London School of Hygiene & Tropical Medicine

A new analysis by researchers at the London School of Hygiene & Tropical Medicine and RAND Europe shows that the additional NHS spending after 1999 resulted in better health outcomes when measured using the concept of "amenable mortality", an indicator proposed for routine use by the current government. Professor Martin McKee, one of the paper's authors, says: "Using the coalition government's chosen measure of health outcomes, it is clear that the increased funding of the NHS in England and Wales under their predecessors made a real difference to health."

The study, published in the latest issue of the Journal of the Royal Society of Medicine, measured deaths amenable to medical care (deaths that should not occur in the presence of timely and effective care) and compared performance in England and Wales with that of Scotland and Northern Ireland.

Martin McKee, Professor of European Public Health at the School, says: "So far, most attention has been paid to measures of 'productivity', counting how many patients were treated at what cost. Yet this measure views patients as objects to be moved through the system as cheaply as possible, with no regard for whether they actually benefit."

This study indicates how, between 1990 and 1999, the pace of decline in deaths amenable to medical care in England and Wales was somewhat slower than in the comparatively more generously-funded Scotland and Northern Ireland. "Once the additional funding was made available to the NHS in England and Wales, the pace of improvement accelerated, overtaking that in the other two nations," Professor McKee adds.

The authors caution that while amenable mortality is a valuable indicator of health system performance, there are certain methodological issues that must be taken into account when interpreting data.

"The picture was not the same across the board. It varied by cause and not every change could be accounted for by the increase in funding. For example, deaths due to breast cancer reduced in all parts of the UK because of changes in the management of the disease in the 1990s, a time when new and effective drugs were being introduced and the national screening programme was being rolled out."