Further evidence comes that the NHS, despite the vast injection of funds, is failing to deliver medical care that is of the average standard in the rest of Europe.
Professor Mike Richards, the national cancer director, has said that in 2004, Britain spent £76 per head on cancer drugs compared with £143 in Germany and £121 in France. Even after adding in private spending on cancer drugs in Britain, our figure still fell well short of the others at £90 a head.
This spending on cancer drugs - particularly new and therefore expensive cancer drugs - is a forward indication of what the survival rates will be (so I am told by Professor Sikora, the leading cancer specialist). So we may be confident that when the figures finally emerge for cancer survival rates for the past few years, Britain will again be among the worst performers. Or, to put it quite clearly, thousands of people will continue to die of cancer in this country because we have the NHS instead of one of the other systems in the advanced world.
The story from the Daily Mail is here.
The situation with prostate cancer is more complex. But there is reason to suspect, at the very least, that the USA has dramatically lowered its deaths from prostate cancer because of active screening. A friend of mine in the USA is screened as a matter of routine for prostate cancer and colon cancer. Prostate cancer is apparently the second biggest killer of men in Britain. The screening test for it is far from ideal. The British medical profession tends to be sceptical of it to the point of hardly using it at all unless the patient pushes hard for it. I suspect that this is one of many instances where the medical opinion of the British has been influenced by the rationing mentality of the NHS. It is true that the American may over-test and over-prescribe but British medicine certainly has the opposite, more serious defect. In any case, in America, where they screen for prostate cancer, the death rates have come down more dramatically than in Britain. Or, to put it clearly again, many men die of prostate cancer each year in Britain because we have the NHS. The news story is here.
In a single week there was yet one more story about how the NHS has failed to perform as intended. Figures from the NHS Information Centre, apparently, show that nearly half the population has not seen an NHS dentist in the past two years. Story here.
It is possible that regular publicity about the bad record of Britain in treating cancer compared to other advanced countries will, eventually, prompt the government to spend more money on cancer drugs. That could be regarded as a 'good thing'. However, given the huge amount of money wasted in the NHS on excess back-up staff, poor use of staff and under-used equipment, it only means that money will be taken away from other service to patients that are less easily measured - care for the elderly for example. So even if the government moved to spend more on cancer drugs, it could well mean no net improvement in the amount of unnecessary suffering British people accept because we have the NHS rather than the medical care of other advanced countries.
Posted by James Bartholomew • Indexed in NHS
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I recall that several years ago Radley Balko posted something about prostate cancer survival rates, UK vs. US, in which the US came out much better. A Brit doctor responded that this wasn't a fair comparison of the systems since the US tends to detect prostate cancer earlier and then treat it much more aggressively. Huh? It might not be a fair comparison of the different approaches to cancer once it has gotten to a late stage, but as a comparison of systems, you definitely expect an advantage to go to the one that detects early and prevents, the latter said to be the Achilles heel of the non-universal care system.
Posted by: Eric H at April 20, 2008 04:50 PM
Of course, we can't afford to spend as much on cancer drugs as they do in other European countries, because we pay our medical staff so much more and give them much more favourable pensions.
The traditional rationing of supply of medical staff and the power of the unions over the NHS has ensured that we pay more and get less.
Posted by: HJHJ at April 21, 2008 10:59 PM
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It would be useful to confirm that the NHS does not spend less on drugs just because, as a monopsony buyer, it pays less per dose.
I have no idea whether that is true, but I could imagine it being argued.
Posted by: Andrew McG at April 19, 2008 11:36 AM