The Pharmaceutical Journal
Vol 279 No 7469 p285
15 September 2007

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UK catches up on health spending but outcomes lag

Increased NHS spending since 2002 means that the UK has caught up with the EU average for spending on health, but lack of productivity and unhealthy lifestyles mean that clinical outcomes are not catching up.

Commenting on his five-year review for the King’s Fund of progress since 2002, published this week, Sir Derek Wanless said: “What is clear from this review is that we are not on course to deliver the sustainable, world-class health care system, and ultimately the healthier nation, that we all desire.”

Sir Derek’s review concludes that extra spending has led to improvements in staffing, better equipment and infrastructure, reduced waiting times, better access to care and improved care for patients with coronary heart disease, cancer, stroke and mental health problems.

But it warns that assumptions about productivity improvements in the 2002 review have not been fulfilled. Hospital activity has increased, but the biggest increase has been in emergency, rather than elective, care. And progress on promoting healthy living has been worse than even the least ambitious prediction in the 2002 review, with dramatic rises in levels of adult and childhood obesity.

King’s Fund chief executive Niall Dickson commented: “If we are going to sustain a system that is comprehensive, tax funded and free at the point of need we will need to be clear about what we want to achieve for this massive investment and be able to demonstrate that high quality, efficient services are being delivered.”

He warned that if improved productivity and efficiency were not achieved then questions would be asked about the long-term viability of the NHS.

NHS Confederation policy director Nigel Edwards said: “The current measure of productivity in the NHS used by the Office of National Statistics is too simplistic and potentially acts as a perverse driver. … We need to radically overhaul the current approach to measuring productivity by putting patient satisfaction at the centre.”

Sir Derek’s first report on the NHS, in 2002, commissioned by the Treasury, led to a 50 per cent increase in NHS spending.