Does poor health justify NHS reform?

doi:10.1136/bmj.d566

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John Appleby, chief economist

¹King’s Fund, London W1G 0AN, UK

j.appleby{at}kingsfund.org.uk

Andrew Lansley claims radical NHS reform is necessary to drive up the UK’s poor health outcomes compared with Europe. But is our record really so bad, questions John Appleby?

On the basis that if it ain’t broke don’t fix it, England’s health secretary, Andrew Lansley, has said that his reforms for the NHS are needed because the country’s health outcomes are among the poorest in Europe. But are they?

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.1 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,2 …