5 January 2009

Late last year the privately run car parking at the Royal Cornwall Hospitals Trust main hospital at Treliske, Truro was reorganised. For users the chief change was an increase in charges of 23 percent for a two-hour slot (or 54 percent if one takes into account the half hour grace the previous system gave for overrun appointments). The hospital is distant for many people in Cornwall and thus expensive in fuel, and regular travel to the hospital and car parking there probably represent a serious tranche of money for many patients and their visitors, though some help is available.

This post is prompted by the news that patients in Scotland and their visitors to NHS hospitals in Scotland will park for free (except at three PFI hospitals). Details are here.

In Wales there is already such free parking and in Northern Ireland parking is free for patients with a longterm illness and their visitors.

The UK department of health said that patients in England would continue to pay because free parking was not a sensible use of money. I think they meant, well, not sensible in England at any rate.

The cancer care organisation Macmillan has explained that cancer patients, whose income it says typically drops by half after their diagnosis, pay more than £300 for hospital car parking during their regular hospital treatment. I think that to require those payments is straightforwardedly uncivilised, a tax on illness as Macmillan says, but the department of health probably think it is a sensible money charge.

NHS prescriptions are free for everyone in Wales and set to become similarly free in Scotland this year and in Northern Ireland next year. They are not free in England (apart from the elderly and for people with certain illnesses) and raise £430 million a year from patients in England.

These lead me to the distribution of public spending in Britain. These are the figures for outturn per capita expenditure for 2008/2009, in £:

Northern Ireland 10 127

Scotland 9412

Wales 9209

England 7960

The England figure includes Cornwall of course. These figures are from the country and regional data in Chapter 9, Table 9.2 of the Public expenditure statistical analyses 2010 (PESA) here.

Decide for yourself if devolution is working fairly for the people of Cornwall and the rest of England.

My view was put in this post:

“I think that UK public expenditure should be redistributed across Britain on the basis of the need of the individuals and communities wherever they live and, where given to communities, to the smallest feasible units rather than large units though devolution has complicated that. In terms of need does it make the best sense to redistribute on a country or even regional basis if we can target more precisely than that? Given the controversy and even ill-will that the present distribution causes, along with the disputes that surround the data, it is time the government looked again at the population-based Barnett formula and at need, and looked again at the collection of the relevant data, so that we can consider what sort of redistribution we want.”

In the meantime, Cornwall pays.

Added 20 January 2009:

Free cancer drug applications begin

The PESA data has been updated to 2008/09.