It\’s all ideology: new research in the Journal of the Royal Society of Medicine this week shows the UK is among the most efficient health services in the world, in lives saved per pound spent.
Umm, no, the report doesn\’t in fact show that.
At least, if I\’m reading it right, I don\’t think it does say that.
Cost-effectiveness is taken as the relation between
economic input and clinical output based upon a
calculation of a ratio of the average GDPHE and
the reduced mortality rate over the period. The
greater the ratio the more cost-effective is that
country’s reduction of mortality rate.
They are not looking at the price per life saved. They\’re looking at the changes in the cost per life saved. By analogy with a car, they\’re looking at acceleration, not average speed.
Countries are ranked by the highest average GDP
over the period (1980–2005) (Table 1).
Total GDPHE: In 1980 the highest GDPHE percentages
were in Sweden (9%), USA (8.8%) and
Germany (8.7%), the lowest being 5.3% in Spain
and 5.6% in both Portugal and the UK.
By the end of the period GDPHE had risen
in every country, except Ireland, the current
highest being the USA (15.3%), Switzerland
(11.6%) and France (11.1%), and the lowest being
Finland and Ireland (7.5%) and Japan (8%). The
Western countries current average of 9.7% is
above the UK’s 9.3%, which is 10th highest of
One of the things you\’ll note is that the NHS had one of the larger rises in health care expenditure as a percentage of GDP. So we would rather expect to see one of the larger changes in health care outcomes, no?
Please note that I\’m not trying to deny that the NHS is efficient: nor state that it\’s not efficient. Only that the report does not say what Polly says it does: it is measuring changes in efficiency, not absolute levels of it.
Oh, and what is the major change that we\’ve seen over the decades in the NHS? Yes, that\’s right, more markets, more marketisation, less direct control from Whitehall.
And increases in effciency.