Cameron NHS ‘evidence’ savaged

An article published in medical journal The Lancet today concludes research claiming to show the introduction of patient choice into the NHS has reduced heart-attack deaths is “fundamentally flawed”, and should not be quoted as evidence backing the forthcoming health Bill.

The study, by academics at the London School of Economics, was quoted by the Prime Minister in a speech he made to NHS staff earlier in the summer as he battled to convince sceptical healthcare workers of the wisdom of his planned overhaul of the NHS – the most radical in its history.

The proposed reforms have attracted enormous controversy for their free-market focus, and yesterday more than 2,000 doctors, nurses, patients and anti-cuts campaigners gathered in Westminster to protest ahead of tomorrow’s debate in the House of Lords.

Protesters waved placards warning that “the NHS is not for sale” – reference to health secretary Andrew Lansley’s plans to open the service up to private healthcare firms on an unprecedented scale.

Andy Burnham, Labour’s new shadow Health Secretary, yesterday offered to support measures giving GPs a leading role in commissioning services – another key aspect of the Bill – if Mr Lansley drops the free-market measures. He said he had written to the Health Secretary and urged him to “listen and change course”.

“The more he digs in, the more he is putting our National Health Service in the danger zone,” Mr Burnham said. “This is a genuine offer that I am making to him – drop your Bill, and we will work with you constructively to reform NHS commissioning.

“That was the aim at the heart of the Bill. Stick with that and you will have our support in reforming NHS commissioning. But this bill goes far, far wider than commissioning. It basically turns our wonderful NHS into a free market, and we will not have that.”

The Government insists patient choice and free-market competition are positive drivers in improving NHS services. But critics have continued to claim the Bill will endanger the health service at a time it is being forced to make savings of £20bn by 2015.

Mr Cameron told NHS staff in June: “Competition is one way we can make things work better for patients. This isn’t ideological theory. A study published by the London School of Economics found hospitals in areas with more choice had lower death rates.”

That study examined the mortality rates for heart attack patients, measured against the number of hospitals within travelling distance of their GP surgery. It also looked at data on various types of elective surgery concluding that areas with greater choice saw lower death rates from heart attacks.

But the report in today’s Lancelet rubbishes the study. Academics led by Professor Allyson Pollock of Queen Mary University of London highlight what they call “a series of errors”, and claim it offers no explanation as to why the availability of choice for such procedures should have any effect on whether heart attack patients survive.

Professor Pollock said: “Our examination reveals it to be fundamentally flawed, amounting to the conclusion that the paper simply doesn’t prove either cause or effect between patient choice and death rates. This work should not be quoted as scientific evidence to support choice, competition or the new health Bill.”

A separate article in the British Medical Journal analyses the impact of competition on care in English hospitals and concludes “the jury is still out” on its effect.