Health: The NHS miracle

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The Independent Culture
THE RULE of the lesser miracle was applied by the 18th-century philosopher David Hume to test the veracity of biblical claims about the doings of Jesus, but I have often found it useful when confronted by extraordinary claims in medicine.

Take the claims this week that the British NHS has a worse record on survival from cancer than Poland, Estonia or almost any other East European country you care to name. We are, it is claimed, bottom of the league for lung cancer survival. This is taken as evidence of the parlous state of the NHS - as if we needed it - and to show that we are really no better off than the citizens of the Third World.

So let us apply the rule of the lesser miracle. Hume's argument was that a rational man should always believe the lesser of two miracles. In the case of Jesus walking on water, it would clearly have been a lesser miracle if his disciples had been deceived by what they saw (a mirage, perhaps?). This, therefore, is what a rational thinker must conclude.

Turning to the NHS, we can ask which is the lesser miracle - that the care provided in Glasgow is indeed worse than in Gdansk, or that there is something wrong with the figures that purport to show that it is. The answer, surely, is inescapable. Indeed, it is the fact that the figures show that Britain performs worse than Poland, Estonia and Slovakia that calls them into question. They defy belief. Yet instead of the figures being questioned, they are used as a stick to beat the NHS.

When we look at the cancer tables we get a clue about what is going on. It is true that Britain's record on cancer is poorer than much of continental Europe, as measured by figures for cancer registrations.

But, as reported in The Independent recently, the explanation has more to do with our excellent cancer registry than with our poor cancer service. The reason we appear to have more cancer deaths is because we are better at counting them.

The NHS needs more money, but not everything money can buy in health is worth doing - and much of it is positively damaging.

Instead of aping the health services in other countries, with their overprescribing and astronomical costs, we need to look carefully and sceptically at the doctors' claims for extra cash - and ensure that it is going to be spent for our benefit, rather than theirs.

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