Adams C B
Department of Neurological Surgery, Radcliffe Infirmary NHS Trust, Oxford.
BMJ. 1995 Dec 9;311(7019):1559-61. doi: 10.1136/bmj.311.7019.1559.
The financial demise of Oxford's department of neurosurgery (OxDONS) was precipitated by the financial rules of the reformed NHS. In particular it was produced by the failure of "resources to follow patients"; the requirement that "prices have to follow costs"; and the use of private income for revenue expenditure, not capital expenditure. This process will eventually affect all hospital departments, but it affected the unit in Oxford sooner as it started as "efficient"--that is, underresourced--and has depended on income from extracontractual referrals and private work. Current NHS accounting rules act as a disincentive to private income being generated in NHS hospitals, and consultants should be aware of this.
牛津大学神经外科系（OxDONS）的财务困境是由改革后的英国国民健康服务体系（NHS）的财务规则所引发的。具体而言，它是由“资源随患者流动”的失败、“价格必须随成本变动”的要求以及将私人收入用于收益性支出而非资本性支出所导致的。这一过程最终将影响所有医院科室，但牛津的这个科室受到的影响更早，因为它一开始就被视为“高效”——即资源不足——并且依赖于合同外转诊和私人业务的收入。现行的NHS会计规则不利于在NHS医院产生私人收入，顾问们应该意识到这一点。
