This month, we published the Health and Social Care Bill, which sets out our plans to modernise the NHS … as with any big change, some myths have crept in and people are understandably nervous about what it will mean for them. So I want to address some of these concerns …Myth number one is that no change is needed at all. I disagree. Despite the best efforts of staff, the NHS does not consistently deliver the patient-centred, responsive care we all want to see. Too often, the decisions of frontline doctors and nurses are over-ridden by a top-down system which doesn’t allow professionals the freedom they need. This is the reason that, despite spending the European average on health, some of the outcomes are poor in comparison. For example, someone in this country is twice as likely to die from a heart attack as someone in France …
Guardian/British Medical Journal 27.01.2012:
The number of people dying from a heart attack has halved in the last decade, with falling rates of smoking, greater use of statins to lower cholesterol, and better NHS care thought to be behind the fall.
Fewer people in England are suffering a heart attack, and fewer of those who do are dying as a result, according to research by Oxford University reported in Thursday’s British Medical Journal.
They used official NHS data on hospital admissions and mortality to study 840,175 men and women who between them had 861,134 heart attacks between 2002 and 2010.
Overall, mortality rates among men fell by 50% and among women by 53%.
Link to the BMJ article
Does poor health justify NHS reform? Prof John Appleby Kings Fund
Heart attack deaths halved in the last decade. BBC
Britian’s record on cancer, who’s right? Straight statistics
Appleby, J. Does poor health justify NHS reform? BMJ (2011) 342:d566
“The official ministerial briefing for the Health and Social Care Bill states that despite spending the same on healthcare, our rate of death from heart disease is double that in France. Although statistics from the Organisation for Economic Cooperation and Development (OECD) confirm that in 2006 the age standardised death rate for acute myocardial infarction was around 19/100,000 in France and 41/100,000 in the United Kingdom, comparing just one year-and with a country with the lowest death rate for myocardial infarction in Europe-reveals only part of the story.
Not only has the UK had the largest fall in death rates from myocardial infarction between 1980 and 2006 of any European country, if trends over the past 30 years continue, it will have a lower death rate than France as soon as 2012. These trends have been achieved with a slower rate of growth in healthcare spending in the UK compared with France and at lower levels of spending every year for the past half century”
There is also plenty of work to read on the differences in medical entries in death certificates and coding. France – more likely to die of ‘old age’.
Richards et al – rates of the diagnostic categories “Definitive” and “possible”
MI were probably underestimated by around 25%.
“Sudden death” coding more likely to be used that ischaemic heart death coding in France, Belgium, Poland.
UK more likely use heart codings as reason. Most of us will die of a heart code. I really hope I do. Even if they code it as sudden death