The British Commission for Healthcare Audit and Inspection, known as the Healthcare Commission, today told the British NHS, it must do more to help people with the greatest need for healthcare. In its first report into the state of British healthcare the independent inspectorate said there are many positive indicators that healthcare provided by the NHS is improving. But it also said the pace of the improvement is not enough for the people who need help most.
Examples of improvement include patients typically waiting less time for treatment in hospital and GP surgeries, falling mortality rates from cancer and many more hospitals having dedicated units for stroke patients, which can greatly improve their chances of recovery. However, the report also found wide variations in healthcare and health between different parts of the country and different groups of the population. For instance, the death rate from cancer is 60% higher in Liverpool than in east Dorset and long term illness or disability is more common among people with lower incomes.
The State of Healthcare Report 2004 examines many aspects of the NHS� provision of healthcare, including care in hospitals and in the community, public health, mental health, care of children and of the elderly.
Sir Ian Kennedy, Chairman of the Healthcare Commission said: �The NHS is highly complex, ranging from GPs� surgeries to intensive care units and from clinics treating those with drug addiction to care for those who need mental healthcare. Some parts of the system are performing better than others.
�It also serves a huge range of people, from pregnant mothers to newborn babies, the chronically ill, those with acute illnesses and those at the end of their lives. It must serve the whole nation, not just those who live in certain areas, or those best able to demand healthcare of good quality.
�My concern, and that of the Healthcare Commission, is that those most in need may still be getting the worst deal.�
The Healthcare Commission today pledged to put inequalities in healthcare and health at the top of its agenda. The Commission will be vigilant in checking that every citizen receives healthcare according to their needs regardless of their circumstances and background. Part of its future work will be dedicated to ensuring that the NHS identifies why the experience of healthcare varies and what it intends to do to address the clear inconsistencies in the provision of services. For example, it appears that a disproportionately high proportion of those compulsorily admitted to mental health units are from black and minority ethnic groups, and the proportion of older people in the population receiving flu vaccinations varies from 49% to 78% across England.
The Healthcare Commission also found variations between England and Wales. For instance, patients are more likely to wait longer for hospital appointments in Wales than in England. In March 2004, fewer than 50 people were waiting more than nine months for an operation in England. In Wales at the end of the same month, 8,457 patients had been waiting longer than 12 months, of which 1,401 had been waiting longer than 18 months.
The Government�s spending on healthcare is increasing. However, the Healthcare Commission is concerned about how those funds are allocated across the country. On historical grounds, some communities receive more money than others. The Government has a formula to address anomalies and to determine how much each community should get, based on the needs of its population, including age, deprivation and amount of ill-health. But many deprived communities, who have the greatest health needs, are not getting as much as they should according to the formula. For instance, Easington in County Durham should be receiving an additional �26.5 million a year while Kensington and Chelsea is receiving �30.3 million a year more than the formula requires.
Sir Ian Kennedy said: �We recognise the Government has a system that, by 2010, will move communities away from their historical funding towards the funding that they should receive. Eventually, more money will go to the communities that most need it. However, 2010 is far away and the Healthcare Commission would like to see more money going to those who need it, more urgently. We believe this is important if the Government is going to achieve its targets for health and healthcare.�
Sir Ian Kennedy also said that solving inequalities in healthcare will also require action to improve the health of people in those communities. This will require partnership between local authorities, schools, healthcare organizations and others. The Healthcare Commission will work with the Audit Commission and other bodies to ensure that all those concerned work towards improving the health of the population.