Charitable funds in the London health service tend to be spent on research and hospital based services rather than community based projects, a new report has shown.
The report, from the Charities Aid Foundation, says that charitable funding in London amounts to about £500m ($700m) a year, equal to about a tenth of the NHS expenditure in the capital. Most of the money is spent on acute services and medical research, even though these areas might not be the most appropriate targets for resources in London.
"Many of London's pressing health needs arise from the broader problems of poverty and deprivation, from London's heterogeneous population with its diverse health experience, and from a rising incidence of problems in mental and sexual health," says charity commissioner Julia Unwin, in an introduction to the report.
"These may gain little direct benefit from extra expenditure on traditional services; they need much more imaginative local responses, to which many different professionals and agencies will need to contribute. Should charitable funders provide these?" she asks.
The report, which was commissioned by the King's Fund and the Guy's and St Thomas's Charitable Foundation, shows that the largest group of funders is the former "Special Trustees," which administer the charitable funds of the long established teaching hospitals in inner London, while the next largest source was the Wellcome Trust.
Although about 40% of the funds was spent on research and about 18% on buildings, equipment, and salaries, principally in NHS hospitals and units, only 6% went on projects based in the community. Only 0.1% went on community mental health projects and only 0.2% on drugs and alcohol projects.
The report's authors, Cathy Pharoah and Ian Mocroft, ask whether the charitable funds help to redress or exacerbate existing disparities in access to health care. They believe that the time has come for people to debate ways in which trustees can maximise the use of charitable funds for health benefit in London.
"The running of traditional ‘hospital' charitable funds is being separated from the institutions in which they have been administered in the past and funds are now to be registered as independent charities with the Charity Commission. This gives trustees more scope and freedom in determining their use," they say.
Coming Full Circle: The Role of Charitable Funds in London's Health is available from CAF Research (tel 01732 520125; pstovell@CAFonline.orgpstovell@CAFonline.org), price £10 plus postage and packing.