Myth one: the NHS is performing poorly compared to other countries' health systems

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Part of The Health and Social Care Bill

When it comes to health results and health care quality are we lagging behind other nations or leading the field?

What have we found?

Our review of NHS performance since 1997, published last year, identified that the NHS has made significant progress over the past decade, with a number of notable achievements.

  • Hospital waiting times reduced dramatically from 1997-2010, with more than 90 per cent of patients waiting less than 18 weeks for treatment last year.
  • Infant mortality has fallen and life expectancy is increasing for all social groups.
  • Smoking rates have fallen, and deaths from cancer and cardiovascular diseases have been steadily declining.
  • Infection rates for MRSA and C. difficile have been significantly reduced, and there are now robust systems for collecting and analysing information on adverse events.
  • In mental health services, access to specialist early intervention and crisis resolution teams is considered among the best in Europe.
  • There is now far more information available to patients, professionals and the public about how services perform.

What other evidence is there?

Our analysis is reflected in national and international surveys:

However, while good progress has been made, performance needs to improve in a number of areas before the NHS can be deemed truly world class. For example:

  • Although cancer survival rates have improved, international comparisons show we still lag behind other countries in survival rates for several types of cancer.
  • While infant mortality has fallen, recent analysis published by the British Medical Journal suggests that UK child mortality rates are higher than in many other European countries.
  • NHS productivity has declined by an average of 0.2 per cent a year since 1995 according to estimates by the Office of National Statistics.
  • While progress has been made in reducing smoking, there have been increases in alcohol consumption and related hospital admissions, and obesity rates have risen significantly.
  • Inequalities in life expectancy between rich and poor have widened, even though life expectancy is increasing for all groups.
  • Support for people with long-term conditions is inconsistent and people continue to be admitted to hospital for conditions that could be managed in the community.
  • Variations in the quality of general practice and in the treatment provided in hospitals remain persistent and widespread

Is it a myth or a fact?

Myth. The evidence shows that the NHS is performing well compared to other countries' health systems, although there is still room for improvement in some areas.


Rod Griffiths

Retired RDPH,
None now, Formerly West Midlands, Faculty of Public Health and NCG.
Comment date
20 May 2011
It would be useful to have some international comparisons on the efficiency question. It seems to me that if you have a massive campaign of staff recruitment, new drugs and PFI hospitals etc. the crude measures of efficiency are almost bound to get worse, but what does it look like in France of Germany or the USA?

Perviz Iqbal

Consultant O & G,
Comment date
20 May 2011
An international comarison of the the cost of health care per head of population would be a more useful indicator of efficiency.
Endless reforms of the NHS are probably the major causeof 0.2 % decline in productivity since 1995. Every reform appears to create more burecarcy and decline in clinical productivity.