Think Tank Claims Extra NHS Billions Largely Wasted

The extra billions invested in the NHS have been largely wasted, an independent thinktank claims today, resulting in far less improvement in services than might have been expected. A report from Civitas (the Institute for the Study of Civil Society) says that while government spending on the NHS has doubled in cash terms from 2000 – an increase of around a third in real terms – productivity has gone down.

“Service improvement has in too many areas resembled a country stroll, whereas expenditure has increased at a sprint,” says James Gubb, the author of The NHS and the NHS Plan. The high-profile targets, such as waiting times and cancer care, have all been met, the report concedes. But this has sometimes been done through “gaming”: in one trust, A&E patients were kept in ambulances until staff were confident they could be treated within the four-hour government target.

But beyond the areas covered by such targets, the improvements are slight, says the report. The UK lags behind in mental health and stroke care, it says, and it is the only Organisation for Economic Cooperation and Development country to register virtually no improvement in death rates from stroke between 1999 and 2003.

The report claims NHS productivity has fallen. It cites estimates from the Office for National Statistics that from 1999-2004, productivity lay somewhere between an average rise of 0.2% and an average fall of 0.5% – though there have been improvements in latter years.

The UK still lags behind other countries, Civitas claims. In 2005 it was 24th out of 27 OECD countries in the number of physicians per 1,000 of the population.

The government strongly denied the Civitas claims, but the British Medical Association said that while it does not agree billions have been wasted, some of the money may have been spent on the wrong things.

“Much more progress could have been made without the diversion of funds into poor value for money schemes such as PFI, ISTCs [Independent Sector Treatment Centres] and blind faith in the benefits of market-orientated healthcare,” said Jonathan Fielden, deputy chairman of the consultants’ committee.

“The chronic underinvestment for years in the health service had to be reversed, taking much of the funding that could have come to frontline care. It is, however, the pursuit of market based healthcare that has diverted too much of the welcome extra funding down an expensive blind alley. It is a course the government seems determined to pursue despite this further evidence of the failure of its course of action.” The “fundamental incoherence of current government policies has led to lack of engagement, frustration and low morale amongst doctors”.

The Department of Health insisted productivity was not down and disputed the Civitas figures. “Thanks to record funding and radical reform, NHS patients are receiving better quality care and taxpayers are getting more bang for their buck,” said a spokesman, citing gains in waiting times, cancer care and heart disease.

“We’re now driving forward with plans to deliver £6.5bn in efficiency savings within two years.”