NHS chief attacks bleak prediction of future cost

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Public Policy Editor

Alan Langlands, the NHS chief executive, yesterday attacked the "gloom and doom" view that the NHS cannot be afforded and that both rationing and privatisation of the health service is inevitable.

In a straightforward rebuke to Sir Duncan Nichol, his predecessor, and Rodney Walker, the outgoing chair of the NHS Trust Federation, Mr Langlands said he wanted to "distance himself" from what he dubbed the "ration-and- privatise brigade".

Launching the NHS annual report, Mr Langlands said there would always be a gap between everything the NHS might wish to do and what was possible. Choices had to be made and setting priorities was "a fact of life".

But that reality was "neither new nor peculiar to the health service". He did not find the arguments in Sir Duncan's Healthcare 2000 report "terribly convincing", and accused Mr Walker of appearing to "talk up some sort of immediate crisis". The NHS was under "significant pressure", Mr Langlands said, but the service was coping, "with good ideas about changing the way things are done".

The pressures of an ageing population, medical advance and heightened expectations were not new, Mr Langlands said, "and the NHS has been responding to them successfully for many years".

Over the next five to 10 years, the population "is not ageing at a pace that we won't be able to cope" given the real terms growth the NHS has been promised. The numbers of people over 85 - whose care on average costs 10 times as much annually as those aged 16 to 44 - were set to rise from only 1.6 per cent of the population to 2.1 per cent between 1990 and 2000.

There were problems over expensive new drugs, but other advances such as minimally invasive surgery and the possible development of artificial bone saved money.

His comments came as Stephen Dorrell, the Secretary of State for Health, praised the Greater Glasgow Health Board for shifting its contracts for breast surgery to six named consultants whose results provided a 10 per cent better survival rate. It has also restricted treatment of testicular cancer to one hospital with and more successful treatment.

NHS Annual Report 1994/5. Free. Telephone 0800 555 777.