9 November 2015
Part of the demonstration in London on 17 October against planned changes to junior hospital doctors’ contracts. Photo Workers.
The latest indictment of Britain’s spending on health has come from a formidable source – the Organisation for Economic Co-operation and Development (OECD), the club of leading capitalist countries.
Back in 2005 the OECD noted that health spending in Britain had risen well above the OECD average. Cancer survival rates were improving across the board and our doctors and nurses were then the highest paid in Western Europe.
Ten years on its current report, Health at a Glance 2015, launched in London on 4 November, has concluded that our NHS needs 26,500 more doctors and 47,700 more nurses to match current average staffing levels across OECD Countries – at a cost around £5 billion a year.
Zero growth
Britain’s spending on health is now well below that of our comparative European partners as a result of zero cost growth per person between 2009 and 2013. The trend continues apace.
We significantly trail Germany, France, Belgium and Denmark now in terms of spending per head of the population. Nigel Edwards Chief Executive of the Nuffield Trust who spoke at the launch of the 2015 Report in London, said that the NHS would need to recruit 75,000 additional staff to bring us back above the OECD average.
Research blocked
The government’s response has been to pretend that all is well with staffing levels – and to block research and guidelines that suggest otherwise.
The National Centre for Clinical and Care Excellence (NICE) – an independent public body which is accountable to the Department of Health –produced authoritative guidelines on safe staffing levels covering acute wards and maternity care in 2013 and 2014. It was planning to produce other reports covering A&E, mental health and community care.
‘Nice has been told to suspend its safe staffing programme.’
But NHS England and its official regulator, Monitor, have chosen to ignore the guidelines. Instead, in June this year NHS England told NICE to suspend its safe staffing programme while it “reviews” its approach to setting safe staffing levels.
Our doctors and nurses lack the necessary support and time to provide good care forcing them to focus on processes rather than patients. The overall conclusion is that, in respect of health care delivery, you get what you pay for.
In terms of quality Britain is in the bottom one-third in relation to the treatment of asthma and chronic obstructive airways disease (COPD), in the same position for cervical, breast and colorectal cancer survival and likewise in respect of MRI units and CT scanning facilities.
Recruitment abroad
Expenditure on doctors and nurses per capita population is similarly low, as is the number of available hospital beds. The figures show that 28.7 per cent of our doctors are recruited abroad, against an OECD average of 17.3 per cent.
Britain has 8.2 nurses and 2.8 doctors per 1,000 population, worse than Norway (16.7 and 4.3), Germany (13 and 4.1) and France (9.4 and 3.3). Only Mexico and China in the cohort studied have fewer doctors per 1000 population than Britain. We have 2.8 hospital beds per 1,000 population, while Germany has 8.3 and France 6.8.
The Secretary of State for Health has responsibility for this, and junior hospital doctors have begun a process which ought to see him begin to be held to account.