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Ire| Sco| Wal| Pol| Bus| Ents| Sci| Tech| Health| EduMon, 27 February, 2006, 14:22 GMT NHS productivity rate 'falling' NHS productivity is stagnant orfalling by most measures, althoughexperts say methods of measuringneed refining. Using the standard comparison ofNHS outputs to inputs, productivityhas been falling by between 0.6% to1.3% a year from 1995 to 2004. This comes after record levels ofmoney have been pumped into theNHS. But the Office for National Statisticssaid a debate was needed about howit was calculated as the resultsdiffered when other factors wereincluded. Comparing outputs - hospital activity- to inputs - labour and capital - hasto date been widely accepted as thebest method of measuringproductivity and is used by theTreasury and Bank of England toinform policy. But attempts are now being made totake into account the quality oftreatment by using patientexperience and survival rates. When quality of treatment isincluded, productivity rangedbetween a 0.2% increase a year to a0.5% decrease from 1999 to 2004. However, the ONS acknowledgedthat this kind of methodology was inits infancy. And then if the rise in real earnings -about 1.5% a year - is also factoredin due to the cost of ill-health beingmore costly to the economy, NHSproductivity rose by an average of0.9% and 1.6% a year. Productivity has proved acontroversial subject followingLabour's record investmentprogramme in the NHS. Since 1997,the NHS budget has doubled and by2008 it will have trebled to bringEngland up to European levels. But the NHS has also found itself inthe midst of a financial crisis, withone in four trusts failing to balancetheir books last year. Critics have argued that while Labourhas invested more, the health serviceis becoming inefficient. National Statistician Karen Dunnellsaid the latest results showed thereneeded to be a discussion over howproductivity was going to bemeasured. Deaths"Measuring value for money in thepublic services is of major importanceto everyone. "What is now needed is a thoroughpublic discussion of themethodologies involved." Health Secretary Patricia Hewittfocussed on the methods thatshowed productivity was increasing,saying government reforms weremaking the NHS more efficient. But she added more work still neededto be done to improve the way it ismeasured. "The Department of Health is nowworking with the ONS towards aneven more comprehensivemeasurement." Nigel Edwards, director of policy atthe NHS Confederation, whichrepresents health service managers,agreed measuring productivity was"complex". "Previous measures of productivityin health have measured healthinputs versus outputs and miss alarge amount of what the NHSactually does." And Alan Maynard, professor ofhealth economics at York University,said: "The problem is that we are notvery good at measuring the physicaland mental outcomes of treatmentand therefore, while the results areinteresting they are somewhatlimited. "We have to improve the way wemeasure outcomes, in particular, inregards to primary care, wherethere is very little data." But Shadow Health Secretary AndrewLansley said the measure showingproductivity decreasing was the mostaccurate as it was virtually impossibleto determine whether improvementsin health were attributable to theNHS or not. BBC News Online is on the web atbbc.co.uk/news