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27-01-2011 | General practice | Article

Basis for reforms challenged


BMJ 2011; 342: d566

Government claims that NHS reform is needed to bring UK patient outcomes up to European standards have been challenged by a leading health economist.

John Appleby, chief economist at the King's Fund, looked at data on outcomes that have been used to justify the Health Bill and found that overall trends create a different picture.

Writing in the BMJ, Appleby explains that while it is true that in 2006 heart disease mortality was twice as high in the UK as in France, trends seen over the past 30 years indicate that the death rate from heart disease will be lower in the UK as soon as 2012.

Moreover, this has been achieved with slower growth in healthcare spending in the UK compared with France.

Appleby also contests the idea that UK cancer mortality rates are relatively poor by comparison with Europe - another key argument for reform. For instance, he argues, lung cancer rates in men are now lower in the UK than in France, while breast cancer mortality is falling faster in the UK than France and is on course to be lower in just a few years.

Appleby said: "Comparing health outcomes across countries is complex and not simply down to healthcare spending, but these trends must challenge one of the government's key justifications for reforming the NHS."

BMJ Editor Fiona Godlee comments that Appleby's findings add to widespread scepticism over the government's "money saving justification" for the Bill.

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Caroline Price