Labour’s health cash boost made ‘real difference’

The findings by independent researchers are significant as they are based on a measure selected by the coalition Government as its chosen measure of health outcomes.

The benefits flowing from vast increases in spending by Labour, which saw the NHS budget increase from £60bn in 2000 to £102bn last year, have provoked huge controversy amid claims the bulk of the extra resources went on pay, with official figures suggesting hospital productivity even fell by 1.4 per cent each year over the period.

Now Ministers want to assess how well health services are performing, as part of moves which will link payment for health services to results, by using new measures assessing how deaths are prevented.

The analysis published in the Journal of the Royal Society of Medicine shows additional NHS spending led to better health outcomes when measured using a concept known as “amenable mortality”, which is being proposed for routine use by the coalition. It calculates numbers of deaths that should not occur when timely and effective care is available.

Study authors say their findings are consistent with international comparisons which reveal “remarkable progress” by the UK as a whole in recent years.

They also claim it also has “important implications for the ongoing debate on NHS reform”.

Co-author Prof Martin McKee, of the London School of Hygiene & Tropical Medicine, said: “Using the coalition Government’s chosen measure of health outcomes, it is clear that the increased funding of the NHS in England and Wales under their predecessors made a real difference to health.”

The study finds that between 1990-99, the pace of decline in amenable deaths in England and Wales was slower than in Scotland and Northern Ireland where health services were better funded.

But once Labour decided to spend more on services with the NHS Plan in 2000, there were significant improvements.

“Once the additional funding was made available to the NHS in England and Wales the pace of improvement accelerated, overtaking that in the other two nations,” he said.

Figures show rates of amenable deaths from heart disease, treatable cancers, respiratory ailments and a range of other conditions fell by more than half in England and Wales. They dropped from 187 per 100,000 for men in 1990 to 84 per 100,000 by 2009 and from 140 per 100,000 deaths in women to 68 per 100,000 deaths over the same period.

Prof McKee said: “So far, most attention has been paid to measures of ‘productivity’, counting how many patients were treated at what cost.

“Yet this measure views patients as objects to be moved through the system as cheaply as possible, with no regard for whether they actually benefit.”

The study authors said it had already been established that the rate of decline in amenable deaths in the UK as a whole since 1998 had been greater than almost all industrialised countries. But the acceleration in the rate of improvement from 1999 onwards suggested the NHS “did indeed convert some of the additional resources into better care”.

They caution that while amenable mortality was a valuable indicator of health system performance, there were problems with using the measure.

“The picture was not the same across the board,” they said. “It varied by cause and not every change could be accounted for by the increase in funding.”

They said trends in treatable cancer improved more among women than men but were linked to other factors, such as changes in disease management, new drugs and national screening.

Similarly, the reduction in deaths from heart disease occurred when health spending was increasing but also when smoking was being banned in public places.

A Department of Health spokesperson said: “It is over-simplistic to make a direct link between increased expenditure and improved outcomes, but it would be surprising if the NHS had not improved given the increased investment over the past decade. That is why this Government is continuing to invest £12.5bn more in the NHS over the next four years.”