Eight myths about NHS reform

On Sunday 12th February I tweeted eight myths about NHS reform. Here they are again, by popular request, in one posting:

Myth one: Healthcare in the UK is unsustainably expensive. No it isn’t – compared to other countries it’s not expensive en.wikipedia.org/wiki/List_of_c…

Now I got lectured on twitter for posting a link to Wikipedia, but this isn’t a research paper and I was looking for a good visual representation (provided someone hasn’t defaced the page) that the UK is, compared to its economic position, not a big spender on healthcare. And bear in mind that we spent a great deal less than this before 2000 or so. Here’s a link to the OECD provided by @Andrew2186 which pretty much confirms the point http://www.oecd-ilibrary.org/sites/health_glance-2011-en/07/01/g7-01-01.html?contentType=&itemId=/content/chapter/health_glance-2011-60-en&containerItemId=/content/serial/19991312&accessItemIds=/content/book/health_glance-2011-en&mimeType=text/html. Finally, bear in mind that this is total expenditure, both public and private, so comparisons are difficult – but in total terms the NHS is still good value.

Myth two: Competition has made things better and ‘saved lives’.

No it hasn’t

lancet.com/journals/lance…

This is important because the government have frequently cited research from the LSE claiming to show ‘competition saves lives’. I really don’t think this work stands up to scrutiny. You’ll find other posts about this topic on my blog.

I have been asked to post the reponse the authors of the research made to these criticisms. They are here:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61708-X/fulltext

And the response of the critics is here:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61890-4/fulltext

What all this shows, for me, is that something that is being trotted out as a fact (‘competition saves lives’) is actually pretty contentious. If the government’s arguments rest on this research, it is not, for me, solid ground.

 

Myth 3: It doesn’t matter whether public or private sector provides healthcare.

It does:

t1ber1us.wordpress.com/2012/02/10/the…

This posting links to another page in this blog. The standard assumption most economists have is that it doesn’t matter whether providers are public or private – but it does. We can’t let major healthcare providers fail (as in go bankrupt). This has profound consequences for the way any healthcare market might work.

Myth four: Buying or choosing healthcare is just like going to a coffee shop.

It isn’t

t1ber1us.wordpress.com/2011/08/02/why…

Again, this links to another entry in this blog. You might think it is an odd thing to try and refute, but there are clinicians out there claiming that choosing healthcare is just like a coffee shop. No, really.

Myth five: Those who oppose #nhsbill oppose all reform.

No we don’t:

t1ber1us.wordpress.com/2012/01/25/non…

The argument often made is something like this. The NHS needs reforming. This is a reform. Therefore those who oppose this reform oppose all reform. This is silly. Here’s my attempt to provide an entirely different set of reforms.

Myth six: The#nhsbill is supported by those working in the NHS.

No, most oppose it.

bbc.co.uk/news/uk-169542…

The BBC’s coverage of the reforms has often been sadly lacking – putting up people claiming to speak for clinicians in favour of the bill, when they are often in a small minority. However, the website above gives a sense of who is in favour, and who against, the Bill. Most are against.

Myth 7: The#nhsbill will streamline management and reduce bureaucracy.

No, it won’t.

abetternhs.wordpress.com/2012/01/31/scr…

It’s interesting to track how the justification for the reforms has changed almost completely in the last year. The latest myth is that it will streamline management, and cut back on bureaucracy. The problem is that the reforms will probably do the opposite.

Myth 8: It’s just lefties that are against the #nhsbill.

No, many Conservatives don’t like it either.

conservativehome.blogs.com/thetorydiary/2…

In the last few days several Conservative commentators have suggested they think the bill is a disaster.  Here’s the Spectator (hardly a bastion of Labour support that is also critical http://www.spectator.co.uk/coffeehouse/7642848/lansleys-battle-shouldve-never-been-fought.thtml).

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One Response to “Eight myths about NHS reform”

  1. Lansley preaches to the nation | Abetternhs's Blog Says:

    […] One reason I and other critics have been campaigning so hard and long against the health bill is that it lacks any evidence. When the bill was announced my immediate response was, ‘Extraordinary changes require extraordinary justification backed up by extraordinary evidence’ . As Paul Corrigan, ex-health advisor to Tony Blair has blogged to death, the government have failed to provide a convincing reason for overhauling the NHS. And Ian Greener today responded with eight myths about NHS reform. […]

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