Government has made huge strides in reforming the NHS but no evidence of a marked improvement in the nation's health, says The King's Fund audit

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The government has made huge strides in reforming the health service since coming to power in 1997, according to an independent audit of the NHS under Labour published today by The King's Fund.

But it warns there are still important problems to be solved and that as yet there is no firm evidence to show the reforms have produced a marked improvement in the nation's health.

The King's Fund audit – commissioned by The Sunday Times – assesses the progress of the NHS in England since 1997. It asks to what extent the last two Labour governments have delivered on the ambitious agenda they set themselves.

An Independent Audit of the National Health Service Under Labour (1997-2005) looks at the government's performance on health against a range of targets, including those on waiting times and spending, as well as progress made on improving care in the three clinical priority areas of cancer, heart disease and mental health.

The key findings of the audit are:

  • NHS spending: Labour has met its spending targets thanks to unprecedented increases in investment. Spending on the NHS in England has now reached European levels of expenditure. But questions remain over the productivity of the NHS and the value for money taxpayers are getting for their investment. Much of the additional new money for the NHS this year will go on pay and other 'cost pressures' such as clinical negligence claims and new drugs. This means the extra money available for additional patient services is only 2.4 per cent.
  • Waiting times: Labour has made huge progress in the area that was its highest priority for the health service. However, more work is required to reduce waiting times for diagnostic tests and end hidden waits.
  • Tackling big killer diseases: Labour has substantially met its targets to get more beds, staff and equipment into services for treating cancer, heart disease and mental health. Mortality from cancer, heart disease and suicide has fallen, although these were falling anyway. Progress on preventative measures, such as reducing smoking and improving diet, seems slow at best.
  • Beds, staff, the private sector and MRSA: Labour has secured a substantial increase in some types of hospital beds and in clinical staff, and has made good progress in modernising NHS facilities. On the downside, rates of MRSA compare badly with other countries, while employment numbers may not be quite as impressive as might first appear as government figures count the number of people employed in the NHS, regardless of whether they are working full or part-time.
  • NHS buildings: In 1997, the average age of NHS buildings was older than the NHS itself. In 2005, this is true of less than a quarter of NHS buildings. By 2010, 40 per cent of NHS buildings will be less than 15 years old.

The King's Fund chief executive Niall Dickson said:

'Overall the results of the audit undertaken by The King's Fund are positive. There has been unprecedented investment and there have been significant improvements in most areas. So, is the NHS better than it was in 1997? We believe it is, although it should be, considering the government has doubled the health service budget since it came to power. But it's too early to give a final verdict. The impact on the nation's health will take longer to emerge and the latest raft of reforms - making greater use of market incentives and regulation – have barely begun.

'While the government can take comfort from many of the findings, it's clear that there is still much more to do as - to be fair - ministers have recognised. Patients are spending too long on so-called hidden waiting lists, such as those for diagnostic tests prior to treatment; there are still staff shortages and major pressures in mental health; and the health service has been slow to wake up to the challenge of antibiotic-resistant bugs such as MRSA. On top of this, the NHS faces a huge challenge in combating the rising tide of preventable ill health. Despite all this, our audit shows that real progress has been made across a range of areas. The job may not be complete, but modernisation is well under way.'

A summary of The King's Fund audit will be published today in The Sunday Times (Sunday, 20 March) with a further summary of the findings to be published in the newspaper on Sunday, 27 March.

Read An Independent Audit of the National Health Service Under Labour (1997-2005)

Notes to editors

1. For further information or interviews, please contact The King's Fund media and public relations office on 020 7307 2581; 07831 554927; or 07774 218439. An ISDN line is available for interviews on 020 7637 0185.

2. An independent audit of the National Health Service under Labour (1997-2005) is not based on original research, but a drawing together of publicly available data. It has been commissioned by The Sunday Times. Two supplements based on The King's Fund audit will appear in The Sunday Times on Sunday, 20 March and Sunday, 27 March.

3. The King's Fund is also in the process of producing a number of election briefings that draw on the independent expertise of its policy and research staff to provide concise overviews of today's hot topics in health and social care. Briefings on patient choice and mental health have already been completed, and further ones are being produced in the following policy areas: care and care services; health care and the private sector; health inequalities and diversity; hospital cleanliness; international health care comparisons; managing long-term conditions; NHS foundation hospitals; NHS funding and the effect of market forces; NHS performance and regulation; NHS workforce; patient and public involvement; primary care; the private finance initiative; and public health.

4. The King's Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through grants. We are a major resource to people working in health, offering leadership and education courses; seminars and workshops; publications; information and library services; and conference and meeting facilities.