Increases in funding for NHS may not improve care

Spending on the NHS is rising at least 50 per cent faster than the number of patients being treated, a think-tank report said yesterday.

Spending on the NHS is rising at least 50 per cent faster than the number of patients being treated, a think-tank report said yesterday.

There was no way of telling if the extra cash is improving care for patients or disappearing down a black hole, the Office of Health Economics (OHE) said.

Studies of health care activity - the number of patients treated in hospitals - showed that on the most optimistic measure it had increased by almost 4 per cent a year between 1999 and 2004. But spending had increased by between 6.1 per cent and 7.3 per cent.

"Health care activity has therefore not increased at a comparable rate to spending on the NHS," the OHE said. "This would seem to imply that the Government has not achieved value for money. Yet the simple answer is no one knows. NHS productivity, or value for money, is not being measured."

Adrian Towse, director of the OHE, a think-tank funded by the pharmaceutical industry, said there was an urgent need to measure health benefits to patients to determine if the Government and the taxpayer were getting value for money.

He said it was "electorally unsustainable" to keep putting more money into the NHS without having an answer.

But it was more complicated than counting patients treated. More care was provided outside hospitals in GPs' surgeries which might increase spending and be better for patients but reduce hospital activity.

The OHE report said: "The Government has increased the use of statins [cholesterol lowering drugs], which increases NHS costs but will reduce the incidence of heart attacks in the UK and therefore the number of heart procedures performed. As heart disease is a major killer in the UK, the health benefit to the nation of this investment is large. Yet by today's measures the NHS will be deemed less productive because it is performing fewer heart procedures and yet had increased drug costs."

The report shows that in 2003, NHS and private spending on health was £91.4bn. Although spending is increasing rapidly, by 2008 spending on health as a proportion of GDP will still be below that in Germany and France in 2002.

The Government is on course to meet its 2008 target for another 15,000 consultants and GPs but will still be below the 2004 levels for doctor numbers in France, Germany and Italy.

John Sussex, deputy director of the OHE, said: "Are those targets going to get us where we want to be with a health system comparable with those of Germany and France? It is a moving target and in 2008 we will still be behind where they were in 2002."