Four nations research reignites row over targets
20 January, 2010 | By Alison Moore
A report comparing the healthcare systems within the UK has reignited the political row over targets.
The report, from the Nuffield Trust, highlights how England is doing better on a number of counts than the other countries in the UK despite lower per head funding.
The government in England used the years of ‘feast’ to reduce long waiting times, and governments in the other countries may find it had to catch up
Scotland, in particular, compares badly on many measures, even when compared with the North East SHA region, which is broadly similar.
The trust found Scotland had the highest rate of spending on the NHS, as well as the highest rates of hospital doctors, GPs and nurses per person.
In contrast, the report found the NHS in England spent less, had fewer health staff per head of population, but made better use of its resources with higher activity levels.
The report highlighted some of the differences in health policy between the four countries, with Scotland having brought in free personal care, while prescription charges have been abolished in Wales. But Scotland also had the highest levels of poor health.
The report said: “The government in England used the years of ‘feast’ to reduce long waiting times, and governments in the other countries may find it had to catch up with performance in England during the years of ‘famine’.”
Nuffield Trust director Jennifer Dixon said: “Some of the differences and trends….will reflect the different policies pursued by each of the four nations since 1999, in particular the greater pressure put on NHS bodies in England to improve performance in a few key areas such as waiting and efficiency, via targets, strong performance management, public reporting of performance by regulators, and financial incentives.”
But shadow health secretary Andrew Lansley said the improvements in the NHS in England had largely been driven by the extra capacity created by “Labour’s tripling of the NHS budget”.
“I have consistently made it clear that Labour have not got value for money as productivity has fallen,” he said.
A Scottish government spokesperson said the report was based on data that was at least three years old and out of date. “Since then there have been significant improvements in NHS Scotland’s performance.
“The measures of productivity in particular fail to take into account the complexity or severity of cases before treatment - nor the quality of outcomes. These measures also only cover a narrow range of hospital procedures and do not reflect the shift in the balance of care from the acute sector into the community in Scotland.”
But Paul Flynn, deputy chairman of the BMA’s consultants committee, said: “Targets have an impact on reducing waiting times but they also have other effects such as distorting clinical priorities.”
A Department of Health spokesman said: “Devolution allows each country to have the freedom to make decisions about the health needs of their population and to focus on disease prevention, health promotion and health services in a way that is best for their public.”
Richard Barker, director of operations and performance at NHS North East, said: “We are obviously pleased to see our combined efforts resulting in positive comparisons with socio-demographically similar areas; however, we would never be complacent or lose sight of the need to do more – particularly within the current economic climate.”
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