentially robbing one part of the system to pay for another."
Andrew Gwynne, Labour's Shadow Health Minister, said NHS England needed to listen carefully to the hundreds of hospital consultants who had raised serious concerns about funding plans for specialist services.
"These proposals could put lives at risk and harm patient care."
He said it was right to move appropriate services out of hospital, into the home and community setting.
"That is how we can reduce pressure on hospitals and allow them to deliver the specialist services that need to be done in the hospital."
