Health Select Committee holds Monitor Accountability Hearing

On Tuesday 2 December 2014, the Health Select Committee, of which Valerie is a member, heard evidence from Baroness Joan Hanham CBE, Chairman of Monitor, and David Bennett, Chief Executive of Monitor.

Valerie said:

“On 26 November 2014 Monitor announced the 2015-16 consultation to the National Tariff Payment System, the results of which will be announced in the New Year. I questioned the very short time frame, a month, for consultation on the proposal, with the deadline of Christmas Eve.”

“The tariff system is designed to address national variations in healthcare payment arrangements and reduce emergency admissions. There is a baseline figure for how many emergency admissions each hospital can make. Once this is passed the Hospital receives 50% of the tariff price for all emergency activity. The remaining 50% must be invested by commissioners into demand management schemes which prevent inappropriate hospital admissions by improving patient care outside of hospital. This new tariff 50%:50% split is based on 2009 levels and will replace the current 70%:30% split.”

I raised the fact that in the last 5 year there has been a major change, for example if an A & E in one area has been recently removed then this puts additional pressure on nearby A & E units and the Trust providing this service should receive additional funding.”

“David Bennett said that analysis of the scheme carried out by Monitor looks as though the scheme has been successful in reducing emergency admissions. Monitor have also increased the price of what hospitals get paid for A & E attendances relative to all other prices.”

“At the Select Committee, Monitor said that they have redesigned the Tariff system into three parts:
(i) There is a fixed payment for everybody in the urgent and emergency care network to cover their fixed costs,(ii)There is an activity-based payment; and (iii) There is a quality-based payment as well to ensure a high quality of service.”

“I asked David Bennett about how he monitors the progress of the work whether he uses a Gantt chart and in particular to reduce the use of agency staff. Mr Bennett told me that he is putting a team together but they do not have a plan that can be used by foundations trusts. I am concerned that there does not seem to be a timeline when work in progress is delivered.”

More information of the Health Select Committee’s inquiry into Monitor can be found here: