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NHS billions 'largely wasted'

Civitas report says health service improvements are modest in relation to level of financial investment

Improvements in the NHS have largely failed to materialise despite huge financial investment by the government, according to a study by independent think tank, Civitas.

While total public spending on the health service soared from £44.9bn during 2000-2001 to £76.4bn five years later (2005-06), the report's author, James Gubb, said service improvement had on the whole ìresembled a country stroll, whereas expenditure has increased at a sprintî.

The study, titled The NHS and the NHS Plan: Is the Extra Money Working?, found that while many of the high profile targets the government had set such as staffing, facilities, waiting times, cancer care and coronary heart disease, had been met, sometimes these had been met `against the spirit of the reforms'.

It cited examples of NHS Trusts playing the system by keeping patients waiting inside ambulances outside A&E wards until staff were confident they could be treated within the four-hour government target once admitted.

Little or no evidence of improvement in NHS performance were found outside the areas where targets had been imposed, the study claimed. Serious shortcomings were found in a number of areas, including mental health and stroke care.

The report said that one of the more astonishing findings was that in spite of the extra billions of pounds spent, productivity in the NHS has not risen, suggesting that the problem `lies not so much with the amount of money spent, but how it is spent'.

According to calculations by the Office of National Statistics, productivity lies somewhere between an average increase of 0.2 per cent per annum or an average decrease of 0.5 per cent between 1999 and 2004, although the study found some evidence of improvement in latter years.

The report also highlights how poorly the UK compares with other countries; it is currently the only Organisation for Economic Cooperation and Development (OECD) country to register virtually no improvement in mortality rates from stroke between 1999 and 2003.

The UK ranks 24th out of 27 countries in the OECD with comparable data in terms of the number of practising doctors per 1,000 population.

ìIn the vast majority of areas improvements in the NHS have in no way increased in proportion to the vast sums of money ploughed into its coffers,î said Gubb. ìIs the extra money working? To a limited extent one has to say yes, for there have been achievements, most notably the NHS's historic inability to deal with long waits for elective care is apparently being reversed. But is it working anything like one would hope? Definitely not.î

The British Medical Association (BMA), representing doctors, said it did not agree that the billions ploughed into the NHS had been wasted, but admitted that much more progress could have been made without the diversion of funds into what it described as ìpoor value for money schemesî such as Private Finance Initiative (PFI) and Independent Sector Treatment Centres (ISTCs) as well as ìblind faithî in market oriented healthcare.

ìThe chronic under-investment for years in the health service had to be reversed, taking much of the funding that could have come to frontline care,î said Dr Jonathan Fielden, deputy chairman of the BMA consultants committee. ìIt is, however, the pursuit of market based healthcare that has diverted too much of the welcome extra funding down an expensive blind alley.î

The Department of Health (DoH) denied that productivity had gone down and disputed the Civitas figures.

ìThanks to record funding and radical reform, NHS patients are receiving better quality care and taxpayers are getting more bang for their buck,î said a DoH spokesman.

He added that the DoH was now ìdriving forward with plans to deliver £6.5bn in efficiency savings within two yearsî.

30th September 2008

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