For those who want to stop no deal, Jeremy Corbyn is the only hope

www.theguardian.com/commentisfree/2019/oct/04/jeremy-corbyn-mps-labour-leader-legitimacy

Many MPs are in denial, refusing to accept the Labour leader’s legitimacy. Yet he is the only one who can prevent Boris Johnson trashing Britain

Departing Tory leaders have developed an odd and presumptuous habit of demanding that the leader of the opposition resign too. “As a party leader who has accepted when her time was up,” Theresa May told Jeremy Corbyn in her final prime minister’s questions, preparing to leave her party to Boris Johnson and the country without a prayer, “perhaps the time has come for him to do the same.”

In 2016, David Cameron – who had called a referendum lost it, only to then break his promise and abandon the country in a moment of self-inflicted crisis – suggested Corbyn’s resignation would be a patriotic act. “It might be in my party’s interest for him to sit there. It’s not in the national interest. I would say, for heaven’s sake, man, go.”

Stranger still, many Labour parliamentarians agreed with them: Cameron’s speech took place in the middle of a full-blown, if woefully inept, coup.

The political and media establishments are still struggling with the choice the Labour party made in 2015. The fact that the decision was emphatic, had to be made twice following the failed coup, and was effectively endorsed by the electorate in 2017, has not been enough. On some level, that goes beyond the political to the psychological: they refuse to accept his tenure as legitimate.

This sense of denial runs deep – as though insisting he should not be the party leader in effect means he’s not. It is a delusion that recalls the author Doris Lessing’s observation of Blair’s declarative approach to politics: “He believes in magic. That if you say a thing it is true.”

Corbyn is the leader of the Labour party. He has a mandate. He represents something other than just himself. That is not a statement of opinion but of fact. One does not have to like it to accept it. But the failure to accept it will have material and strategic consequences. And, with a general election imminent and the future of the country’s relationship with Europe finely balanced, the moment of reckoning with that fact is long overdue. For there is no route to a second referendum without Labour; there is no means of defeating Johnson without Labour. The party remains the largest, and by far the most effective, electoral obstacle to most of the immediate crises that progressives wish to prevent. Once again that is not a case for Corbyn or for Labour, but for reality.

Jeremy Corbyn is congratulated on winning the Labour leadership in 2015.
‘The political and media establishments are still struggling with the choice that the Labour party made in 2015.’ Jeremy Corbyn is congratulated on winning the Labour leadership in 2015. Photograph: Stefan Wermuth/Reuters

Earlier this week, when asked which was worse, a no-deal Brexit or Corbyn as prime minister, the Liberal Democrats’ Scotland spokesman, Jamie Stone, said: “It may be that somebody else may emerge from the Labour party. I think the ball is very much in the Labour party’s court to see what alternatives they could find.”

That is not going to happen. Liberal Democrats don’t get to choose the Labour leader. Labour does. The Lib Dems have long struggled to understand this. In 2010 Nick Clegg said he could work with Labour, just not Gordon Brown. Two years later they said they could work with Labour but the shadow chancellor Ed Balls must go.

There is candour in this. It is effectively the position of his party and many others, including a few disgruntled Labour members, for whom a potential Labour government under Corbyn is somehow worse than the actual no-deal Brexit under Johnson that may soon happen. But there is a clear contradiction too. Some of those who have devoted the past few years to stopping any kind of Brexit now claim that the only thing worse than a no-deal Brexit – the worst kind of Brexit they could possibly imagine – is the leader of the only party that can stop a no-deal Brexit.

None of this is a reason to necessarily support Labour or Corbyn. There are all sorts of reasons, from antisemitism to an insufficiently pro-European stance, as to why progressives might decide not to back Labour at this moment; and the calculations are very different outside England and in those areas where tactical voting offers the best hope of getting rid of Conservatives. And given the redistributive agenda that Labour laid out at last week’s conference, there are all sorts of reasons why progressives might back it, too.

Political parties are not entitled to anyone’s support. They must earn it. The moment they start blaming voters for not supporting them, they are sunk. That’s as true for Labour under Corbyn as it was for the US Democrats under nominee Al Gore. But that does not absolve the voter from the strategic and moral responsibility of accounting for their vote.

In the second round of the French presidential elections in 2002, which pitted the conservative Jacques Chirac against the far-right candidate Jean-Marie Le Pen, a Communist party local councillor, François Giacalone, voted for the conservative. “When the house is on fire,” he said, “you don’t care too much if the water you put it out with is dirty.”

Right now, the house is on fire. Johnson’s first couple of months in office have illustrated that what’s at stake is not a contest between bad and worse. This is a leader who uses the police as props; breaks the law to undermine democracy; and stokes division with rhetoric that can and has been easily co-opted by the far right, pitting a section of the population against parliament and the judiciary. Johnson’s cabinet and its agenda, both with regards to Brexit and beyond, do not represent a mere shift to the right but a paradigmatic sea-change in British politics that, where Europe is concerned, may have irreversible consequences.

Those who last year were literally on the fringe of the Tory party conference have this week been running the show. The coming election will not just be about opposing Brexit – it’ll be about defending democratic norms. The key consequence of understanding that Corbyn is the legitimate leader of the Labour party is understanding that this fire cannot be extinguished without him.

Gary Younge is a Guardian columnist

Using housing wealth to fund social care: why the Care Act 2014 is unfair

Posted: 04 Feb 2015 06:30 AM PST

Nicholas HopkinsEmma Laurie

The Care Act 2014 reinforces the expectation of leaving housing wealth as an inheritance, which perpetuates inequalities across generations, argue Nicholas Hopkins and Emma Laurie. Intergenerational fairness requires homeowners to use a greater proportion of their housing wealth to fund social care rather than relying on the state.

The issue of funding social care costs is one that provokes strong feelings. Many homeowners resent the idea of having to sell the family home to pay for residential care costs. But with an ageing population, a real concern is raised over who should pay. The Commission on Funding of Care and Support (the Dilnot Commission) was an independent body tasked by government with reviewing the funding system for care and support in England. Its report, Fairer Care Funding, provided advice and recommendations to government and was subsequently enacted in the Care Act 2014.

The Dilnot Commission’s overriding objective was to make the system of funding adult social care fairer as well as sustainable. The Commission took the view that it was fair to limit the extent to which an individual is required to draw on their own wealth, including housing wealth, to pay for the costs of their care. It also recommended that the home should not have to be sold during the owner’s lifetime in order to pay for social care costs.

To achieve these two objectives, the Care Act 2014 places a cap on individual liability for care costs and provides a scheme of Universal Deferred Payment (UDP). UDP is intended to prevent ‘forced sales’ of the home. Despite its name, it is not intended to be available to everyone. We consider that the measure is justified and that its operation could be confined to those who would otherwise have to sell their home. This could be achieved by making UDP available only to those who could not pay the capped sum from non-housing assets.

Our concerns with the Care Act 2014

Our principal concern lies with the Act’s treatment of housing wealth through the cap. Its effect is to preserve individual wealth and, in practice housing wealth, at the expense of the public purse. Ultimately, it will benefit those who will inherit that wealth. The use of public funds to preserve an inheritance lies at the heart of our criticism.

By passing a greater proportion of the costs of social care to the state, the Act will inevitably have undesirable – and unfair – consequence for the younger generation of taxpayers. We therefore advocate a phased scheme which would aim to change the expectation of leaving housing wealth as inheritance and, instead, inculcate an expectation of using housing wealth to fund social care costs.

This will be a controversial argument for many people. We understand the sense of unfairness felt by current homeowners at having to use housing wealth to pay for their social care costs and the desire to leave housing wealth as an inheritance. The ability to provide an inheritance is one of the bases on which homeownership has been promoted. Equally, there is understandable confusion about the different funding models for health and social care. While health care is provided free at the point of delivery, social care is means-tested and incorporates an assessment of a person’s assets to determine eligibility for financial support from the state.

The need for intergenerational fairness

Nevertheless, the wider concern of intergenerational fairness requires homeowners to use a greater proportion of their housing wealth. There is a growing recognition that issues of intergenerational fairness must form part of the ‘social contract’ between individuals and the state. In the UK, life expectancy has been growing while the birth rate has been falling. The consequence is popularly referred to as a ‘demographic time-bomb’, and the phenomenon of an ageing population is a policy concern that has been taken up at international, European and national levels.

But government policy on the need for intergenerational fairness is inconsistent. On one hand, the government has taken steps to increase the age of eligibility for the old-age pension and further increases are planned. On the other hand, it has passed the Care Act 2014 which entails a greater proportion of the costs falling on the state and, inevitably, the younger generation.

Changing expectations

Inculcating an expectation of drawing on housing wealth to fund older age care can address our concerns of intergenerational fairness. Such a policy reflects the principle of asset-based welfare, which entails expanding asset holdings among low-income households as a means of reducing wealth inequalities and promoting wealth-creating behaviour among citizens.

Successive governments since the 1950s have consistently encouraged homeownership and, as a result, housing wealth now exceeds other forms of investment to become by far the largest element in personal disposable assets. Homeownership has spread wealth more widely than any other form of asset or investment. Despite doing so, housing wealth is unequally distributed. Many older property owners have seen large, tax-free capital gains over the past few decades due to the rising value of property. The proportion of housing wealth held by older people is forecast to grow, while the term ‘generation rent’ has been coined to refer to those younger people who have no realistic prospect of buying their home. Inculcating an expectation that people will look to their housing asset, rather than to the state, to fund their welfare can reduce those intergenerational disadvantages by requiring homeowners to use the wealth in their lifetime.

Homeownership has not been explicitly promoted with the idea that the wealth will be drawn upon to fund the owner’s older age. Combined with the lack of understanding of the difference between health and social care, it is perhaps unsurprising that a strong sense of unfairness is felt at the prospect of housing wealth accumulated over a lifetime being dissipated by the requirement to fund a few years of social care. However, rather than attempting to change expectations, the Dilnot Commission’s proposals, as implemented by the Care Act 2014, appear uncritically to accept the perception of unfairness. The Act reinforces the expectation of leaving housing wealth as an inheritance, which perpetuates inequalities across generations. As a result, the funding model provided by the Act is neither fair nor sustainable.

The Coalition’s Record on Health: Policy, Spending and Outcomes 2010-2015

David Cameron promised in 2010 to “cut the deficit, not the NHS”. But how have the Coalition’s policies – including health reforms which are widely viewed as going beyond election commitments – impacted on health?

– While the Coalition has ‘protected’ health relative to other expenditure areas, growth in real health spending has been exceptionally low by the standards of previous governments. Average annual growth rates have lagged behind the rates that are deemed necessary to maintain and extend NHS care in response to increasing need and demand.
– Forecasts warn of an NHS ‘funding gap’ as wide as £30bn by 2020/21 unless the growing pressures on services are offset by productivity gains and funding increases during the next Parliament.
– Major health reforms emphasising decentralization, competition and outcomes have been implemented. These have transformed the policy landscape for the commissioning, management and provision of health services in England. The overall framework for political responsibility and accountability for health services in England has also changed.
– Minimum care standards, inspection and quality regulation have been revised and strengthened following the Mid-Staffordshire NHS Foundation Trust Public Inquiry.
– Key indicators point to increasing pressure on healthcare access and quality. These include indicators on patient access to GPs, accident and emergency services and cancer care. Public satisfaction with the NHS is considerably lower than a peak reached in 2010.
– The UK’s ranking on OECD “international league tables” remained disappointing for some health outcomes including female life expectancy and infant mortality.
– Suicide and mental health problems remained more prevalent following the 2007 economic crisis.
– Health inequalities remained deeply entrenched. The difference in average life expectancy between men living in the poorest and most prosperous areas of England is nine years, and six years for women.

http://sticerd.lse.ac.uk/case/_new/news/year.asp?yyyy=2015#772

Tony Blair: Labour must search for answers and not merely aspire to be a repository for people’s anger

The centre has not shifted to the left, says Tony Blair. Labour must resist the easy option of tying itself to those forces whose anti-Tory shouts are loudest. 

The paradox of the financial crisis is that, despite being widely held to have been caused by under-regulated markets, it has not brought a decisive shift to the left. But what might happen is that the left believes such a shift has occurred and behaves accordingly. The risk, which is highly visible here in Britain, is that the country returns to a familiar left/right battle. The familiarity is because such a contest dominated the 20th century. The risk is because in the 21st century such a contest debilitates rather than advances the nation.

This is at present crystallising around debates over austerity, welfare, immigration and Europe. Suddenly, parts of the political landscape that had been cast in shadow for some years, at least under New Labour and the first years of coalition government, are illuminated in sharp relief. The Conser­vative Party is back clothing itself in the mantle of fiscal responsibility, buttressed by moves against “benefit scroungers”, immigrants squeezing out British workers and – of course – Labour profligacy.

The Labour Party is back as the party opposing “Tory cuts”, highlighting the cruel consequences of the Conservative policies on welfare and representing the disadvantaged and vulnerable (the Lib Dems are in a bit of a fix, frankly).

For the Conservatives, this scenario is less menacing than it seems. They are now going to inspire loathing on the left. But they’re used to that. They’re back on the old territory of harsh reality, tough decisions, piercing the supposed veil of idealistic fantasy that prevents the left from governing sensibly. Compassionate Conservatism mat­tered when compassion was in vogue. But it isn’t now. Getting the house in order is.

For Labour, the opposite is true. This scenario is more menacing than it seems. The ease with which it can settle back into its old territory of defending the status quo, allying itself, even anchoring itself, to the interests that will passionately and often justly oppose what the government is doing, is so apparently rewarding, that the exercise of political will lies not in going there, but in resisting the temptation to go there.

So where should progressive politics position itself, not just in Britain but in Europe as a whole? How do we oppose smartly and govern sensibly?

The guiding principle should be that we are the seekers after answers, not the repository for people’s anger. In the first case, we have to be dispassionate even when the issues arouse great passion. In the second case, we are simple fellow-travellers in sympathy; we are not leaders. And in these times, above all, people want leadership.

So, for Britain, start with an analysis of where we stand as a country. The financial crisis has not created the need for change; it has merely exposed it. Demographics – the age profile of our population – technology and globalisation all mean that the systems we created post-1945 have to change radically. This is so, irrespective of the financial catastrophe of 2008 and its aftermath.

Labour should be very robust in knocking down the notion that it “created” the crisis. In 2007/2008 the cyclically adjusted current Budget balance was under 1 per cent of GDP. Public debt was significantly below 1997. Over the whole 13 years, the debt-to-GDP ratio was better than the Conservative record from 1979-97. Of course there is a case for saying a tightening around 2005 would have been more prudent. But the effect of this pales into insignificance compared to the financial tsunami that occurred globally, starting with the sub-prime mortgage debacle in the US.

However, the crisis has occurred and no one can get permission to govern unless they deal with its reality. The more profound point is: even if it hadn’t happened, the case for fundamental reform of the postwar state is clear. For example:

What is driving the rise in housing benefit spending, and if it is the absence of housing, how do we build more?

 How do we improve the skillset of those who are unemployed when the shortage of skills is the clearest barrier to employment?

 How do we take the health and education reforms of the last Labour government to a new level, given the huge improvement in results they brought about?

 What is the right balance between universal and means-tested help for pensioners?

How do we use technology to cut costs and drive change in our education, health, crime and immigration systems?

 How do we focus on the really hard core of socially excluded families, separating them from those who are just temporarily down on their luck?

 What could the developments around DNA do to cut crime?

There are another 20 such questions, but they all involve this approach: a root-and-branch inquiry, from first principles, into where we spend money, and why.

On the economy, we should have one simple test: what produces growth and jobs? There is roughly $1trn (£650bn) of UK corporate reserves. What would give companies the confidence to invest it? What does a modern industrial strategy look like? How do we rebuild the financial sector? There is no need to provide every bit of detail. People don’t expect it. But they want to know where we’re coming from because that is a clue as to where we would go, if elected.

Sketch out the answers to these questions and you have a vision of the future. For progressives, that is of the absolute essence. The issue isn’t, and hasn’t been for at least 50 years, whether we believe in social justice. The issue is how progressive politics fulfils that mission as times, conditions and objective realities change around us. Having such a modern vision elevates the debate. It helps avoid the danger of tactical victories that lead to strategic defeats.

It means, for example, that we don’t tack right on immigration and Europe, and tack left on tax and spending. It keeps us out of our comfort zone but on a centre ground that is ultimately both more satisfying and more productive for party and country.

You are invited to read this free preview of the upcoming centenary issue of the New Statesman, out on 11 April. 

http://newstatesman100.tumblr.com/post/47687650241/tony-blair-labour-must-search-for-answers-and-not

The Spirit of ’45 – first look review | Film | guardian.co.uk

Ken Loach’s account of the Labour postwar programme of nationalisation favours reminiscence at the expense of detail, but it certainly packs an emotional punch

Andrew Pulver

guardian.co.uk, Monday 11 February 2013 11.25 GMT

Labour of love … a still from Ken Loach’s The Spirit of ’45

No one can accuse Ken Loach of sitting on the fence. This account of Labour’s postwar general election victory and the subsequent programme of nationalisation is about as partial as they come. In Loach’s eyes this was a glorious time, when the experiences of the second world war were put to era-changing use on a home front still crippled as much by the depression of the 1930s as by military expenditure. The rush of socialist enthusiasm ended dangerously exploitative conditions in heavy industry, rebuilt lousy housing and established a free-to-all medical service.

The Spirit of ’45

Production year: 2013

Country: UK

Directors: Ken Loach

More on this film

Well, Loach’s film certainly packs an emotional punch. He calls on a string of retirees – former mineworkers, nurses and the like – to tell their stories. It’s clear that a big part of Loach’s purpose is to confront the decades of media propaganda that have characterised unionised workers as overpaid shirkers, brakes on growth and “the enemy within”, as Loach’s principal bete noire, Margaret Thatcher, would have it. Indeed, as Loach presents it, this was a time when the union man (and woman) was a heroic figure, straddling the age and hewing the future with bare hands. It’s stirring stuff.

But I do have to confess to feeling a tiny bit disappointed. Although Loach’s film is certainly engaging – largely down to his spirited interviewees – there’s something a little sketchy about it. We know that this was an epoch-making period, that the 1945 election was great national drama, that Attlee was a great leader – but the film rushes through it all with little attempt at in-depth contextualisation. Loach’s aim is to favour memories and reminiscences (as the title indicates); I’d have liked the exhortatory tone leavened with more detail. Rather bafflingly, for example, he completely blanks that other great project of the 1945 Labour government, the disengagement from empire – the global impact of which has arguably been greater.

But it would be churlish to pick too many holes. This is clearly a subject Loach has great feeling for, even if he keeps himself scrupulously off camera. There’s a very contemporary purpose at work here too: to remind people, if nothing else, why the NHS is worth fighting for at the very moment it’s being dismantled. Films are rarely this committed or, indeed, persuasive.

via The Spirit of ’45 – first look review | Film | guardian.co.uk.

Accountability and transparency demand that Freedom of Information requirements should be an essential corollary of receiving public funding, throughout the whole of the NHS

Posted: 30 Jan 2013 05:15 AM PST

Changing patterns of provision for public services can have serious implications for existing standards of public accountability, converting large swathes of previously open and published information into ‘commercially confidential’ material kept secret by for-profit companies. Grahame Morris MP argues that the solution to this creeping decrease in accountability is to require that FOI rules on public disclosure apply even-handedly to all service providers within the NHS, whether they are in the public or private sectors.

In late January 2013 the Department of Health announced the formation of an expert panel within the Department advising the government on ‘Strengthening the NHS Constitution’. Replacing the older NHS Future Forum working group, this panel would “oversee the consultation on strengthening the NHS Constitution” and “develop a set of proposals to give the NHS Constitution greater traction so that patients, staff and the public are clear what to do, and who to turn to, when their expectations under the Constitution are not”. The Department also disclosed the Commercial Director of Virgin Care (that Dr Vivienne McVey), has become a member of an expert panel within the Department advising the government on ‘Strengthening the NHS Constitution’. Now Virgin Care is actively involved in bidding for lucrative NHS contracts up and down the country, and is now controversially running some NHS services in Southern England. So Dr McVey’s company is just one of a number of private companies, from home and abroad, now bidding for an estimated £7 billion of NHS contracts that have in recent months been put out to tender. In common with other private healthcare companies, Virgin Care stated in an interview to the Financial Times that it intends to make an 8 per cent profit from NHS contracts, which are financed by us, the taxpayer.

The question any reasonable observer might ask is what possible interest could Virgin Care have in ‘strengthening’ the NHS constitution, when their business model would seem to be premised on public provision performing poorly? So taxpayers and patients may justifiably ask if Virgin Care’s Commercial Director is the best person to take up this important advisory position. Most people accept that transparency is a key tenet of a strong NHS. So what might Dr McKay have to say about the current bidding practices for NHS contracts that allow commercial organisations such as Virgin Care to withhold details of those bids under the cloak of ‘commercial confidentiality’, while NHS Trusts have to reveal all and are subject to the Freedom of Information Act? Does Dr McKay and Virgin Care support the extension of the FOI Act to follow the public pound to include private medical firms running parts of our NHS?

These considerations, together with substantial support from community activists campaigning against the fragmentation and privatisation of our NHS, lead me to table a Parliamentary Early Day Motion calling for private health care companies also to be subject to the Freedom of Information Act. It has attracted the signatures of 85 MPs from 7 different parties and it has received plenty of supportive comment in the media, including in The Guardian. If you, like me believe that our NHS should not be put up for sale through secretive bidding processes, please ask your MP to sign as well. Details of the motion (known as EDM 773) are as follows:

‘That this House notes that

the most significant development that has followed from the Government’s healthcare reforms has been the 7 billion worth of new contracts being made available to the private health sector;

further notes that at least five former advisers to the Prime Minister and the Chancellor of the Exchequer are now working for lobbying firms with private healthcare clients;

recalls the Prime Minister’s own reported remarks prior to the general election when he described lobbying as `the next big scandal waiting to happen’;

recognises the growing scandal of the procurement model that favours the private health sector over the NHS, by allowing private companies to hide behind commercial confidentiality and which compromises the best practice aspirations of the public sector;

condemns the practice of revolving doors, whereby Government health advisers move to lucrative contracts in the private healthcare sector, especially at a time when the privatisation of the NHS is proceeding by stealth;

is deeply concerned at the unfair advantages being handed to private healthcare companies; and

demands that in future all private healthcare companies be subject to freedom of information requests under the terms of the Freedom of Information Act 2000 in the same way as existing NHS public sector organisations’ .

Over the years there have been many campaigns launched to save our NHS, but never has there been a more important time as now, to do just that. Achieving a level playing field in bids for NHS contracts is only a start. In my own view, the next Labour Government needs to move to take the ‘for profit’ sector out of public health and our NHS, once and for all.

Note: This article gives the views of the author, and not the position of the British Politics and Policy blog, nor of the London School of Economics. Please read our comments policy before posting.

About the author

Grahame Morris MP is the Labour Member of Parliament for Easington.

NHS cancer figures contradict David Cameron and Andrew Lansley’s claims

The prime minister and health secretary have criticised the NHS on cancer, but new figures suggest the service is a world leader

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Comments (134)
Denis Campbell, health correspondent
guardian.co.uk, Monday 7 November 2011 18.48 GMT
Article history

Andrew Lansley and David Cameron, who have used criticisms of the NHS record on cancer to justify a planned shakeup. Photograph: Dan Kitwood/PA
David Cameron and Andrew Lansley’s repeated criticisms of the NHS’s record on cancer have been contradicted by new research that shows the health service to be an international leader in tackling the disease.

The findings challenge the government’s claims that NHS failings on cancer contribute to 5,000-10,000 unnecessary cancer deaths a year, which ministers have used as a key reason for pushing through their radical shakeup of the service.

In fact, the NHS in England and Wales has helped achieve the biggest drop in cancer deaths and displayed the most efficient use of resources among 10 leading countries worldwide, according to the study published in the British Journal of Cancer.

“These results challenge the feeble justification of the government’s changes, which appear to be based upon overhyped media representation, rather than hard comparable evidence. This paper should be a real boost to cancer patients and their families because the NHS’s performance on cancer is much better than the media presents. It challenges the government’s assertion that the NHS is inefficient and ineffective at treating cancer – an argument for reforming the NHS,” said Prof Colin Pritchard, a health academic at Bournemouth University.

He co-wrote the research with Dr Tamas Hickish, a consultant medical oncologist at Poole and Royal Bournemouth and Christchurch hospitals in Dorset.

The research shows that ministers have misrepresented the NHS’s record on cancer in order to gain support for their unpopular shakeup, said Pritchard.

The prime minister and the health secretary have said that both survival and death rates from the disease in Britain are low by international standards. Cameron, for example, claimed during last year’s general election campaign that Britain had a higher rate of cancer deaths than Bulgaria.

The authors studied cancer mortality and the amount of GDP spent on healthcare between 1979 and 2006 in England and Wales and nine other countries, including Germany, the US, Spain, Japan and France.

While cancer deaths fell everywhere, England and Wales saw the biggest drop in mortality among males aged 15-74 – down 31%. While six countries saw falls of at least 20%, England and Wales – which in 1979-81 had the third highest rate with 4,156 deaths per million men – improved the most, achieving the fifth lowest rate among the 10 countries by 2004-06 with 2,869 deaths per million. Among men aged 55-64 and 65-74, who are more likely to get cancer, mortality dropped by 35% and 28%.

While mortality among women the same age declined by less, at 19%, that was the third biggest improvement after Japan (23%) and Germany (20%).

And the NHS was the most efficient of the 10 countries at reducing cancer mortality ratios once the proportions of GDP spent on healthcare were compared, the study found. While England and Wales spent less on health than most others, they achieved the biggest overall annual fall in cancer mortality over the 27-year period, of 900 deaths per million. Once average GDP spending on healthcare was compared, the NHS saw the biggest fall in male and female cancer deaths of an extra 119 lives a year per 1% of GDP spent, ahead of the Netherlands (74) and almost double that in Germany (68), France (67) and Japan (60).

“That shows how good England and Wales are on cancer care, relative to spend. We do significantly more with proportionately less. It means that 34,484 people are alive today that wouldn’t have been if things had not improved since 1980,” said Pritchard.

Two authoritative studies have concluded that cancer survival rates in the UK have lagged behind those in comparable major developed countries, though experts dispute which indicators give the most accurate picture of Britain’s cancer performance. For example, Prof John Appleby, chief economist at the King’s Fund health thinktank, published research in the British Medical Journal earlier this year which disputed the portrayal of Britain as “the sick man of Europe” and argued that cancer survival rates had been improving, significantly in the case of breast cancer.

Duleep Allirajah, policy manager at Macmillan Cancer Support, said: “In the past 10 years cancer services in the UK have improved dramatically. Waiting times have decreased and services have been modernised.” But, with cancer survival improving, the NHS now has to address new challenges, notably improving care for patients who have undergone treatment.

“Far too many people in the UK still experience sometimes serious problems related to their cancer treatment. For many these can persist up to 10 years after treatment. The focus now must be for the government and the NHS to address the issues of aftercare and making sure cancer is treated as a long term condition,” said Allirajah.

Pritchard said: “David Cameron and Andrew Lansley are happier with NHS ‘bad news’ stories rather than, as our research shows, that we should celebrate the NHS which, in monetary terms, is vastly superior to the private healthcare system of the USA.

“Of course we should always be looking to improve. But the only way to judge the NHS is to compare it with other countries, which shows that we are still getting the NHS on the comparative cheap.”

The Department of Health declined to respond directly to Pritchard and Hickish’s findings. “There is a difference between achieving efficiency and the results patients receive. While it is good that NHS cancer treatment is relatively efficient, we know that the results patients actually get lag behind many other countries,” said a spokesman.

“Our cancer strategy is clear – we aim to save 5,000 lives extra every year by 2015 which will bring us up to the level achieved in many other comparable countries. We owe it to patients to deliver standards which are up there with the best in the world,” he added.

http://www.guardian.co.uk/society/2011/nov/07/nhs-cancer-figures-cameron-lansley