NHS Wandsworth and St George's Hospital in Dispute Over Tariffs

St George's Hospital and NHS Wandsworth, formerly known as Wandsworth PCT, are at loggerheads over the tariff to be charged for various hospital services. The situation has gotten so bad that at the Hospital Trust Board meeting on 31 March, 2009, the Board agreed that unless the situation can be resolved the whole thing will have to be settled by arbitration. Asked who would arbitrate, the Hospital's Chief Executive replied that is would be the job of NHS London.

St George's relies heavily on the revenue received from NHS Wandsworth and other local NHS bodies. Together its make up for over three quarters of the Hospital's total income.

The former PCTs are the backbone of the hospital's finances, without their payment for services the hospital would not survive.

That it has come to this- a falling out between different NHS bodies- is all as a result of the crazy purchaser provider split that was introduced into the NHS by the Tories, and continued by New Labour. Under this arrangement one part of the NHS buys services from the other part.

In simple terms money is given to the local NHS, be it Wandsworth, Merton,Kingston, or wherever and the local NHS then pays the local hospital for services, X Rays, Out Patient Appointments etc.

So, someone visits their local doctor, who refers them to the Hospital of their choice-most people chose their local hospital - they are treated at the hospital, and the local NHS body in which the patient lives is charged accordingly. It is what's know as the 'internal market' It's wasteful, bureaucratic, and inevitably leads to conflicts within the NHS. Lord Darzi may wax lyrical about 'co-operation' between all parts of the NHS, but with an internal market this just will not happen.

The conflict between St George's and the other NHS bodies in the area is an inevitable result of the introduction of competition into the NHS. Different parts of what ought to be a united organisation and now fighting each other over who should get the larger share of the budget. If NHS Wandsworth and its associates win it will be less money for St George's. If St George's win it will mean that NHS Wandsworth has less money to spend.

Hasn't someone told them, it all comes out of the same pot anyway. There is only one solution. Scrap the NHS internal market.