Science is about evidence. Politics rarely is. As Stephen Hawking observed recently, politicians will sometimes cherry-pick evidence to justify policy. Yet in choosing to politicise his arguments, Professor Hawking falls into the same trap as the very politicians he accuses of being economical with the truth, by peddling several myths about the state and direction of the NHS under the current Government, when the evidence shows quite the opposite.
Myth One: The Tories are privatising the NHS. Professor Hawking asserts that “we see the balance of power in the UK with Private Healthcare companies”. Actually the evidence is to the contrary, less than eight per cent of healthcare spend is in the private sector. For decades this myth has been peddled by the left, but has been dismissed by every credible analyst, including the highly respected King’s Fund.
Myth Two: We are heading “towards a US-style insurance system.” In fact, quite the opposite is true. Private medical coverage has been shrinking for years and is down 9.4 per cent from its 2009 peak under Labour.
Myth Three: The NHS is the victim of “underfunding and cuts.”The reality is that health is the service for which public expenditure has increased the most in the last 20 years. The evidence from Treasury data shows that real terms spending has more than doubled from £62.8 billion in 1994-5 to £134.1 billion in 2014-5. Furthermore, the share of GDP spent on healthcare is now equal to the average across the OECD and the major EU economies, while the Government has pledged to increase the NHS Budget by at least a further £8 billion in this Parliament.
Myth Four: Political decisions have caused “dangerous staff shortages.” Since May 2010, the NHS has invested in almost 32,400 more professionally qualified clinical staff, including over 11,500 more doctors and 12,500 more nurses in our hospital wards. Further, an extra 1,500 doctors a year will be trained by the NHS by 2020, a 25 per cent increase in the number of domestic medical students. In addition, the NHS is providing funding for an extra 10,000 places for nurses, midwives and other healthcare professionals.
Myth Five: The Secretary of State has “cherry-picked” evidence for a “weekend effect”. In simple terms this means he has identified an unacceptable variation in care across the week. Actually, the Secretary of State settled on the most comprehensive study on this issue, the Freemantle et al (2015) study which found that patients who are admitted on a Saturday and Sunday are sicker and face an increased likelihood of death within 30 days, even when severity of illness is taken into account. So, it is not surprising that the Secretary of State has settled on a solution that seeks to ensure that patients receive consistent standards of care, including consultant assessment and access to diagnostic tests, seven days a week. This began as a clinically led process under NHS Medical Director, Professor Sir Bruce Keogh. His Seven Day Services Forum recognised what almost all doctors privately concede – that the quality and resilience of the service offered in some of our hospitals is not as good at the weekend as during the week.
Professor Hawking, who has made a career out of evidence-based scientific analysis, has himself fallen into the trap of political hyperbole and generalisations, with almost no evidence behind the very arguments he is trying to make. As the Secretary of State aptly put it “wanting to believe something, doesn’t make it true – especially as it means ignoring record funding, record numbers of doctors and an NHS delivering more operations more safely than ever before in its history.”
Across almost every benchmark the evidence is the NHS is delivering for patients. Cancer survival rates are now at a record high. We have overtaken France on cervical cancer survival rates and Germany for colorectal cancer survival rates. 100,000 patients have been helped by the Cancer Drugs Fund, with 130 more people starting treatment for cancer every day than under Labour. In mental health, we have the biggest expansion in Europe with over £1 billion of additional investment by 2020. Despite greater pressure than ever before, A&E are seeing 2,500 more people every day within 4 hours, with over 1,500 more emergency care doctors since 2010. Outpatients are up by 25,000 every day, with 5,000 additional operations daily, and MRSA rates have almost halved to the lowest rates in Europe. Heart attacks and stroke deaths have fallen by one of the fastest rates in the OECD, with the number of heart attacks treated within 90 minutes nearly doubling over the past ten years.
As recently as last month, the highly respected independent think tank, the Commonwealth Fund, rated the NHS as the “fairest healthcare system in the world with the smallest differences in healthcare accessed by rich and poor of any major country.”
However, notwithstanding Professor Hawking’s evidence-free polemic attacking the Government’s recent track record in healthcare generally, and the Secretary of State’s performance specifically, I think we can all agree with our greatest living scientist, a man who has beaten all the odds with the unstinting support of the NHS throughout his whole adult life, that the National Health Service is “Britain’s finest public service and a cornerstone of our society.”