OXDONS SYNDROME - THE INEVITABLE DISEASE OF THE NHS REFORMS

The financial demise of Oxford's department of neurosurgery (OxDONS) w as precipitated by the financial rules of the reformed NHS. In particu lar 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 affec ted the unit in Oxford sooner as it Started as ''efficient''--that is, underresourced--and has depended on income from extracontractual refe rrals and private work. Current NHS accounting rules act as a disincen tive to private income being generated in NHS hospitals, and consultan ts should be aware of this.