Primary care funding down as drive to shift care out of hospitals stalls

By Gareth Iacobucci | 30 Jan 2012

Exlusive: Millions of pounds of funding was stripped from primary care last year while investment in secondary care surged by almost three quarters of a billion pounds, a Pulse investigation has revealed.

Our analysis of figures obtained under the Freedom of Information Act shows that the Government's stated aim of reducing secondary care activity and shifting more work into primary care is yet to move beyond rhetoric, with  expenditure on secondary care up 1.4% last year, while primary care spending and investment in general practice each fell by 0.2%.

GP leaders said primary care was being wrongfully targeted for crude efficiency savings that would be better targeted at the hospital sector.

Data obtained from 61 PCTs shows that investment in primary care increased by 3.5% between 2009/10 and 2010/11, in line with trends since the introduction of the new GP contract.

But the trend was reversed in 2011/12, when investment in primary care across the 61 PCT areas fell by £11.34m, despite the pressing aim to reduce secondary care activity to meet NHS chief executive Sir David Nicholson's daunting £20bn worth of efficiency savings by 2015.

In contrast secondary care spending rose by £295m this year and £578m the previous year.

Extrapolated across England, the figures suggest hospital funding soared by around £732m last year, while primary care funding fell by almost £30m.

The investigation also showed that prescribing costs fell by 1.3% last year, suggesting the Government's QIPP drive has had some success in driving down drug spend.

Although investment in general practice dropped overall, spend on out-of-hours care increased by 0.6% in 2011/12, after increasing by 2.5% the previous year. 

General practice premises spend increased by 6% in last year, after suffering a drop of 3.5% the year before.

Dr Michael Dixon, chair of NHS Alliance and a GP in Cullompton, Devon, said: ‘It does mean the rhetoric is hollow.'

‘GPs are not going to play ball in terms of being responsible for more rational use of resources unless they can see their patients and practices getting some benefit from that. That's why primary care needs to take the reins. One of the prime success factors for the new reforms will be to see that reversed.'

Dr John Ashcroft, a GP in Ilkeston, Derbyshire, said talk of investing more money in primary care had failed to match the reality.

He said: ‘PCTs' job originally was to develop primary care. We haven't seen that happen. The system is set up to hose money into hospitals. People say worthy things, but the simple reality is, the money keeps going in the wrong direction.'

A DH spokesperson said: ‘Community-based care is more than just primary care. Our hospital activity data suggests that the NHS is starting to treat more people in the most appropriate setting and preventing unnecessary admissions.'

‘Moving care away from hospitals and treating patients closer to their homes, in the community, is not only better for patients, but a better use of NHS resources.'

‘£87.5 billion has been made available to Primary Care Trusts to provide care for local patients in 2012/13. This includes £300m for reablement services to help give people the community care they need to become more independent after being in hospital, which is double the £150m invested in 2011/12.'

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