Today’s report from the London School of Economics into whether competition works in the NHS is likely to be cherry-picked (to use an apt term) by both sides in their fights for and against the health bill.
Ministers will love its headline finding, that competition works in the NHS. The researchers found that after Labour introduced competition between hospitals in 2006, waiting times before operations (an internationally recognised measure of transparency) fell. Using the kind of terminology only academics can, the report’s authors found “moderate but statistically significant” reductions in patients’ length of stay. They added:
These 7 to 9 per cent gains would have produced non-trivial savings.
Good news for the government, since the parts of the NHS bill encouraging competition are easily the most controversial, and the most likely to trigger a rebellion in the Lords early next month.
The health department quickly tried to capitalise on the report, stressing it had “listened to the advice of its author [Zack Cooper]” when formulating its propsals.
But there is some red meat for the bill’s opponents too. When Labour extended competition to include private providers in 2008, those NHS hospitals that faced the most private competition found waiting times for operations lengthening. Private providers, it seems, were creaming off the most lucrative and easiest to treat patients, leaving the health service struggling to deal with the rest.
Ministers say the strict guidelines enacted by their bill and the watchdog role being performed by Monitor, the watchdog, will make sure there is no “cherry-picking” of services by the private sector.
But voters remain highly sceptical. A new survey out today from YouGov shows that Labour has a 15-point lead over the Conservatives when it comes to which party to trust with the NHS. As Peter Kellner, the YouGov president, suggested on the Today programme this morning, the public is largely hostile to the idea of competition in public services. And no piece of LSE research, no matter how thorough, is likely to change that.
Jim Pickard
Kiran Stacey