Friday, January 18, 2008

TPA On NHS Underperformance

Brown's billions made no difference to a trend driven by technological catch-up

The TaxPayers' Alliance has today published an extremely interesting study of NHS performance. It finds that compared to major European healthcare systems, NHS underperformance is causing 17,157 deaths per year, and that £34 billion of extra spending under Brown has made no difference to UK mortality.

In a triumph of determined number crunching, TPA Researcher Matt Sinclair has analysed data from the World Health Organisation to estimate the number of deaths that could plausibly have been averted by the NHS since the 1980s. The measure used is known as “mortality amenable to healthcare”, originally developed in work for the British Medical Journal, and principally focused on cancers and circulatory diseases.

The study finds:
  • If the UK were to achieve the same level of “mortality amenable to healthcare” as the average of the other European countries studied (Germany, France, the Netherlands and Spain), there would have been 17,157 fewer deaths in 2004, the most recent year for which data is available
  • This is equivalent to over five times the total number of deaths in road accidents and over two and a half times the number of deaths related to alcohol in 2004.
  • Steady improvements in mortality rates have been made at almost exactly the same rate throughout the Thatcher, Major and Blair governments despite huge increases in spending from 1999 to date. Brown's massive extra NHS spending has made no discernable difference
  • If NHS spending had continued to increase relative to European peers at its pre-1999 rate £34.3 billion – £1,350 per household – less would have been spent between 1999 and 2004. In 2004 alone, £9.8 billion less would have been spent, 9.7 per cent of total spending in that year.

The report confirms the view of many inside and outside the NHS, that Brown's billions have largely been wasted. An unreformed and increasingly bureaucratised nationalised industry has simply become even more bloated.

Professor Karol Sikora, Medical Director of CancerPartnersUK, steering group member of Doctors for Reform and author of the foreword to the report, says:

“The NHS should not be a religion, with its structure set in tablets of stone. We face a choice between a modern, consumer driven service for all or a decaying, bureaucratic system which only those with their own resources manage to escape. Politicians need to read this report carefully and determine the optimal strategy they can put to a well informed public. Those that capture the best way forward will carry the British voter with them.”

How true, Prof. How very true.

PS That chart is stunning, isn't it? It shows how rates of "mortality amenable to healthcare" are going down both here and in Europe, but we are lagging. We've often been criticised on BOM for drawing simplistic conclusions from charts, but surely the Big Message here is clear: we should thank God for (largely American) technology. The politico dominated NHS has lagged international best practice for years, but we can at least coat-tail on technological progress made overseas. We will never catch up with Europe unless we implement a choice and competition model, but even the NHS has now learned how to buy new life saving technology (eg angioplasty was invented several decades ago, became the the most common medical intervention in the world ten years ago, and is now finally available on the NHS).