UK Health 'Poor'

The UK has faired badly in a European health league table.

December saw publication of the worldwide and regional results for the Global Burden of Disease Study 2010 (GBD 2010). Now, the first country report based on GBD data is published.

The results for the UK are mixed. Although life expectancy has improved, so has the average for comparable European countries. In several areas—breast cancer, ischaemic heart disease, respiratory infections, chronic obstructive pulmonary disease, the severity of its tobacco epidemic—the UK seems to be doing poorly compared with its neighbours. The UK ranking against other nations for mortality has "worsened substantially" for those aged 20—54 years.

The authors, who include several leading UK experts and policy makers, recommend specific initiatives to address these deficiencies: a renewed focus on drug misuse, integrated medical care, reducing salt intake, tackling the major causes of chronic disability, and bringing more energy to the social and economic determinants of disease, disability, and risk. The UK GBD results are an independent scientific report card on decades of NHS reorganisations that have often had more to do with political ideology than sound evidence. Now is an opportunity for a different approach.

The provenance of the UK report is interesting to consider. The day before the GBD was launched publicly in London last December, a separate and private presentation of the UK GBD data was made to UK policy makers. The response was immediate and encouraging. There was strong interest in developing the presentation into a research paper for publication and subsequent review by the UK's Department of Health. The GBD results do not by themselves offer definitive prescriptions for the predicaments they describe. And they do not provide a simple verdict on the performance of the UK health system. But they do offer a quantitative means to monitor measures of health and disease and to enable more rational review and discussion of health priorities. This work is an important step forward for health policy.

Health secretary Jeremy Hunt said: "For too long we have been lagging behind and I want the reformed health system to take up this challenge and turn this shocking underperformance around."

(GK)