Coffee House

Why is the NHS spending public money on inferior treatment, and why don’t patients know about it?

4 June 2013

11:10 AM

4 June 2013

11:10 AM

The NHS reform debate remains fixated with money. Budgets, we are led to believe, are directly related to the quality of treatment a patient receives. But in too many areas the same spending in comparable areas is producing widely differing results.

Most patients remain in the dark, thinking that if a treatment is available locally, then a national service will deliver similar outcomes. Yet the NHS’ own data shows this is untrue.

Take mental health. Both North Tyneside and Gateshead have similar health characteristics. They spend similar sums per head on a course of treatment -£214 in North Tyneside and £215 in Gateshead – both above the national average of £205. Yet according to the NHS figures, a patient is twice as likely to commit suicide following treatment in North Tyneside as they are in Gateshead. It is unlikely that patients and their families are aware of the disparity in outcomes between the two hospitals, but given the choice I can hazard a guess where they’d prefer to be treated.


Likewise, Devon PCT and the neighbouring trust in Torbay spend roughly the same amount on care following treatment at a neonatal unit. The data suggests that an infant is twice as likely to die in its first 28 days in Torbay Care Trust as in Devon. Expectant parents have a right to this information and should be empowered to choose the hospital where their child has the best chance of recovery.

In some cases spending far more on treatment manages to deliver worse results. On cancer care, the Islington Clinical Commissioning Group spent more than twice as much per head as their neighbours in Westminster, yet a patient is 73 per cent more likely to die in Islington than in Westminster. Does a journey of 3.5 miles fully explain such a remarkable contrast in survival rates?

Some might have expected the Department of Health to challenge NHS trusts where mortality rates should have raised a red flag and take these departments to task. Yet Sir David Nicholson, the outgoing NHS Chief Executive told the PAC that looking into this alarming trend was not his job but rather an internal matter for each hospital board. In practice many boards are reluctant to be self critical.

The NHS will only be at the forefront of health systems when patient choice is at the heart of its service. And for that to happen, patients need to know about the data on outcomes, rather than it lying hidden on a statistics website.

Steve Barclay is the Conservative MP for North East Cambridgeshire and Member of the Public Accounts Select Committee

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Show comments
  • alabenn

    The NHS is almost beyond control, criticise it and you are vilified by all sides politically and also these white rags that now masquerade as newspapers.
    Politicians are now a group of neutered cats squabbling over a pointless organisation that like them is sterile, not clean sterile, sterile in the way of giving life to what began as a hope and is now a parody.
    The papers will attack and destroy anyone if it increased their circulation, they do this regardless of the damage they cause or the lives that are lost because the principal place to go for treatment of illness has now become a monster that spreads disease and in some cases actively kills its clients/customers, no one is a patient now.
    I remember the Sun and Mirror calling the nurses Angels almost as a mantra just to shaft the Thatcher governments pay policy, they missed prophetic words “of death” from the Angels tag line.

  • kyalami

    Why is the NHS spending any money on homeopathy? It’s nothing more than Western witch-doctoring.

  • HookesLaw

    The while point of the NHS keeping and publishing these statistics is to drive towards best practice
    l cannot provide any links at Moment but a cursory slosh of NHS and Best Practice will reveal An ocean of results
    A pathetic article but No wonder given the mumbling shambling irrelevant display by the Spectator editor on Sky News last night
    The NHS is Working had and this is the rubbish it is faced with

    • Darnell Jackson

      I had two weeks in hospital following surgery for a leg fracture and was shocked by the whole experience.

      The NHS may be working hard alright, just not necessarily on the important things.

      • anyfool

        Be thankful you come out alive, check your records to see if they tried to put you on the Liverpool Care Pathway.

      • HookesLaw

        And how many other people were treated at the same time as you?
        The intent of the NHS to observe best practice is still clear and ongoing

        • Darnell Jackson

          Loads, we had a ward full of people who were terrified.

          Best practice is reserved for the private sector.

    • Dicky14

      Are you sure about that? When NHS England, the HSCIC and Dr Foster can’t agree what the stats are regarding Leeds Maternity Unit and Dr Keogh then shuts it down to only reopen it ‘because it was a suspension of licence’ are you sure you’re not just a shill who’s taken offence and leapt to some spurious knee jerk trolling without really having a bleeding clue what you’re on about?

      • HookesLaw

        If you are saying the stats could be better well that is a fair comment to make but if its true is another argument
        Its the argument worth making unlike the above one

    • anyfool

      Must agree about the Sky News Paper Review, he appeared shy and not in control of his faculties, maybe the mike was acting up, not a good advert for a position at the BBC or anywhere come to that.

    • McClane

      My mother’s very recent experience in the NHS was a disaster. She dehydrated, She was taken to the local hospital. She was allowed there to dehydrate for a week until she was transferred to hospital in the nearby town where she was put a on drip. Two days later she was back from being close to death.

      The staff nurse there asked me, couldn’t they have done this before?

      You say, the NHS is working hard. I say, no, some staff in the NHS are working hard, some just couldn’t give a toss.

  • DavidL

    Well said. Publication of outcomes data would be the best possible thing for patients, and ultimately for the NHS itself. This has been known for many years, but powerful professional interests are implacably opposed, and no politician has yet had the courage to tell the professions to back off.

    • HookesLaw

      You speak from total ignorance

      • DavidL

        Far from it.