NHS reforms & proposed spending questioned

By Dr. Ananya Mandal, MDJan 27 2011

According to John Appleby, Chief Economist at the King’s Fund, deaths from heart attacks and cancer in the UK are falling despite lower spending on health than in countries such as France. This, he said calls attention to the Government’s claim that poor outcomes justify a £1.4 billion restructuring of the NHS that will pass control of budgets from managers to GPs. He said, “Comparing health outcomes across countries is complex and not simply down to healthcare spending, but these trends must challenge one of the government’s key justifications for reforming the NHS.”

He wrote in an article for the British Medical Journal published online on Friday in which he spoke of the figures that show that Britain had the largest fall in death rates from heart attacks of any European country between 1980 and 2006. “If trends over the past 30 years continue, it will have a lower death rate than France as soon as 2012.” He also pointed out that death rates for lung cancer in men and breast cancer in women have fallen in Britain, as fewer people now smoke. The Office for National Statistics also shows figures that survival rates for sufferers of many types of tumours are also improving. Despite these improvements, Britain spends far less (8.7 per cent of GDP) on health than France (11.2 per cent).

However experts believe that it is the family doctors’ frustrations with the current healthcare system in England are the driving force behind the controversial Health and Social Care Bill, which will lead to the scrapping of Primary Care Trusts and the establishment of new GP-led “consortia” that can purchase care from state-run hospitals or private providers. The Prime Minister said, “So many of you are telling me about your frustration with the current system, that you want to do more and become more involved. That is what is behind all this.” Health Secretary Andrew Lansley has said the changes are needed to make the NHS more responsive to patients. But he has also based the proposals on the fact that outcomes in England - the numbers dying early from disease and how long they are surviving - lag behind other European countries.

Health minister Lord Howe said, “There is a wealth of research which demonstrates beyond doubt that UK health outcomes are relatively worse than they could be…Our proposals will put the NHS on a more sustainable footing for the future, empower clinicians to design services in the best interests of patients and ensure it is comparable to the world's best-performing health systems.”

The British Medical Association in retaliation to these figures will hold an emergency meeting of its council in March to discuss them.