A further problem is the shocking regional variation in performanance. 48% of lung cancer sufferers in Kensington and Chelsea survive; 85% of those diagnosed in Herefordshire die within a year. Both breast cancer survival rates in Torbay (99%) and Tower Hamlets (89%) and bowel cancer survival rates in Telford (80%) and Hastings (58%) indicate how divides between rich and poor and between the provinces and metropolises have not been redressed. This is not the legacy Brown and Blair intended.
What is to be done? UK health spending corresponds with other developed countries: this latest disappointment is not an excuse for government, present or future, to reach for our chequebooks. Plainly, record investments were spent unwisely. World class care is a target determined by outcomes, not an outcome determined by targets. The NHS labours under the weight of its own tremendous fabric; adopting mutualism over management will revolutionise NHS ownership and management, placing it in the hands of users and staff not bureaucrats, which should aid efficiency.
By itself, structural reform provides an incomplete solution; re-emphasising the importance and expertise of personnel is equally important. Diagnosis relies on the awareness of doctors as much as it does on patients. That is not to explain the NHS’s failings solely by the incompetence of its physicians, quite the reverse. Despite employing nearly as many people as the Red Army, the NHS has one of the lowest counts of doctors per 1,000 head of population in the developed world: 2.48 to 4.03 in Belgium. Put simply, there are too few GPs referring to too few specialists.