The Evil Tariff...Is treatment rationing coming to a Trust near you

General practitioners have been put in control of their budgets and they do what they can to spend as little money as possible. MS drugs are so expensive that they have been centrally funded by NHS. 

NHS England has been paying for the costs of MS drugs...but in a little published deal this may change and the costs may be pushed onto the Hospital Trusts with an enhanced Tariff.  

http://www.england.nhs.uk/resources/pay-syst/tariff-guide/

The deadline for providers to choose between the Enhanced Tariff Option (ETO) and Default Tariff Rollover was 4 March 2015. 210 out of 241 NHS trusts and foundation trusts (87 percent of all NHS providers) will move to the new voluntary tariff option for 2015/16
What does this mean?

"Commissioners will now withhold 30 per cent of the value of care...(things including high cost drugs....) above a provider’s agreed baseline. These funds must continue to be spent on managing the demand for care, and for the avoidance of doubt, this investment decision must continue to be co-ordinated with other decisions made by commissioners on demand management".
So as I understand correctly if Hospital trusts exceed their current budget they will have to pay for 30% of the costs of the drug. So are they going to want to spent about £10,000 to put someone on Alemtuzumab or ocreluzimab. Will it lead to drug rationing?

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