Some are getting poorer?… so the headline “NHS does basics worse than other rich nations” will not surprise professionals

Some of us are getting poorer in many ways… so the headline from Chris Smyth in The Times 5th November 2015 “NHS does basics worse than other rich nations” will not surprise professionals. The rural areas leech their most ambitious youngsters to the cities, and the poorer regions similarly to the richer ones. How can we alter this centuries old shift? If we are officially doing worse Nationally, we are actually doing even worse Regionally. There are two choices: embrace the tend, but give those in the poorer areas choices and options to travel to areas where care is better, or to fight the trend and direct resources to unproven areas and try to improve inequalities… Evidence that the latter works is not good, and there is some evidence that the outcomes from such well intentioned efforts may be perverse.. In the end rationing has to be overt, and graded by income.. If we fail we decline…


Patients are dying because NHS care for conditions such as cancer and heart attacks is “mediocre” and lags behind other rich countries.

Britain “does not do the basic things very well” and would need thousands more doctors and nurses to bring care up to the standard of countries such as Germany, the Organisation for Economic Co-operation and Development said. It added that obesity levels were “dire” and ministers ought to threaten companies with a sugar tax.

Its analysis of health data from developed countries found that hospital care was “pretty mediocre”.

Britain ranks 14th and 24th out of 34 countries for men and women’s life expectancy rates.

Mark Pearson, the OECD’s deputy director for social affairs, said that “while access to care in the UK is good, the quality of care is uneven and continues to lag behind that in many other OECD countries”. (OECD Health at a glance 2015)

He added that a below average performance among rich countries “sounds OK but the OECD does include countries like Turkey and Chile so we would expect to be doing particularly well . . . there are some good things to say about quality but there are too many bad things.”

To bring the NHS up to the OECD average would require hiring 47,700 extra nurses and 26,500 extra doctors, at a total cost of up to £5 billion a year.

Britain spends £2,100 per person on healthcare, slightly below the OECD average. Mr Pearson said: “It’s therefore spending significantly less than countries we like to compare ourselves to — the Netherlands, Germany, France, Canada.

“It’s unrealistic if we spend that much less to expect performance as good.”

Constant NHS reform and a management obsessed with meeting Whitehall targets also distract from basic care, Mr Pearson said, condemning “this urge to tinker with the system rather than get the basics right”.

He said the government’s current emphasis on publishing data was welcome but not enough to improve standards if staff did not have time or trust to use the information properly.

Nigel Edwards, chief executive of the Nuffield Trust, said the reliance on junior doctors doing six-month placements could contribute to poor care.

The Nuffield Trust comments:

Is quality of care getting better or worse?

The quality of health and social care received by patients has been under the microscope in recent weeks.

Yesterday we helped the OECD launch their assessment of healthcare across developed countries, which shows the UK lagging behind on several key quality indicators. On Monday we launched Closer to Critical?, the third annual statement from our joint QualityWatch programme with the Health Foundation, which found that quality is also deteriorating in some areas, despite areas of excellent care. Both reports came hot on the heels of the Care Quality Commission’s State of Care report, which raised concerns about patient safety.

In a new blog, Nigel Edwards and Lucia Kossarova reflect on the state of UK health care, arguing that our inability to get the basics right should be leading us to ask some searching questions about how our system works.

And the UK? Politicians failed to address the reality of the un-rationed NHS

This entry was posted in A Personal View, Professionals, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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