Research which claims to show that the introduction of patient choice in the NHS reduced deaths from heart attacks is flawed and misleading, according to a report published in The Lancet.
The original study was used by the Government to advance its controversial Health and Social Care Bill 2011 and was the basis for the Prime Minister’s statement that ‘competition is one way we can make things work better for patients’.
In the new report*, academics - led by Professor Allyson Pollock of Queen Mary, University of London - point out a series of errors in the study and conclude that it is ‘fundamentally flawed’.
The research David Cameron referred to was a paper by Zack Cooper and colleagues which was published by LSE Health. It examined the mortality rates for heart attack patients measured against the number of hospitals within travelling distance of the patient’s GP surgery. It also looked at data on elective surgery for hernia, cataract repair, knee arthroscopy, hip replacement and knee replacement, and claims to show that introducing greater choice in elective surgery led to lower death rates from heart attacks.
Professor Pollock and her colleagues - including Professor Alison Macfarlane at City University London - say that, crucially, the study offers no explanation as to why the availability of choice for such elective procedures should have any effect on whether heart attack patients survive.
The Lancet report also points out the following:
Professor Pollock said: “The Government’s Health Bill has faced enormous opposition from the public and from health professionals. In trying to win over his critics the Prime Minister has used the study by Zack Cooper to justify competition within the National Health Service.
“Our examination of this research reveals it to be fundamentally flawed, amounting to the conclusion that the paper simply doesn’t prove either cause or effect between patient choice and death rates.
“This work should not be quoted as scientific evidence to support choice, competition or the new Health and Social Care Bill.”
*‘Statistical association is not causation: claims that patient choice and market competition in the NHS reduce AMI mortality are misleading and false’, Pollock, A, et al, Lancet Online First publication, 10 October 2011
Professor Pollock has teamed up with Professor Trisha Greenhalgh to teach three new MSc programmes in global health, starting in September 2012. For more information visit www.blizard.qmul.ac.uk/study.
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