Sunday, September 07, 2003

U.S. Surgery Safer than under NHS

Another data point to consider for those who believe that British-style single-payer healthcare systems are the way forward:

Patients who have major operations on the National Health Service are four times more likely to die than Americans undergoing such surgery, according to a new study.

The difference in mortality rates was blamed on long NHS waiting lists, a shortage of specialists and competition for intensive care beds.

The joint study, carried out by University College London and a team from Columbia University in New York, found that patients in Britain who were most at risk of complications after major surgery were not being seen by specialists and were not reaching intensive care units in time to save them.

The study followed 1,100 patients at the Queen Alexandra Hospital in Portsmouth and compared them with 1,000 patients who had undergone similar major surgery at the Mount Sinai Hospital in Manhattan.

The results showed that just under 10 per cent of the British patients died in hospital after major surgery, compared with 2.5 per cent of the American patients.

Each year, more than three million operations are carried out on the NHS and about 350,000 of these are emergencies which carry a higher risk of complications.

Professor Monty Mythen, head of anaesthesia at UCL who led the British side of the research, said: "The main difference seems to be in the quality of post-operative care and who cares."

Prof Mythen, who also oversees the critical care facilities at Great Ormond Street Hospital, said: "In the Manhattan hospital, the care after surgery is delivered largely by a consultant surgeon and an anaesthetist. We know from other research that more than one third of those who die after a major operation in Britain are not seen by a similar consultant.

"In America, everyone would go into a critical care bed - they go into a highly monitored environment. That doesn't happen routinely in the UK."

Health ministers, meanwhile, will present new figures this week showing another annual rise in the number of intensive care beds - although Britain still lags behind America and much of Europe in critical care facilities.

Those who still believe that longevity figures tell the entire story should think carefully about the shortcomings of relying on such a simplistic measure. Life expectancy figures have little to do with the quality of healthcare received as such, given the fact that it is heavily influenced by infant mortality, and the differences in violent deaths between societies. Central planning does not, has never, and will never work, wherever tried.