Yes, OK – you’re absolutely right, in these terms. The fact remains, though, however you cut it that British cancer survival rates for many cancers are still significantly worse than the European best despite increased funding under Labour. Maybe it’s just a matter of time and Milburn’s plans will bear fruit when all the data is in – but any such assumption or implication is based faith, not evidence. I can appreciate the need to score points off Tories on the NHS and believed in the 1980s and 90s that its problems were essentially down to insufficient funding. But it got much more funding in the 2000s with questionable results. To put it another way, I was voting Labour long before it was fashionable on the assumption that they would get the NHS to something like world class status; the bottom line is that they didn’t do this in power, thousands died of cancer and other conditions who would have survived in, say, France – that’s not excusable – full stop. LC’s line of absolute defence of the NHS, unquestioned support for what the likes of Milburn, Hewitt and Reid did, is not tenable, ignores deeper problems and ultimately won’t lead to sensible policy proposals.

Jonathan the UK spends about 16% less per person less than France on healthcare.
http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita

“thousands died of cancer and other conditions who would have survived in, say, France”

Jonothan,

Can you provide references to these figures please?

Cheers

Nick

@1, Jonathan,

Have a read of this:
http://www.bmj.com/content/342/bmj.d566.full

This is also very good: http://www.bmj.com/content/341/bmj.c4112.extract
(But I’m sorry the full article is not available unless you’re a subscriber.)

The important point in this article is that the way cancer survival data is collected across Europe varies in such a way as to make any comparison between countries very problematic. Additionally, over the past 15 years the UK has shown the fastest improving survival rates for Breast cancer of any European country.

It is also important to note that UK patients, on average present later than our European neighbours and this has a hugely significant effect on prognosis.

In short, the comparisons of outcomes are entirely false, oh and UK spending is still less than France’s…

Whilst some of what the previous government did with the NHS was very dangerous – mostly making it easier for Lansley to do what he wants to do, failing to improve healthcare is not a charge that can be reasonably made. That’s why the Tories keep moaning about productivity (that’s also a lie, by the way).

AFZ

Jonathan

Are you suggesting that Lansley’s plan to chop-up the NHS and give it away to providers like Southern Cross (and Blackrock) will vastly improve the UK’s cancer survival rates?

Given that money is obviously a big issue, I think our NHS does brilliantly.

Consequently, did you spend much time in hospital in the 80′s/90′s or the 2000′s?

I’m guessing that you probably didn’t. The NHS in the 80′s/90′s was unbelievably terrible (I’d go into detail but it get’s boring repeating myself). Everything dramatically improved during the 2000′s.

Frank,

I’m guessing that you probably didn’t. The NHS in the 80?s/90?s was unbelievably terrible (I’d go into detail but it get’s boring repeating myself). Everything dramatically improved during the 2000?s.

Yes – the waiting to get on the waiting lists was a wonderful innovation for those with crippling back pain I noticed…

So was the rapid increase in superbugs.

I don’t think the current NHS is bad (despite its structure, rather than because of it – most of the staff are pretty heroic) but it is difficult to improve it when things go wrong. It may be better than the NHS of two to three decades ago (hopefully it is…). But that in itself is a fairly weak argument – we’re better, so lets rest on our laurels and ignore the fact problems persist.

Watchman

…So was the rapid increase in superbugs.

Please explain what a superbug is and moreover how the NHS compares to other first world healthcare systems.

Thanks

Dr Alienfromzog

afz,

Please explain what a superbug is and moreover how the NHS compares to other first world healthcare systems.

Media shorthand for a antibiotic-resistant strain of an illness of the sort that can develop in hospitals.

I have little knowledge of other country’s healthcare systems (the French apparently did an excellent job of saving my nephew’s life once, but I suspect ours would as well – A&E is pretty good in every developed country) – I suspect they face the same problem of diseases developing immunity, but I’m not sure whether they have people avoidably die of MRSA or Neumonia to the same degree as we do.

If you have information on this, I would love to see it.

Hey Watchman,

I do have some information. I apologise for my tone, I find the term ‘superbug’ intensely annoying.

As I’m sure you know it is usually MRSA that the media refer to as a ‘superbug’ MRSA stands for Methicillin-resistant Staphlococcus aureus Staph. aureus is a very clever bug, it is found on the skin and in the nose of around a third of the people who read this at any given time. It can cause a range of nasty infections including, cellulitis, septicaemia, pneumonia etc. Traditionally Staph. aureus is treated with a penicillin; Flucloxicillin in the UK, Methicillin in the US. (I can’t remember the technical difference between Flucloxicillin and Methicillin but they’re very similar) So an MRSA is a strain of Staphlococcus aureus that is resistant to Flucloxicillin.

How significant is this resistance?
The answer to that question is actually quite variable. Firstly, the vast majority of MRSA strains remain sensitive to multiple antibiotics and are thus relatively easy to treat. Furthermore when you look at the virulence of Staphlococcus aureus strains, the most virulent (i.e. the most dangerous) strains are usually not MRSA. It’s not really accurate to say that someone died from MRSA; some people die from Staph. aureus sepsis and the resistance to Flucloxicillin is almost never an issue. There are multi-resistant strains around – but not in the UK.

So what is all the fuss about?
Staphlococcus aureus can survive on all sorts of surfaces, skin, curtains, floors, walls etc. MRSA is found primarily in hospitals – where it developed as that’s where antibiotics are most used. It is also found, increasingly in the community – especially care homes, anywhere where vulnerable people live close together. Of course having MRSA on your skin doesn’t matter at all – the same as having fully sensitive Staph. aureus doesn’t affect you at all. It is only dangerous when it gets in.

Increasingly the evidence shows that MRSA is not really just a nosicomal (i.e. hospital-acquired infection) http://www.ncbi.nlm.nih.gov/pubmed/21521706

Many patients get infections in hospitals. I would not argue that hospital cleanliness is unimportant, but if you managed to sterilize the entire building and staff, you still wouldn’t reduce infections very much, as the vast majority of infections come from the patient’s own skin. The reason why people get infections in hospital is predominantly because they are ill and therefore vulnerable. MRSA is thought to be a marker of hospital cleanliness because of it’s association with hospitals, but as an infection, it is certainly not a super-bug. E.coli 0157 is a superbug, that’s really nasty as you may have seen in the recent news.

MRSA rates internationally are controversial. http://tinyurl.com/3dm8sgk is a good place to start. As you can see, whilst on these data Britain is worse than some, it is by no means unique. Importantly, the recording of MRSA is very very variable, and I don’t personally trust national-level statistical comparisons very much as the methodology is extremely variable. They have very similar levels of MRSA in the US – from CDC: http://tinyurl.com/ybvp2p3

There are a couple of points to note, if you look at the literature, MRSA became endemic in the UK in the 1990s and has been falling, certainly since 2005. So once again it is a success of investment in the NHS. http://tinyurl.com/create.php is a good little snippet of the data.

Dr AFZ