Source · Select Committees · Public Accounts Committee
Recommendation 17
17
Accepted
NHS funding mechanisms create perverse incentives, disadvantaging deprived areas for childhood vaccinations.
Conclusion
We asked about the equity of NHS funding mechanisms and the risk of perverse incentives, using as an example the distribution of money for childhood inoculations. GP surgeries receive a payment for every child that gets a vaccine.29 In our view, this funding mechanism favours wealthier areas where parents are more willing to inoculate their children. At the same time, more deprived areas, known for higher levels of vaccine hesitancy, receive less funding and therefore have fewer resources to carry out much-needed activities to boost uptake, such as outreach and education.30
Government Response Summary
The government states that NHS funding allocations already account for deprivation and health inequalities, and that NHSE regularly reviews the formula used to set allocations, noting evidence that NHSE investment is reaching those most in need.
Government Response
Accepted
HM Government
Accepted
4.2 NHS funding allocations (including for primary care) already take account of deprivation and health inequalities. Areas with populations of relatively greater deprivation and higher premature mortality receive a relatively higher level of funding to recognize greater need and help tackle health inequalities, for example through supporting outreach activity. 4.3 NHSE regularly reviews and updates the formula used to set allocations and will do so again ahead of setting financial allocations for 2026-27. 4.4 There is also evidence that NHSE investment in a range of interventions is reaching those most in need of help, for example: • Targeted Lung Health Checks programme, which seeks to diagnose lung cancer at an early stage, has now invited nearly 30% of the eligible population and is diagnosing around 200 cancers per month, 75% at an early stage. The Rapid Cancer Registration Dataset shows that people from disadvantaged backgrounds are now most likely to be diagnosed with lung cancer at an early stage. • Early intervention in mental health: 44% of pupils and learners have access to Mental Health Support Teams as of Spring 2024, exceeding the original commitment to cover 20%-25% of the country and 50% coverage is expected in Spring 2025.