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The British Journal of Psychiatry (2002) 181: 200-207
© 2002 The Royal College of Psychiatrists

REVIEW ARTICLE

Beds, budgets and burdens: learning disability expenditure v. workload across English health authorities

Comparative review

BUNNY FORSYTH, MRCPsych and PAUL WINTERBOTTOM, MRCPsych

Learning Disability Services, Gloucestershire Partnership NHS Trust, UK

Correspondence: Dr Bunny Forsyth, Heathfield, 30 Denmark Road, Gloucester GLI 3HZ, UK. E-mail: bunny.forsyth{at}blueyonder.co.uk

Declaration of interest

B.F. & P.W. work for Gloucestershire, a rural county.

Background Following the closure of asylums and widespread changes in the population distribution of people with learning disabilities, there has been little investigation of changing expenditure requirements of health authorities in England.

Aims To compare expenditure on learning disability health services across England with the burden of services regionally, as estimated by numbers of people with learning disabilities.

Method A national database was set up using data from the National Audit Commission and the Department of Health. The spend/burden ratio was calculated and correlation tests for likely causes of inequality were applied.

Results There is widespread discrepancy from the median spend/burden ratio of £10260 per person with learning disability. There is a positive correlation between ratios and levels of net exports of people funded by their local authority social services to reside‘out of area’. Comparative underspending occurs in rural areas.

Conclusions There are inequalities in levels of spending on learning disability services. Comparison of regions suggests resources may not be allocated fairly. Health authorities should ensure that population increases are mirrored by appropriate adjustments in expenditure.


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