The NHS reform debate remains fixated with money. Budgets, we are led to believe, are directly related to the quality of treatment a patient receives. But in too many areas the same spending in comparable areas is producing widely differing results.
Most patients remain in the dark, thinking that if a treatment is available locally, then a national service will deliver similar outcomes. Yet the NHS’ own data shows this is untrue.
Take mental health. Both North Tyneside and Gateshead have similar health characteristics. They spend similar sums per head on a course of treatment -£214 in North Tyneside and £215 in Gateshead – both above the national average of £205. Yet according to the NHS figures, a patient is twice as likely to commit suicide following treatment in North Tyneside as they are in Gateshead. It is unlikely that patients and their families are aware of the disparity in outcomes between the two hospitals, but given the choice I can hazard a guess where they’d prefer to be treated.
Likewise, Devon PCT and the neighbouring trust in Torbay spend roughly the same amount on care following treatment at a neonatal unit. The data suggests that an infant is twice as likely to die in its first 28 days in Torbay Care Trust as in Devon. Expectant parents have a right to this information and should be empowered to choose the hospital where their child has the best chance of recovery.
In some cases spending far more on treatment manages to deliver worse results. On cancer care, the Islington Clinical Commissioning Group spent more than twice as much per head as their neighbours in Westminster, yet a patient is 73 per cent more likely to die in Islington than in Westminster. Does a journey of 3.5 miles fully explain such a remarkable contrast in survival rates?
Some might have expected the Department of Health to challenge NHS trusts where mortality rates should have raised a red flag and take these departments to task. Yet Sir David Nicholson, the outgoing NHS Chief Executive told the PAC that looking into this alarming trend was not his job but rather an internal matter for each hospital board. In practice many boards are reluctant to be self critical.
The NHS will only be at the forefront of health systems when patient choice is at the heart of its service. And for that to happen, patients need to know about the data on outcomes, rather than it lying hidden on a statistics website.
Steve Barclay is the Conservative MP for North East Cambridgeshire and Member of the Public Accounts Select Committee
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