There is evidence – and then there is evidence.
Filed Under (Health Policy) by Paul on 15-02-2011
I am sure a very great deal will happen to the current Secretary of State between now and January 2013, but for those of us who will still be making sense of the Government NHS reforms at that time, it is a date that will be an important one for us all to remember.
Around that time a new report will be published that will either crush the Government’s rationale for NHS reforms, or make the case.
One of the interesting sights of the last month has been watching the Government try to stand up the main part of its narrative for reform – that the NHS is not as good as other countries’ health systems.
It is a task fraught with difficulties because at the same time the Government wants to say that the NHS is a marvellous institution which they love. So the sentence starts with a statement that it is marvellous, and needs to end with a clause which says that it is of course not marvellous enough.
The main case for reform is that having now spent as much as other European Countries on health care we are not getting good enough outcomes.
The great John Appleby suggested that there were some problems with the data that the Government were using on heart attacks since the data showed a clear trend of very sharp improvement. Whilst if you took the date 2006 as the data point it was clear we were below the European average, the speed of improvement was such that by 2012 – without the reforms – we would be better than average.
Recently an OECD report came out on the current Secretary of State’s favourite statistics – Mortality Amenable to Health Care…
“Amenable mortality is generally defined as premature deaths that should not occur in the presence of effective and timely care. It takes into account premature deaths for a list of diseases for which effective interventions are deemed to exist and might prevent deaths before a certain age limit (usually 75)
Collecting this data can take some time so this paper is based upon 2007 data. And its true the UK is below the average with 86 deaths per 100,000 that could have been saved. This compared to for example, 59 in France, 70 in Norway, 79 in Finland, and 81 in Germany. But as always it’s much worse at 103 in the US.
So the 2007 statistic makes the Government case.
But the problem for the Government is that the UK is improving very fast. Between 1997 and 2007 we have improved by 5.2% a year (only Ireland is improving at a faster rate). That could mean that by the time the 2009 figures are computed we are above the European average, and almost certainly means that by the time the 2011 figures are computed we will be well above that average.
You will have recognised that both 2009 and 2011 are dates occurring before the Government’s NHS reforms will have been implemented.
It will be four years – and right next to the latest possible date for the next general election – before we get the 2011 figures.
But in two years’ time, just 3 months before the abolition of PCTs (If all goes according to plan), we will get the statistics which may well show that the Government rationale for the need for its reforms – cannot be substantiated by the data for 2009.
Depending on how the country is feeling about the reforms at that date, having new evidence that undermines the Government’s case about why the reforms were needed will be an interesting moment.
