Expenditure on Mental Health Care by English Health Authorities
BRITISH JOURNAL OF PSYCHIATRY #2000), 177, 267^274 Expenditure on mental health care by English Executive, 1997). Using the approach de- scribed by Glover 1999), the proportion health authorities: a potential cause of inequity of the total allocated to the purchase of mental health services was assumed to be the proportion of the weighted capitation JONATHAN BINDMAN, GYLES GLOVER, DAVID GOLDBERG derived from theuse of the YorkPsy- and DANIEL CHISHOLM chiatric Carr-HilllCarr-Hil et aletal, 1994,1994aa) and Com- munity Psychiatric Buckingham et aletal,, 1996) Need indices. In 1997±1998, the de- cision was taken to weight 11.08% the `programme weight') of the age- and cost- weighted population of each area using Background TheYork resource The importance of equity in mental health these two indices, applied in the ratio allocation formula includes a calculation of services has recently been re-emphasised 88.06:11.94 NHS Executive, 1997). Acheson, 1998). Painstaking efforts are the amount needed to purchase mental made to ensure that National Health Service health services equitablyin each health NHS) resources are allocated equitably be- authority in England.However, the tween health authorities, using a formula Special allocations for purchasing amount whichis actually spenton services which takes account of the need for mental mental health services is at the discretion of the authority. health services Carr-Hill et al, 1994,1994aa;Smith In addition to the general allocation, health et al, 1996), although the final allocation is authorities receive other sums, special allo- Aims To compare expenditure on not divided according to different clinical cations, intended for the purchase of mental mentalhealth services with allocation, and areas.
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