Some rather weak responses to our report on NHS performance

January 18, 2008 3:23 PM

Here at the TaxPayers' Alliance we're used to rather unconvincing government responses to our reports.  Tessa Jowell produced the memorably meaningless argument that it "is a mistake to view 2012 as a cost, rather than an investment" - as if investments don't have costs.  The DFID managed to completely contradict their own press release in a response to our study on hate education in the Palestinian Territories.


Today we've had some equally lackluster responses to our study Wasting Lives: A statistical analysis of NHS performance in European context since 1981.


The King's Fund, quoted in the Guardian, were good enough to acknowledge that our basic methodological approach is valid.  Unfortunately, they then tried to diminish the conclusions of our study by placing them in a completely inappropriate context.


Even if the statistic that total mortality is between 750,000 and 1,000,000 is accurate that isn't the correct number to compare with our estimate of 17,000 deaths from poor NHS performance.  Most deaths occur either from a condition, or at an age, that they should not be considered amenable to healthcare and therefore have a limited part to play in any discussion of the ability of the NHS to save lives.


The proper comparison is with total amenable mortality and that comparison is contained in our study.  As the Times noted "mortality from [amenable] conditions is 26.9 per cent higher in the UK than the average in the four European countries, and 48.6 per cent higher than in France, the best-performing country."  This is a very significant difference.  We only cited the number of lives lost more prominently as we didn't want the human tragedy to be lost in a fog of more esoteric statistics.


If the King's Fund don't think that 17,000 deaths is a high number then why do we concern ourselves with deaths on the road or deaths related to alcohol?  Neither are nearly as lethal as poor NHS performance.


Health Minister Ben Bradshaw responds for the Government with a quote in the Guardian.  First, he said that the gap between EU peers and the UK has been narrowing.  That was clearly acknowledged in our study.  However, it has been narrowing at pretty much exactly the same slow pace since 1981 despite a huge cash injection since 1999.  There are probably several trends underlying that pattern, technological change that erodes established advantages is probably particularly important.  There is a lot of analysis of the trend in our report but, suffice it to say, Bradshaw has to explain how exactly his government has spent so much more, £34 billion, and got exactly the same results.


He follows that with a meaningless ad hominem.  Hopefully Guardian readers will be open minded enough to know that calling someone "rightwing" is a poor substitute for being able to point out how they are wrong.


Finally he accuses us of admitting that our figures are "more than three years out of date".  We did no such thing.  The data used in our report is the very latest available mortality data. It describes deaths in 2004 for the simple reason that mortality statistics for more recent years just don't exist yet.  2004 isn't that long ago and is five years after the cash injection whose effects we wanted to study.  Almost all statistical analyses have to look a certain distance into the past thanks to the time taken, by the relevant organisations, to produce the statistics that they analyse.  If Ben Bradshaw isn't willing to accept any study that does so you have to wonder how he understands health policy at all.

Here at the TaxPayers' Alliance we're used to rather unconvincing government responses to our reports.  Tessa Jowell produced the memorably meaningless argument that it "is a mistake to view 2012 as a cost, rather than an investment" - as if investments don't have costs.  The DFID managed to completely contradict their own press release in a response to our study on hate education in the Palestinian Territories.


Today we've had some equally lackluster responses to our study Wasting Lives: A statistical analysis of NHS performance in European context since 1981.


The King's Fund, quoted in the Guardian, were good enough to acknowledge that our basic methodological approach is valid.  Unfortunately, they then tried to diminish the conclusions of our study by placing them in a completely inappropriate context.


Even if the statistic that total mortality is between 750,000 and 1,000,000 is accurate that isn't the correct number to compare with our estimate of 17,000 deaths from poor NHS performance.  Most deaths occur either from a condition, or at an age, that they should not be considered amenable to healthcare and therefore have a limited part to play in any discussion of the ability of the NHS to save lives.


The proper comparison is with total amenable mortality and that comparison is contained in our study.  As the Times noted "mortality from [amenable] conditions is 26.9 per cent higher in the UK than the average in the four European countries, and 48.6 per cent higher than in France, the best-performing country."  This is a very significant difference.  We only cited the number of lives lost more prominently as we didn't want the human tragedy to be lost in a fog of more esoteric statistics.


If the King's Fund don't think that 17,000 deaths is a high number then why do we concern ourselves with deaths on the road or deaths related to alcohol?  Neither are nearly as lethal as poor NHS performance.


Health Minister Ben Bradshaw responds for the Government with a quote in the Guardian.  First, he said that the gap between EU peers and the UK has been narrowing.  That was clearly acknowledged in our study.  However, it has been narrowing at pretty much exactly the same slow pace since 1981 despite a huge cash injection since 1999.  There are probably several trends underlying that pattern, technological change that erodes established advantages is probably particularly important.  There is a lot of analysis of the trend in our report but, suffice it to say, Bradshaw has to explain how exactly his government has spent so much more, £34 billion, and got exactly the same results.


He follows that with a meaningless ad hominem.  Hopefully Guardian readers will be open minded enough to know that calling someone "rightwing" is a poor substitute for being able to point out how they are wrong.


Finally he accuses us of admitting that our figures are "more than three years out of date".  We did no such thing.  The data used in our report is the very latest available mortality data. It describes deaths in 2004 for the simple reason that mortality statistics for more recent years just don't exist yet.  2004 isn't that long ago and is five years after the cash injection whose effects we wanted to study.  Almost all statistical analyses have to look a certain distance into the past thanks to the time taken, by the relevant organisations, to produce the statistics that they analyse.  If Ben Bradshaw isn't willing to accept any study that does so you have to wonder how he understands health policy at all.

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