The UK has one of the worst healthcare systems in the developed world according to a damning new report which said the nation has an “outstandingly poor” record of preventing ill health.
Hospitals are now so short-staffed and underequipped that people are also dying needlessly because of a chronic lack of investment. The verdict, from the Organisation for Economic Co-operation and Development (OECD), will make embarrassing reading for David Cameron who denied the cash-strapped NHS is heading for its worst winter crisis.
Staff are too rushed to improve levels of care that have in many areas fallen below countries such as Turkey, Portugal and Poland. Almost 75,000 more doctors and nurses are needed to match standards in similar countries the OECD said in its annual Health at a Glance study comparing the quality of healthcare across 34 countries.
While access to care is “generally good” the quality of care in the UK is “poor to mediocre” across several key health areas, obesity levels are “dire” and the NHS struggles to get even the “basics” right, the report said citing a lack of investment over the last six years.
Britain was placed on a par with Chile and Poland as countries still lagging behind the best performers in survival following diagnosis for different types of cancer. The UK came 21st out of 23 countries on cervical cancer survival, 20th out of 23 countries on breast and bowel cancer survival and 19th out of 31 countries on stroke.
In numbers: the NHS crisis
The organisation called for “urgent attention” to combat high rates of smoking, harmful alcohol consumption and obesity, which are all above the OECD average, to reduce premature mortality in the United Kingdom. Some 19 per cent of adults in the OECD are obese on average, but the figure in the UK is 25 per cent.
While survival after hospital admission for heart attack and stroke is improving it is “worse than many other OECD countries” including Canada, Italy, the Netherlands and Spain, the 220-page study said. The UK is ranked 20th out of 32 countries on heart attack deaths.
Mark Pearson, OECD Deputy Director of Employment, Labour and Social Affairs, said many medics were too rushed to improve the care they give.
He said: “At the moment in the NHS I think there is the risk that people do not have the time to do that. What they are doing is going through the processes ... rather than being a learning organisation, an organisation that can improve.”
He said the UK was doing “outstandingly poorly” on preventing ill health by tackling issues such as obesity thanks to lower than average levels of public investment in healthcare which was mirrored by a “somewhat mediocre performance across the board - from relatively low staffing levels, to high rates of avoidable admissions for asthma and lung disease”.
NHS funding had remained static between 2009 and 2013, the OECD report said. Mr Pearson said the UK was spending “considerably less” than many OECD countries and that “you get what you pay for” in healthcare.
The OECD average number of nurses and doctors is 9.1 and 3.3 per 1,000 population respectively, while the figure in the UK is 8.2 and 2.8. Nine countries including Greece, Italy and Portugal have more doctors per head.
Nigel Edwards, Chief Executive of the think tank the Nuffield Trust, who helped launch the report at a meeting in central London on 4 November, said 47,700 more nurses and 26,500 more doctors were needed to match the OECD average. The extra staff would cost the NHS another £5bn a year.
Mr Edwards also called junior doctors “the backbone of the workforce in hospitals” rather than more highly qualified doctors.
His verdict came as Health Secretary Jeremy Hunt writes to all 50,000 junior doctors in England in a last ditch attempt to persuade them not to take industrial action. Mr Hunt’s letter includes fresh clarification on what the changes involve to their new contracts, due to come into effect next August, and a few concessions. Basic pay is to rise by 11 per cent, but other elements, including what constitutes unsociable hours, are being curbed.
The report said that spending “out-of-pocket” on health goods and services is low in the UK and unmet care needs for medical or dental care are also comfortably below the OECD average. Waiting times for planned interventions such as hip and knee replacement are now lower than in most other OECD countries reporting data.
The UK also won praise for its coverage of vaccinations, such as the flu jab for the over 65s, while breast and cervical screening rates are well above the OECD average.
“However, too many lives are still lost because the quality of care is not improving fast enough,” the report said. “Survival following diagnosis for cancer has increased in the United Kingdom over the past 10 years, but the UK still remains in the bottom third of OECD countries in five-year relative survival for colorectal cancer, breast cancer and cervical cancer, though survival rates are improving at least as fast as the OECD average. The United Kingdom does not excel at delivering high-quality acute care either.”
David Cameron refused to answer Jeremy Corbyn at Prime Minister’s questions when the Labour leader asked whether he could guarantee there would be no winter crisis in the NHS. Mr Cameron said the NHS was benefiting from an injection of £10bn not supported by Labour at the last election.
A Department of Health spokesperson said: “We are making the NHS the safest healthcare system in the world which is why we have invested £10 billion to fund the NHS’s own plan for its future. We know there are areas where the NHS can improve which is why we have prioritised investment in the frontline and there are already more than 21,400 extra clinical staff, including 10,500 additional doctors and more than 7,600 additional nurses on our wards since May 2010.
“The OECD report shows there are many indicators where the NHS continues to be the envy of the world.”