NHS trust facing £38m funding gap

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13 October 2011 Last updated at 13:02 GMT A Surrey hospital trust is facing a spending gap of £38m this year which is predicted to get worse, it has emerged.

Epsom and St Helier NHS has balanced its books for the past four years but is facing a future shortfall.

Spokesman Antony Tiernan said the trust was facing two challenges - increased care costs and fewer people being treated in hospital.

The National Audit Office (NAO) has named the trust as one of 20 not able to achieve foundation status.

'Other options' needed

Mr Tiernan, director of communications and corporate affairs, said: "There is an ageing population. The cost of drugs and technology is increasing and people have more complex conditions so obviously that's increasing the price of NHS care.

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This is the year where it starts. The gap between our income and expenditure this year is £38m”

End Quote Antony Tiernan Epsom and St Helier NHS "More people are being treated in the community, so out of hospital, in their local GP centres and in local care centres, which means that money isn't coming into the hospital.

"When we looked forward over the next five, 10, 15 years for the future income for Epsom and St Helier hospitals the money wouldn't be there."

Mr Tiernan added: "Our existing situation shows this is the year where it starts.

"The gap between our income and expenditure this year is £38m because of those challenges and that would get worse year on year."

He said the trust had to find "other options" for running its hospitals to meet its financial challenges.

Epsom and St Helier NHS has said it is not viable to become a foundation trust in its present form and is seeking to merge with another trust.

An NAO study has said 80% of trusts in England yet to achieve foundation status are facing financial issues.

The government has scrapped a deadline for trusts to achieve foundation trust status by April 2014, but still expects the majority to become foundation trusts either on their own or through merger "as soon as clinically feasible".

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Facing Planetary Enemy No. 1: Agriculture

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Enlarge Cliff Owen/AP

Early morning view of an automated irrigation system in on a farm in Sudlersville, MD

Cliff Owen/AP

Early morning view of an automated irrigation system in on a farm in Sudlersville, MD

For the past 200 years, ever since Thomas Malthus published his Essay on the Principle of Population, big thinkers have been wondering whether Earth-dwellers will eventually run out of food.

Today, a global group of scientists released a fresh look at the question. They add a different, environmental twist to it. Can we feed the world without destroying the environment?

It's a good question, because agriculture is probably the single most destructive thing that humans do to the earth.

 

Consider: Cropland and pasture now cover 40 percent of our planet's land surface; farming consumes nearly three-quarters of all the water that humans use for any purpose; farming accounts for a third of all the emissions of greenhouse gases that humans release into the environment. (Those greenhouse emission come from clearing forests or grassland for crops, the emissions of methane from rice paddies, and the conversion of nitrogen fertilizer into nitrous oxide — a powerful greenhouse gas.)

That's bad enough, but Jonathan Foley from the University of Minnesota, who led this new analysis, says it's likely to get worse. Demand for food is expected to double over the next forty years. Are we truly, to quote environmentalist Bill McKibben, facing the "end of nature"?

According to the new study, not necessarily. But avoiding mass deforestation and food scarcity is going to take some very big changes. Briefly: Big investments in food production in places (think Ukraine and Uganda) where current farm land isn't producing as much food as it could; much more efficient use of water and fertilizer; less wasted food; and (controversy alert!) eating less meat. About 40 percent of the planet's crops, according to this study, currently are fed to animals.

Unfortunately, the paper does not really explain how this will happen. There's no global dictator who can, for instance, abolish feedlots where corn is fed to cattle.

What we have instead of a dictator is the global marketplace, setting prices for land, corn, meat, and everything else. Those prices drive decisions by farmers. But Thomas Hertel, an economist at Purdue University, says those markets can help solve our planetary problem — especially if we step in to make those markets work better.

For example, governments can put a price on forests, making it really, really expensive to cut down trees for crops. They can charge more for water or fertilizer, discouraging waste.

But when food gets scarce, Hertel says, markets do respond. Prices go up, farming gets more profitable, and farmers grow more food. Markets will balance supple and demand for food, Hertel says.

But at what cost? Will food get really expensive, driving down consumption and really hurting the world's poorest people? Right now, that's one of the biggest, most interesting questions that agricultural economists are debating.

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