Health Policy InsightEditorial Tuesday 8 November 2011: Measuring up to the whiplash
Today's Guardian reports on the work published by Colin Pritchard and Tamas Hickish in the British Journal of Cancer.
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Pritchard and Hickish's study was of cancer mortality rates and the amount of GDP spent on healthcare between 1979 and 2006 in England and Wales, compared with nine other countries, including Germany, the USA, Spain, Japan and France. It concludes that the NHS in England and Wales, in Pritchard's words, "how good England and Wales are on cancer care, relative to spend. We do significantly more with proportionately less".
Professor Pritchard's words to The Guardian are strong: "These results challenge the feeble justification of the government's changes, which appear to be based upon overhyped media representation, rather than hard comparable evidence. This paper should be a real boost to cancer patients and their families because the NHS's performance on cancer is much better than the media presents. It challenges the government's assertion that the NHS is inefficient and ineffective at treating cancer – an argument for reforming the NHS".
Meanwhile, research by BBC News's Nick Triggle finds that bed-blocking appears to be making an unwelcome return. The shortage of available community support has meant that DH figures show that in the past two months, there have been over 128,000 days of delays in hospitals in England. This represents an increase of 11% on the same period in 2010.
The BBC News piece correctly notes that "the number of days lost still represents a small proportion - just over 2% - of the overall number of days all types of patients spend in hospital".
It doesn't detail the considerable cuts to local authority funding by central government. These cuts to social care have a major impact on delayed discharges, despite Comrade Sir David rightly insisting on a £1 billion transfer form the NHS to local councils.
One of the admirable things about the Coalition Government is its insistence on greater transparency in the public sector. It means we can see a problem coming.
Whether we can act on it in time is another matter. Mike Birtwhistle of MHP Health Mandate Communications is a former colleague of Bill Morgan's - and also an informed and useful blogger. Today, Birtwhistle wrote about whether we need to spend more on the NHS.
Brtwhistle writes, "funding could be critical to who wins the battle on health. Both George Osborne and Ed Balls – nothing if not shrewd political operators – should be alive to this. They might well consider announcing some small but highly symbolic additional increases in health spending, as they seek to win the health debate. Relatively small allocations of additional funding are, after all, a tried and tested part of a Chancellor’s armoury. Whether such increases could be enough to fundamentally alter NHS delivery is almost beside the point. They would make good politics".
He's not wrong - about either the scant real difference or the politics. But only one of the two men can meaningfully announce another little shakedown of The Magical Money Tree Where Cash Grows For Free. It isn't Ed Balls. It's also arguable that Labour are stuck with an economic credibility problem in the court of public opinion.
But it's not very much easier for Osborne to do this. He knows that squirts of cash on the NHS will lead to a) calls for more squirts of cash from the NHS, and b) increased resentment from aridly un-squirted departments.
He also knows that the longer the insane havering in the Eurozone over bailing out insolvent Greece and defending illiquid Italy, the more damage is likely to happen to the UK economy.
And thus to his deficit reduction plans.
The UK is not at the front of the queue for a bit of vigorous bond market S&M action. Nor is it all that far back. The whiplash starts here?