Incomplete data created myth of lagging NHS improvements?

Clear improvements in NHS productivity in England are not being properly recognised, according to prestigious medical publication the Lancet (registration required).

 

It says a “myth” has grown up that the health service became less productive as funding increased under Labour, resulting in what the report calls a “flawed consensus” that NHS productivity fell in the decade after 2000.

 

The problem is that the government has used this misunderstanding to defend its highly controversial NHS reforms, claims Nick Black from the Department of Public Health and policy at the London School of Hygiene and Tropical Medicine in London.

 

His analysis suggested assumptions that hospital productivity fell by 1.4% a year, and overall NHS productivity fell by 0.4% a year, are based on analyses by the Office for National Statistics which omit increases in community-based services, and so may have underestimated the amount of work carried out by the health service at the coal face.

 

The study also raises concerns over the way that changes in quality were assessed, arguing that measures of safety and effectiveness were too narrow, prompting him to call for a “review of a much wider range of data than was previously available suggests substantial improvements in the quality of health care”.

 

Factors politicians and policy makers seem to be neglecting: falling mortality rates, greater compliance with clinical guidelines, and improving public satisfaction.

 

The paper acknowledges "some uncertainty" surrounding these data, but still concludes that even a modest improvement in the overall figure, of 0.5% a year, would mean that productivity rose over the decade rather than fell.

 

Black claims the Coalition has used concerns over NHS productivity to argue for its health service reforms, which Labour’s poor defence of its own NHS success has compounded.

 

Health Minister Simon Burns told the BBC in response that the government had always been clear that productivity in the NHS needed to improve.

 

"We are investing an additional £12.5bn in the NHS but we want to make every penny count… We know the NHS can meet this challenge.