NHS BILLIONS SQUANDERED

The tens of billions of extra cash poured into the National Health Service by Labour has been "largely wasted", according to a study by the think tank Civitas to be published this week. It says that while the government has mainly succeeded in meeting its NHS targets, the underlying picture is one of "little or no evidence of improvement in NHS performance, which ranks among the worst in the developed world". Most damningly, the Civitas report finds that any improvements in healthcare in Britain have lagged behind other countries, despite the fact that money has been injected into health in Britain at a much faster rate than elsewhere. "In the vast majority of areas improvements in the NHS have in no way increased in proportion to the vast sums of money ploughed into its coffers," said James Gubb, the report's author.

The study shows that spending on the NHS has almost doubled from o44.9 billion six years ago. Even allowing for inflation, the increase is still one-third. Ministers boast that the extra spending means key targets have been met on improved facilities, waiting times, cancer care and coronary heart disease. But the emphasis on targets has resulted in what the report calls "gaming" - other services being neglected in order to achieve targets. In some NHS trusts patients have been kept waiting in ambulances until managers were confident they could meet the four-hour waiting-time target inside the hospital.

The policy has also been accompanied by inefficiency. Official figures show NHS productivity has been declining by up to 0.5% a year, implying that a significant proportion of the extra funds injected have not led to improved patient care. The report also highlights the continued poor performance of the NHS compared with other countries. Britain is virtually the only advanced country not to have recorded an improvement in mortality rates from strokes in recent years, and fatalities are twice the level recorded in Australia, Canada, Japan, Sweden, Switzerland and America. Britain ranks 24th out of 27 countries in the Organisation for Economic Co-operation and Development with comparable data in terms of the number of practising doctors per 1,000 population.

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