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* NHS is Among Worst in the West
* NHS 'Like a Sausage Factory'
* French Doctor Quits NHS in Disgust
* One In Two Will Suffer Cancer
* Experts Call for Free Care

The Government's plan to pour billions into the National Health Service may be doomed to failure, according to an international study that exposes how far Britain lags behind other western countries in treating patients.
A two-year research project by the Paris-based OECD, which is to be published today, shows that Britain's healthcare system is one of the least effective and ranks alongside Hungary, one of the poorest OECD members, on key measures.
Significantly, the research suggests that systems where doctors are paid according to the numbers of treatments they carry out - a "fee-for-service" system - offers improved standards of care. It criticises "supply side constraints" in the NHS, which amount to an unacknowledged rationing of resources.
The study, which focused on three of the biggest medical killers - heart disease, stroke and breast cancer - will be a blow to Gordon Brown, the chancellor. He has announced plans to increase NHS spending from £65 billion this year to more than £105 billion in 2007-08 but has rejected an expanded role for private insurance or a continental-style social insurance system.
The OECD research suggests that such systems deliver better healthcare relative to the amount of money poured in.
The study was carried out by 40 teams working in 17 different countries. It looked at illness and treatment and at the way healthcare was funded and money spent. The findings to be published at a conference in Washington are likely to demolish any notions that the NHS is the envy of the world. "If you don't pay doctors according to performance, any other change you make to the system is merely tinkering" said a senior researcher.
Victims of heart disease, stroke or breast cancer in Britain die early and un-necessarily compared with most other western countries, OECD figures show.
The Department of Health rejected the findings and said that the health service's performance had improved dramatically since data was collected by the OECD study in the late 1990s.
Alan Milburn, the health secretary said "After decades of underfunding the NHS needs the investment we are now making to put us up with the best healthcare systems in Europe. The investment has got to be matched by reform".
The OECD found that countries that rewarded medical specialists by paying them according to performance tended to get better results. Cardiac surgeons in countries such as Belgium and Switzerland carried out many more operations than NHS doctors on fixed salaries, even though Britain has much higher heart disease levels.

The NHS was being turned into a "sausage factory" by the Government's emphasis on crude productivity targets at the expense of patient care, a doctor said yesterday.
Dr lan Bogle, chairman of the British Medical Association, said that the Health Service had become a "Punch and Judy show" in which patients and staff were used as "playthings" by the politicians.
He told BMA's annual conference in Harrogate that the extra billions promised in the Budget for health were welcome.
But he warned: "I hope politicians will have the sense to let the professionals get on with the job without unnecessary hoops, hurdles, targets and wheezes from Whitehall.
"Do we want this new money to help us to deliver a sausage factory service based on productivity targets which ignores the needs of individuals and the importance of time with patients? Crude productivity targets are no measure of quality."
To applause, he added: "Doctors arc not working on a production line. Doctors are providing individual care for individual patients with individual needs."
He told the Government it must consult the profession before announcing major changes.
Dr Bogle added: "Make no mistake, we will bite, and we will bite hard and where it hurts, if that's what it takes to make the Government understand that it cannot use the NHS, those who work in it and those who need it, as political playthings."

A senior French doctor brought in to shake up GP services in central London has resigned in disgust after just four months, saying the NHS is incompetently managed and inherently resistant to change.
Alain Sanouiller, 42, began working for the health service in May. However, last month he decided to leave early after falling out with his colleagues, who, he says, stubbornly resisted any change or reform.
As a monitor of NHS standards, Sanouiller was asked to review patient care at Westminster Primary Care Trust, which covers staff working at Buckingham Palace, as well as civil servants in Whitehall and the Palace of Westminster.
He immediately identified 110 people who were receiving sub-standard treatment, and 12 who had to be recalled urgently.
He also claimed that 90% of patients being treated at other outpatient clinics where he worked were receiving inadequate care, with up to 15% being "put at danger".

Cancer rates in Britain will reach epidemic proportions over the next two decades, with double the number of people suffering the disease, public health experts predict.
It is already estimated that one in three people will get cancer during his or her lifetime - but in about ten years that will rise to one in two.
“There are about a million people who have cancer and we estimate that in 2015 the figure will increase to two million,” said Prof Karol Sikora, a cancer specialist at London’s Hammersmith hospital. “Cancer is going to become so commonplace it will be almost nor­mal and will affect virtually every family. If you go back -20 years-and the ‘c’ word was mentioned, people got very frightened but increasingly we will start to treat it as a chronic illness - like reheumatoid arthritis."
The pandemic has serious implications for the NHS, with budgets already under strain from the spiralling cost of anti-cancer drugs.
The main reason for the increase is rising life expectancy, Prof Sikora told the British Association for the Advancement of Science's conference at Slaford University. The prediciton is based on analysis of trends in Europe and America.

An independent group of experts appointed by the Government to investigate Britain’s confusing long-term health care system has slammed ministers for ignoring its recommendations.
Members of the Royal Commission on Long Term Care yesterday again called for free personal care to be made avail­able to those Britons who need it, as the committee recommended when its report was published in 1999.
Nine of the 11 original Royal Commission members issued a state­ment calling for the Government to follow the Scottish Executive’s lead in offering free care services.
In Scotland, long-term care is free of charge but different rules apply in England, Northern Ireland and Wales, where the National Health Service pays for nursing care for all patients who need it - but will only pay for their personal care under exceptional circumstances.
The commissioners said that “huge ethical, conceptual and practical difficul­ties” in distinguishing between nursing and personal care for ill and disabled people had left the system on the verge of collapse. The commissioners warned that rules which make financial support from the State dependent upon the type of carer the patient has, rather than the nature of the care needed, meant care providers had become more important than those whom the system is supposed to be helping.
“We urge the Government to take the necessary action, and soon,” said Commission chairman Lord Stewart Sutherland.
Pensioner charities welcomed the statement. Help the Aged spokeswoman Annie Stevenson said: “Long-term care is in disarray and is an issue that won’t go away until the Government deals with it properly - we would like to see the Government commit to the principle of free personal care.”

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