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Spin Doctors
Monday March 13 2000
Reporter John Ware
Producer Janice Finch

Panorama investigates accusations that Government announcements on the NHS are misleading, inaccurate and often amount to recycling the same information to create a more positive "spin" than the real figures.

Experts interviewed by the programme accuse the government of creative accounting to increase the apparent amount of extra funding.

Sometimes "Extra" money for the NHS is announced, without revealing that it is not new money. Sometimes, "extra" doctors are announced without acknowledging they are already in the system, and critics say that misleading comparisons are made with EU spending averages.

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Ian Bogle, Chairman of the BMA Council, concludes: "They are seeking to portray themselves as doing better than they are, both in workforce terms and in financial terms. I think if they came open with the profession and with the public, we would actually assist them with moving forward."
Romola Christopherson. Former Head of communications Department of Health
Romola Chistopherson, who was Head of Communications at the Department of Health until January 1999, tells the programme that press announcements are carefully worded: "There is a sort of lexicon of words and ways you can describe something to accommodate the reality¿ if it really is new, then you'll use 'new'... 'extra', 'boost', 'cash for' doesn't necessarily mean its the first time it's been announced and this is 'new, never been thought of money before'."

There is a sort of lexicon of words and ways you can describe something to accommodate the reality ... if it really is new, then you'll use 'new' ... 'extra', 'boost', 'cash for' doesn't necessarily mean its the first time it's been announced and this is 'new, never been thought of money before

Romola Christopherson

John Appleby, Programme Director at the King's Fund tells Panorama:

I think the build-up does create the impression that there's an awful lot of money sloshing around within the service ¿ I mean the government could be creating a bigger sort of expectations gap between the users of the service and their own rhetoric

The Comprehensive spending review

Panorama shows how on 16 July 1998, Frank Dobson announced the result of the government's "comprehensive spending review" would be an extra £21 billion pounds of investment in the NHS over the following three years.

The real budget increase was less than half that amount - £10.3bn. However, the government used creative accounting - cumulatively counting each year's increase along with the next years to get their figure.

Despite initial advice from the Health Department's communications chief against using cumulative totals, and subsequent criticism from the Treasury Select Committee, the Prime Minister continues to quote the £21bn increase.

According to Romola Christopherson

I certainly had reservations about ... the accusations of triple counting. My recollection is that I would have alerted them to that potential, but that's my job, and at the end of the day it's up to ministers to decide

John Appleby, Chief Economist at the Kings Fund tells the programme: "I think it was very misleading. ¿ It's the wrong way of actually presenting the figures. I've never seen it done before."

I think it was very misleading ... It's the wrong way of actually presenting the figures. I've never seen it done before

John Appleby, Chief Economist, the Kings Fund

Waiting lists

This year, the Government also claimed to spending a "new £320m" on reducing waiting lists. Yet, this figure is precisely the same amount as the sum spent last year on waiting lists but allocated under a new label - the "modernisation fund".

Last year, Frank Dobson made the first of four announcements about a "boost" of £20m to pay for the Instant Booking system to reduce waiting lists.

Terry Nixon
Terry Nixon is 56 and has cancer of the gullet. Over the last few months he's lost four and a half stone. It took his GP five weeks to get referred to a specialist. It took longer to get the first test results and a scan to see how far the cancer had spread. It was in fact three months from his referral to when he got his full results - by which time his cancer was inoperable.

Accident and Emergency funding

Panorama shows how the government announced £30 million extra spending on Accident and Emergency "modernisation schemes" four times:

  • The Prime Minister made the first announcement in in September 1998
  • Followed a month later by Frank Dobson
  • A month later the £30m extra cash was again announced
  • And in February 1999, Tony Blair again announced a £30m "cash boost" to A&E units.

    According to Ian Bogle:

    They're certainly confusing my colleagues and I think confusing the public, by announcing the same thing over and over again in slightly different terms.

    Doctors

    In August 1998, the government announced that it was on course to deliver its promise to deliver an extra 7000 doctors.

    According to the BMA, this figure was not quite as impressive as it would seem. Dr Bogle tells Panorama:

    We would be expecting 7000 doctors to come out of medical school and into practice over that three-year period, so it's misleading, if it is perceived, that those are 7,000 extra doctors over and above anything we could have anticipated. Those are doctors already in the system¿ and that isn't a net gain of doctors because some doctors will retire; some will leave the profession.

    Raising spending to the EU average

    According to the King's fund, The Prime Minster's announcement that spending on the NHS would be raised to the EU average doesn't add up. The Government calculates that the EU average spend is 7.9% of GDP.

    The King's fund say that this figure is a crude average which does not take into account the different sizes of EU countries - giving Germany the same weight as Luxembourg - and that the real figure is 9%.

    Therefore, they calculate that rather raising spending by 5% annually to match the EU, the real annual increase needed is 9.7%

    Appleby tells Panorama

    It's not legitimate to add up the percentages. You should do what's known as a weighted average, and that gives the truer target figure. It's not wrong, but it's incredibly misleading


    Related links:

    Department of Health

    The Kings Fund

    British Medical Association

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