Ministers 'massaged NHS statistics'

Radical Statistics health group says ministerial statements on impact o f reforms are not supported by figures
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The Independent Online
BY ROSIE WATERHOUSE Health Services Correspondent

Ministers use statistics about the National Health Service in a selective and misleading way to present a positive picture of the Government's reforms, according to an analysis by independent statisticians.

The analysis will reinforce controversy over the Government's use of official statistics. In the Independent yesterday Bill McLennan, head of the Government Statistical Service said the Government should change its method of counting unemployment .

His remarks prompted Labour to call on the Prime Minister to accept an internationally-recognised definition.

The Radical Statistics health group has studied statements and claims about the success of the Government's reforms of the health service made in the latest NHS Executive annual report and by ministers, including Virginia Bottomley, Secretary of State for Health, and Gerald Malone, Minister for Health.

The group concluded: "The information released tends to be selective good news. . . . Ministerial press releases use statistics in an undefined and misleading way. The statistics themselves do not even support the interpretations politicians place on them."

But Tom Sackville, junior health minister, said: "There is absolutely no basis for any charge of misuse of statistics and health ministers are absolutely scrupulous in their use of figures supplied to them and validated by civil servants."

In a preview of a report to be pubished in the new year the group examined the statistics under several key headings.

Funding The 1993-94 NHS Executive annual report says: "Under the Government, NHS spending has risen from £7bn to £37bn, a 64 per cent increase."

The group argues that the figures are in cash terms and the increase is in real terms, which take no account of actual spending ahead of inflation. For example, spending on the running costs of the hospital and community health services, which account for about two thirds of NHS spending, rose by 37 per cent ahead of general inflation as measured by the Gross Domestic Product deflator over the years from 1978-79 to 1990-91, but by only 13 per cent ahead of NHS pay and prices.

Patients treated In Commons debate in October, Mrs Bottomley said: "New figures from the Government's statistical service show that in the past year alone NHS hospitals treated an extra 455,000 patients. That is a 4.7 per cent increase."

The analysis argues that the statistics are actually numbers of in-patient "finished consultant episodes" plus day cases.

Up to the financial year 1987-88, people were counted each time they were discharged from hospital and the statistics were expressed in terms of "discharges and deaths". Since the financial year 1988-89, in-patients have also been counted each time they change consultant or speciality within a hospital stay.

Therefore, the figures Mrs Bottomley referred to actually showed that the number of finished consultant episodes - not individual patients - rose by 455,000.

Waiting lists The NHS Executive annual report says: "There was good progress during the year on reducing waiting times for in- patient and day case treatment."

The number of people on waiting lists has actually risen in recent years to 1,063,302 and the Radical Statistics analysis argues the Government has shifted its agenda to waiting times. Waiting times are measured from the date the clinician decides to admit the patient. Delays in making such decisions can make recorded waiting times shorter. In addition, patients already on the waiting list who are subsequently offered a date but are unable to attend have their waiting times calculated from the most recent date offered. These are known as self- deferred cases.

Data requested by the Commons Health Select Committee show self-deferrals rose from 48,343 from March to June in 1988 to 66,901 from September to December in 1993. The number removed from the waiting list rose from 90,931 to 219,564.

Building projects The NHS Executive annual report said: "During the year 100 major schemes each costing over £1m were completed and 206 schemes totalling over £1.2bn were in progress".

The Radical Statistics report said: "This is not as impressive as it may seem as there is often more than one such scheme in each successive phase of a development on the same site. In contrast, the average number of acute beds available daily decreased by 37,000 from 147,000 in 1979 to 110,000 in 1993-94. Over that period the number of acute beds in the private sector in England rose by 4,476.

Public satisfaction Mrs Bottomley said last month: "Increased public satisfaction with the NHS is a sign that the benefits of the Government's reforms are showing through."

The statisticians' analysis shows that in 1993, some 44 per cent of people questioned said they were very or quite satisfied compared with 37 per cent in 1990 - fewer than the 55 per cent in 1983.