DOCSLIB.ORG

Labour's Record on Health (1997-2010)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Labour's Record on Health (1997-2010) WP02 Labour’s record on health (1997-2010) Working Paper 2 July 2013 Labour’s Record on Health (1997-2010) Polly Vizard and Polina Obolenskaya Preface This is one of a series of papers arising from a programme of research called Social Policy in a Cold Climate, designed to examine the effects of the major economic and political changes in the UK since 2007, particularly their impact on the distribution of wealth, poverty, inequality and spatial difference. The analysis includes policies and spending decisions from the last period of the Labour government (2007-2010), including the beginning of the financial crisis, as well as those made by the Coalition government since May 2010. The programme is funded by the Joseph Rowntree Foundation and the Nuffield Foundation, with London-specific analysis funded by the Trust for London. The views expressed are those of the authors and not necessarily those of the funders. The research is taking place from October 2011 to May 2015. More detail and other papers in the series will be found at: http://sticerd.lse.ac.uk/case/_new/research/Social_Policy_in_a_Cold_Climate.asp In our first set of papers, we look back at the policies of the Labour government from 1997 to 2010, charting their approach and assessing their impact on the distribution of outcomes and on poverty and inequality particularly. This provides a basis for analysing and understanding the changes that have subsequently taken place under the Coalition. 1 WP02 Labour’s record on health (1997-2010) Acknowledgements We are grateful to numerous individuals and organizations for their support in writing this paper. The Social Policy in a Cold Climate team including Ruth Lupton, John Hills, Tania Burchardt and Kitty Stewart has provided input, comments and guidance. The project’s lead advisor Howard Glennerster has provided specialist expertise and has helped us to shape and develop this paper in numerous ways. The work has also benefited from input and feedback from a project Advisory Group and expert comments from Julian Le Grand (LSE) and John Appelby (Kings Fund) and a discussion with Carl Emmerson (IFS). We are also extremely grateful to Abigail McKnight for editing the series and for substantive comments as the work has progressed. Nic Warner and Joe Johannes have provided critical IT expertise and Cheryl Conner has provided excellent administrative support. Responsibilities for errors in fact, substance or interpretation remains with the authors. We welcome comments on this paper, to [email protected]. 2 WP02 Labour’s record on health (1997-2010) Contents Summary ................................................................................................................................................ 7 1. Introduction ................................................................................................................................... 14 2. Goals, Policy Aims and Policies ................................................................................................... 19 Labour’s second term (2001-2005) .................................................................................................. 25 Labour’s third term (2005-2010)....................................................................................................... 28 Health policy in the devolved administrations .................................................................................. 30 3. Resources ..................................................................................................................................... 32 Real expenditure on healthcare ....................................................................................................... 33 Real total (public and private) expenditure on healthcare ................................................................ 36 International comparisons ................................................................................................................ 42 The distribution and allocation of resources across the countries and regions of the UK ................ 45 Resource allocations to local populations determined by their medical needs ................................ 46 5. Inputs and Outputs ....................................................................................................................... 52 How big was the supply side expansion? ........................................................................................ 53 Indirect estimates of the growth in healthcare supply ...................................................................... 53 Official ONS estimates of healthcare inputs, outputs and productivity ............................................. 54 Input growth ..................................................................................................................................... 55 Output growth .................................................................................................................................. 56 The debate about healthcare productivity ........................................................................................ 58 Limitations and caveats ................................................................................................................... 60 Are comparisons between public sector and private sector productivity growth valid and meaningful? ..................................................................................................................................... 61 Supply, demand and need ............................................................................................................... 63 6. Healthcare Outcomes ...................................................................................................................... 66 Access to healthcare ........................................................................................................................ 66 Patient experience and satisfaction ................................................................................................. 75 Variations in healthcare quality and sub-standard care ................................................................... 80 7. Overall Health Outcomes ................................................................................................................. 83 Life expectancy and infant mortality ................................................................................................. 85 Infant mortality ................................................................................................................................. 86 Circulatory disease and cancer mortality ......................................................................................... 88 Mental health and suicide ................................................................................................................ 90 7. Inequalities in Health Outcomes ................................................................................................... 94 Inequalities by area deprivation and social class ............................................................................. 95 Life expectancy ................................................................................................................................ 95 Infant mortality ............................................................................................................................... 102 Cancer and circulatory disease mortality ....................................................................................... 102 3 WP02 Labour’s record on health (1997-2010) Health inequalities by ethnicity and country of birth ....................................................................... 107 Marmot and beyond ....................................................................................................................... 107 8. Lifestyle, Behavioural and Risk Factors ..................................................................................... 111 Smoking and alcohol ..................................................................................................................... 111 Obesity, diet and exercise ............................................................................................................ 112 Teenage pregnancy and risk factors amongst young people ........................................................ 115 Cross-cutting analysis by social class ........................................................................................... 116 9. The UK’s International Position .................................................................................................. 118 Healthcare outcomes ..................................................................................................................... 118 Health outcomes and risk factors .................................................................................................. 124 10. Conclusions: Overall Evaluation and Looking Forward .......................................................... 133 References ........................................................................................................................................ 138 List of tables Table 1: Public sector expenditure on health, United Kingdom, 1991/2-2009/10 (a) .......................... 34 Table 2: Average real annual growth rate of public sector expenditure on health by political administration, the United Kingdom, 1959/51 – 2009/10
Load more

Recommended publications
  • A National Health Service: the British White Paper
    posals were not carried into effect. A National Health Service: The British Sixteen years later similar proposals were made by a Voluntary Hospitals White Paper* Commission established by the Brit• ish Hospitals Association under the THE BRITISH WHITE PAPER on a Na• Health Insurance was enacted in chairmanship of Lord Sankey. tional Health Service was made pub• 1911; shortly after medical benefits lic on February 17. In it the Minister became payable it was recognized One of the most complete official of Health and the Secretary of State that there was a strong case for add• surveys of Scottish health services for Scotland recommend the estab• ing consultant services to the general and health problems ever attempted lishment of a National Health Service practitioner services provided. In was published in 1936 in the Cathcart "which will provide for everyone all 1920, a Consultative Council on Med• report of the Committee on Scottish the medical advice, treatment and ical and Allied Services, appointed by Health Services. Their recommenda• care they may require." The pro• the Minister of Health, with Lord tions assume throughout that the posals are offered at this time for dis• Dawson of Penn as chairman, re• separate medical services must be cussion in Parliament and in the ported and recommended a compre• integrated and that the coordinated country but not as fixed decisions. hensive scheme under which all forms medical service should be based, as "The Government will welcome con• of medical service would be made far as possible, on the family doctor. structive criticism and they hope that available, under suitable conditions, The latest official report on hospital the next stage—the stage of consul• to the population at large.
    [Show full text]
  • The NHS in Wales: Structure and Services (Update)
    The NHS in Wales: Structure and services (update) Abstract This paper updates Research Paper 03/094 and provides briefing on the structure of the NHS in Wales following the restructuring in 2003, and further reforms announced by the First Minister in 2004. May 2005 Members’ Research Service / Gwasanaeth Ymchwil yr Aelodau Members’ Research Service: Enquiry Gwasanaeth Ymchwil yr Aelodau: Ymholiad The NHS in Wales: Structures and Services (update) Dan Stevenson / Steve Boyce May 2005 Paper number: 05/ 023 © Crown copyright 2005 Enquiry no: 04/2661/dps Date: 12 May 2004 This document has been prepared by the Members’ Research Service to provide Assembly Members and their staff with information and for no other purpose. Every effort has been made to ensure that the information is accurate, however, we cannot be held responsible for any inaccuracies found later in the original source material, provided that the original source is not the Members’ Research Service itself. This document does not constitute an expression of opinion by the National Assembly, the Welsh Assembly Government or any other of the Assembly’s constituent parts or connected bodies. Members’ Research Service: Enquiry Gwasanaeth Ymchwil yr Aelodau: Ymholiad Members’ Research Service: Enquiry Gwasanaeth Ymchwil yr Aelodau: Ymholiad Contents 1 Introduction .......................................................................................................... 1 2 Recent reforms of the NHS in Wales................................................................... 2 2.1 NHS reforms in Wales up to April 2003 ................................................................. 2 2.2 Main features of the 2003 NHS organisational reforms ......................................... 2 2.3 Background to the 2003 NHS reforms ................................................................... 3 2.4 Reforms announced by the First Minister on 30 November 2004........................... 4 3 The NHS in Wales: Commissioners and Providers of healthcare services ....
    [Show full text]
  • Devolution V2.3
    Is Devolution Creating Diversity in Education and Health? A report on Health and Education Policy and Performance in Wales and Scotland. Prof Colin Talbot, Dr Carole Johnson and Mark Freestone Commissioned by the BBC (World This Weekend, Radio 4) 1 of 29 Is Devolution Creating Diversity in Education and Health? A report on Health and Education Policy and Performance in Wales and Scotland. Prof. Colin Talbot, Dr Carole Johnson and Mark Freestone Nottingham Policy Centre University of Nottingham August 2004 Commissioned by the BBC (World This Weekend, Radio 4) 2 of 29 1 Summary This research was carried out in August 2004 for the BBC. We have simply collated and analysed existing information about the new devolved governments of Wales and Scotland in the fields of health and education. We have focussed on inputs (what is being spent), policies and results. This is not meant to be a comprehensive analysis but has focussed on noteworthy issues of difference and divergence. A surprising amount of change is taking place (especially in health), given initial scepticism about just how ‘devolved’ the new institutions would be. But also a great deal remains the same – the underlying educational and especially health problems in Wales and Scotland have not (yet) dramatically improved and in some areas have gotten markedly worse (e.g. waiting list problems in Wales). Here we provide a simple summary of what we have found so far in gathering and analysing what evidence is available on the policies and performance of the new devolved administrations in the field of health and education.
    [Show full text]
  • Pupil Behaviour in Schools in England
    Research Report DFE-RR218 Pupil behaviour in schools in England Education Standards Analysis and Research Division The views expressed in this report are the authors’ and do not necessarily reflect those of the Department for Education. Executive summary Aim The aim of this topic note is to bring together the evidence around pupil behaviour in schools in England. It examines what is known about the nature and standard of behaviour in English schools; the impact of poor behaviour on pupils and teachers; and what schools and teachers can do to promote good pupil behaviour. Where possible it also draws on international evidence to compare what is happening in England with other nations or to expand the available research. Summary of key findings Chapter 2: The standard and nature of pupil behaviour in school • According to Ofsted inspection data, the majority of schools have Good or Outstanding levels of behaviour. As at December 2011, 92.3% of all schools in England were judged Good or Outstanding for standards of behaviour. A further 7.5% were judged Satisfactory and less than one per cent (0.3%) were judged Inadequate (Ofsted, 2012). • There is some variation by school type, where 93.9% of primary schools, 84.4% of secondary schools, 92.9% of special schools and 83.2% of Pupil Referral Units (PRUs) were judged by Ofsted to have Good or Outstanding standards of behaviour. • There is mixed evidence on the extent of poor behaviour reported by teachers. Surveys of teachers show that pupils are mainly regarded as behaving well, with around 70% reporting good behaviour (NFER, 2012, forthcoming; NFER, 2008; Wilson et al, 2007; COI, 2005).
    [Show full text]
  • Download the Rich Picture on Non Hodgkin Lymphoma
    THe RicH PiCtuRE Mario, 54, living with non-Hodgkin lymphoma Understanding the numbers, needs and experiences of people affected by cancer About this ‘Rich Picture’ This document is a collation of the key available evidence about the numbers, needs and experiences of people affected by cancer. Our aim is that the insight within this document will summarise the numbers, needs and experiences of people affected by cancer for Macmillan staff, cancer care professionals, volunteers and other interested parties. It includes data specific to the particular group who are the focus of this Rich Picture, as well as more generic information about all people affected by cancer where specific data are not available or where the information applies to all groups of people with cancer. The Rich Picture is intended to be accessible to both clinical and non-clinical cancer support staff. Therefore the language and facts included are intended to cater for information needs of both groups. We have included references to other documents to help with interpretation of some facts included, and a Jargon Buster of some technical terms is included in Appendix A. The information could be valuable in many ways: • Adding weight and evidence to negotiations with partners and commissioners • Providing evidence to support campaigning • Enabling more effective marketing • Inspiring and engaging supporters to give and do more • Providing some insight into the lives of people with cancer This document is not intended to • Be a comprehensive collation of all evidence on the group affected by cancer who are the focus of this Rich Picture • Suggest or recommend that specific action should be taken For simplicity, the year to which the data in this document relate and the sample size is not always shown in the main sections, however this is shown in the original data linked from the references section.
    [Show full text]
  • The Coalition's Record on Housing
    Working Paper 18 January 2015 The Coalition’s Record on Housing: Policy, Spending and Outcomes 2010-2015 Rebecca Tunstall WP18 The Coalition’s Record on Housing: Policy, Spending and Outcomes 2010-2015. Acknowledgements The author would like to thank Kathleen Kelly, Stuart Lowe, Ruth Lupton, Bert Provan, Rachael Takens- Milne, David Utting, Sharon Witherspoon and staff at the Centre for Housing Policy at the University of York for their comments on drafts of this paper. The paper draws on Office for National Statistics (ONS) statistics which are subject to Crown copyright and are reproduced under the Open Government Licence v.3.0. 2 WP18 The Coalition’s Record on Housing: Policy, Spending and Outcomes 2010-2015. Contents Summary .................................................................................................................................................... 5 1. Introduction .......................................................................................................................................... 8 2. The Coalition’s housing policy goals.................................................................................................. 13 The Coalition Agreement ................................................................................................................... 13 The Localism Act 2011 ...................................................................................................................... 15 Laying the Foundations 2011 ...........................................................................................................
    [Show full text]
  • Watching the FIFA World Cup 2010 in England: the Sojourner Perspective
    Watching the FIFA World Cup 2010 in England: the sojourner perspective Ian Jones, Lorraine Brown* and Steven Richards School of Tourism, Bournemouth University, Poole, UK (Received 18 March 2011; final version received 3 September 2012) Recent years have seen an emergence of a varied academic literature focused on the football fan, with a wealth of studies exploring issues such as hooliganism, fan behaviour and fan identification. No research, however, has documented the experiences and perspectives of the international sojourner, who follows the tele- vised tournament far away from the home country. This paper offers a contribu- tion to the literature on fandom by focusing on the experiences of becoming a temporary fan among a sample of nine international students in England during the period of the 2010 FIFA World Cup. It shows the importance of the tourna- ment for students away from their home nation, acting as a point of celebration and as a means of bringing sojourners of the same nationality together to sup- port their team. It reveals how the tournament offered escape from stress, became a focal point for social interaction, provided the opportunity for recrea- tion of home, and for the reinforcement of feelings of national identity. Keywords: temporary fans; sojourners; FIFA World Cup; escapism; social interaction; identity Introduction The aim of this paper is to explore how a particular type of sport consumer – the sojourner – experiences watching a sporting mega as a ‘temporary fan’ (Hunt, Bristol, & Bawshaw, 1999) of the sport event whilst residing outside their own country. The sojourn is defined as temporary between-culture contact of between six months and five years; sojourners include international students, migrants and refugees (Ward, Bochner, & Furnham, 2001).
    [Show full text]
  • The Four Health Systems of the United Kingdom: How Do They Compare?
    The four health systems of the United Kingdom: how do they compare? Gwyn Bevan, Marina Karanikolos, Jo Exley, Ellen Nolte, Sheelah Connolly and Nicholas Mays Source report April 2014 About this research This report is the fourth in a series dating back to 1999 which looks at how the publicly financed health care systems in the four countries of the UK have fared before and after devolution. The report was commissioned jointly by The Health Foundation and the Nuffield Trust. The research team was led by Nicholas Mays at the London School of Hygiene and Tropical Medicine. The research looks at how the four national health systems compare and how they have performed in terms of quality and productivity before and after devolution. The research also examines performance in North East England, which is acknowledged to be the region that is most comparable to Wales, Scotland and Northern Ireland in terms of socioeconomic and other indicators. This report, along with an accompanying summary report, data appendices, digital outputs and a short report on the history of devolution (to be published later in 2014), are available to download free of charge at www.nuffieldtrust.org.uk/compare-uk-health www.health.org.uk/compareUKhealth. Acknowledgements We are grateful: to government statisticians in the four countries for guidance on sources of data, highlighting problems of comparability and for checking the data we have used; for comments on the draft report from anonymous referees and from Vernon Bogdanor, Alec Morton and Laura Schang; and for guidance on national clinical audits from Nick Black and on nursing data from Jim Buchan.
    [Show full text]
  • NHS Reorganisation After the Pandemic
    EDITORIALS BMJ: first published as 10.1136/bmj.m4468 on 18 November 2020. Downloaded from Health Foundation, London, UK [email protected] NHS reorganisation after the pandemic Cite this as: BMJ 2020;371:m4468 Major structural change should not be part of the plan for recovery http://dx.doi.org/10.1136/bmj.m4468 Published: 18 November 2020 Hugh Alderwick head of policy Before covid-19 hit, national NHS bodies had asked the day-to-day workings of the NHS—something the 1 the government to make changes to NHS legislation. 2012 act sought to loosen. These changes were designed to make it easier for NHS England has become the de facto headquarters NHS organisations in England to collaborate to plan for NHS strategy under Simon Stevens, its chief and deliver services—including through establishing executive. The previous health secretary, Jeremy joint committees between commissioners and 2 Hunt, has said he never felt he “lacked a power to providers. Since then, government and the NHS have 9 give direction” to the NHS under the 2012 act. But been focused on managing covid-19. Proposals for perhaps the incumbent feels less powerful. Reform new legislation were temporarily shelved. to bring NHS England under closer political control But not for long: legislation for the NHS in England may also help build a narrative, ahead of any covid-19 seems to be back on the agenda. Media stories public inquiry, that arm’s length bodies—not emerged in the summer that the prime minister was government—are to blame for England’s pandemic considering proposals for a major NHS performance.
    [Show full text]
  • Frontiers of Health Report V9.Indd
    Social Research Institute Frontiers of performance in the NHS II “Stop looking up to the Department... and start looking out to your local populations and patients” David Nicholson NHS Chief Executive About Ipsos MORI Ipsos MORI is the sum total of two successful research companies, Ipsos UK and MORI, which joined together in October 2005 to create the second largest research company in the UK. We offer a full range of quantitative and qualitative research services, as well as extensive international research capacity. The Ipsos MORI Social Research Institute works closely with national government, local public services and the not-for-profit sector. We help policy makers understand what works in terms of service delivery, and we provide robust evidence to bridge the gulf between the public and politicians — we also provide a host of background information for clients on key policy challenges. The NHS and Public Health research team is a leading provider of research on attitudes of public service users, staff and other stakeholders. The team works extensively with the Department of Health and many Trusts and Strategic Health Authorities on a wide range of issues, from communications approaches to patient satisfaction, using the full range of research techniques. 2 Ipsos MORI: Frontiers of performance in the NHS II Contents Foreword 2 Executive Summary 4 Introduction 6 How is performance measured in the NHS? 6 Structure of the report 9 Part 1 – PCTs 11 1. What factors are associated with positive patient ratings of PCTs? 12 A. The effect of objective performance measures 12 B. Local population factors 16 C.
    [Show full text]
  • 1 TREORCHY Ramah Chapel JHD TJ 2 PENTRE St Peter's Church JHD
    1947 TOTAL NO DATE VENUE ARTISTS REMARKS PROCEEDS CHOIR CON ACC AUD 1 1 Sun July TREORCHY Cas Powell, Jack A collection of £12 made for Choir Funds JHD TJ 20 Hughes, D. Davies, choir funds – the start of a Ramah Chapel Eddie Hughes glorious future! 2 2 Sun July PENTRE Olive Jones & organists A £2.2.0 from the church to Choir Funds JHD TJ 27 Nancy Dotter, Myra choir funds St Peter’s Church Lewis, Bryn Howells 3 3 Sun Aug CWMPARC Leslie Edwards, Idris A £7 collection for the choir Choir Funds JHD TJ 10 Higgon, Tom Griffiths. funds Salem Chapel Eddie Hughes 4 4 Mon PORTHCAWL Hilda Edwards, Idris The first “away” concert JHD TJ Sept 14 Higgon, Eddie Hughes. The Pavilion D. Davies 5 5 Sun Dec TREORCHY Hilda Edwards, Idris Organised by the Chapel JHD TJ 9 Higgon, D. Davies Fellowship Bethlehem Chapel 1948 TOTAL NO DATE VENUE ARTISTS REMARKS PROCEEDS CHOIR CON ACC AUD 6 1 Sun TREORCHY Linda Parker, William The Choir’s First Celebrity JHD TJ April 1 Parsons Concert Bethlehem Chapel Sat May Adjudicators Dr The Whitsun Eisteddfod. £20 won for 7 2 TREORCHY nd JHD TJ 18 Sumpsion & Ivor Owen Awarded 2 Place (behind Choir Funds Parc & Dare Hall Pendyrus) on Nidaros Sat June Adjudicator: Prof Semi-National Eisteddfod. £40 won for 8 3 LLANHARAN st JHD TJ 26 Joseph Lewis Awarded 1 Place for Choir Funds Eisteddfod Field (Guildhall School Mus) performance of Nidaros 9 4 Sun TREHERBERT Miss Bick, Tom £10 to church JHD TJ June 27 Griffiths, Idris Higgon funds Blaen-y-Cwm Chapel 10 5 Sun July TREORCHY Sam Griffiths, Haydn First appearance of Sam £15 to chapel JHD TJ 2 Parfitt, Master John Griffiths as choir soloist funds Ramah Chapel Hughes 11 6 Sun July CWMPARC W.
    [Show full text]
  • Metafiction in New Zealand from the 1960S to the Present Day
    Metafiction in New Zealand from the 1960s to the present day A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in English Massey University, Albany, New Zealand Matthew Harris 2011 Metafiction in New Zealand from the 1960s to the present day (2011) by Matthew Harris (for Massey University) is licensed under a Creative Commons - Attribution -NonCommercial -NoDerivs 3.0 Unported License. Permissions beyond the scope of this license may be available at www.matthewjamesharris.com. ii ABSTRACT While studies of metafiction have proliferated across America and Europe, the present thesis is the first full-length assessment of its place in the literature of New Zealand. Taking as its point of reference a selection of works from authors Janet Frame, C.K. Stead, Russell Haley, Michael Jackson and Charlotte Randall, this thesis employs a synthesis of contextual and performative frameworks to examine how the internationally- prevalent mode of metafiction has influenced New Zealand fiction since the middle of the 20 th century. While metafictional texts have conventionally been thought to undermine notions of realism and sever illusions of representation, this thesis explores ways in which the metafictional mode in New Zealand since the 1960s might be seen to expand and augment realism by depicting individual modes of thought and naturalising unique forms of self-reflection, during what some commentators have seen as a period of cultural ‘inwardness’ following various socio-political shifts in the latter
    [Show full text]