Education And Debate

NHS “indicators of success”: what do they tell us?

BMJ 1995; 310 doi: (Published 22 April 1995) Cite this as: BMJ 1995;310:1045
  1. Radical Statistics Health Groupa
  1. a c/o London Hazards Centre, Interchange Studios, London NW5 3NQ
  • Accepted 23 March 1995

In the absence of any systematic evaluation of the changes it has made to the NHS, the government cites three “indicators of success.” These are record numbers of patients treated, shorter waiting times for hospital treatment, and more children being immunised against the main childhood diseases. Closer inspection of the statistics reveals that they do not support the conclusions inferred from them and that they are misleading measures of the impact of the changes made to the NHS.

The government has repeatedly claimed that the introduction of the internal market and the other changes to the NHS are a huge success. What evidence is there for this? There has still been no rigorous evaluation of the changes. Instead, government politicians keep quoting statistics to support their views. For example, Virginia Bottomley's speech to the 1994 Conservative Party conference (Conservative Party press release 751/94, 1994) and the 1993-4 annual report of the NHS Executive quoted the usual indicators of success. These were record numbers of “patients treated,” shorter waiting times for hospital treatment, and more children being immunised against the main childhood diseases.1 These same statistics were quoted three years ago in a document making similar claims for the success of the first six months of the internal market.2

This article takes a closer look at these statistics about the NHS in England, to see whether the claims based on them are justified, and closes by recommending ways of making NHS data more informative.

More patients treated?

“New figures from the government's statistical service show that in the past year alone, NHS hospitals treated an extra 455000 patients. That is a 4.7% increase.”3

Ministers frequently quote figures about the activity in NHS hospitals as if they referred to the actual numbers of people treated, but the statistics cited above by Virginia …

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