The main questions I would ask about this graph are:
1. What went so wrong in 1996?
2. What started to go right in 2003?
The Tories' record looks particularly awful because of a huge rise from 1996 to 1998. This period also makes Labour's record look much better. Without it, we have pretty much a steady state from 1994 to 2003. It would be very interesting to know the reason for this huge anomaly.
But there is a definite downward trend in the period from 2003 to the present. It would be interesting to know what changed in 2002-3 to make this happen.
There were a lot of people who were on waiting lists to get onto waiting lists, and when proper reporting was put in place Doctors were no longer allowed to hide those people. I remember a discussion with my father complaining that doctors were no longer allowed to just move people about and reprioritise patients so that people with low need were effectively put off forever.
And it takes time to put people into place - getting new personnel through the system and putting new systems in place takes a lot of time and effort - and for the first while you're running to stand still - and then the backlog clears, and suddenly you're running downhill. It's like paying off a big loan - at first you're just paying off a little more than the interest, but as the debt lowers the same amount of cash pays off much more of it each month.
2003-present? Labour began to concentrate almost exclusively on lists and league tables. So Hospitals concentrated on paying more attention to those lists and league tables. The numbers came down because ways were found to reduce them. Whether that improved quality of service is almost completely irrelevant to this set of statistics
It's what happened in most public sector establishments. Most damage, by far, has been caused to the Police who now have to spend so much time doing paperwork carving out their Achievements that they have very little time left to do actual Policing. The terrible reputation our Police service now endures is almost entirely because of this policy.
It takes 5 years to qualify as a doctor, plus a year or two to know what you're doing. Labour created something like 5 new medical schools, and expanded student places at others. So about 5 years after they were first elected, lots of new doctors started work, and another year later they were actually effective. (The OECD says that we went from 1.9 doctors per 1000 people in 2000 to 2.5 doctors per 1000 people in 2007. Nurses went from 9.2 to 10.0 per 1000 people over the same period. pdf link.) I think this may have at least something to do with the 2002-3 decrease.
It seems likely to me that waiting lists will have a vicious circle - with a long waiting list, the average treatment is carried out on a sicker person (because they've waited longer for treatment), and is therefore more complicated and takes more resources, so the number of treatments that can be carried out falls, so waiting lists lengthen. If this is true then the cause of the big increase in 1996 may well be several years earlier.
It takes 5 years to qualify as a doctor, plus a year or two to know what you're doing. Labour created something like 5 new medical schools, and expanded student places at others. So about 5 years after they were first elected, lots of new doctors started work, and another year later they were actually effective. (The OECD says that we went from 1.9 doctors per 1000 people in 2000 to 2.5 doctors per 1000 people in 2007. Nurses went from 9.2 to 10.0 per 1000 people over the same period. pdf link.) I think this may have at least something to do with the 2002-3 decrease.
Yeah, that sounds pretty plausible, especially given those OECD numbers.
It seems likely to me that waiting lists will have a vicious circle - with a long waiting list, the average treatment is carried out on a sicker person (because they've waited longer for treatment), and is therefore more complicated and takes more resources, so the number of treatments that can be carried out falls, so waiting lists lengthen. If this is true then the cause of the big increase in 1996 may well be several years earlier.
Fair enough, but then we have to wonder what caused the equally sharp drop in 1998. A change in clinical priorities such that the number of treatments increased, a change in recording/classification practices such that people were removed from these figures without necessarily being treated, or something else?
no subject
Date: 2010-02-01 01:55 pm (UTC)1. What went so wrong in 1996?
2. What started to go right in 2003?
The Tories' record looks particularly awful because of a huge rise from 1996 to 1998. This period also makes Labour's record look much better. Without it, we have pretty much a steady state from 1994 to 2003. It would be very interesting to know the reason for this huge anomaly.
But there is a definite downward trend in the period from 2003 to the present. It would be interesting to know what changed in 2002-3 to make this happen.
no subject
Date: 2010-02-01 02:02 pm (UTC)And it takes time to put people into place - getting new personnel through the system and putting new systems in place takes a lot of time and effort - and for the first while you're running to stand still - and then the backlog clears, and suddenly you're running downhill. It's like paying off a big loan - at first you're just paying off a little more than the interest, but as the debt lowers the same amount of cash pays off much more of it each month.
no subject
Date: 2010-02-01 02:18 pm (UTC)no subject
Date: 2010-02-01 07:37 pm (UTC)no subject
Date: 2010-02-01 10:28 pm (UTC)no subject
Date: 2010-02-01 04:09 pm (UTC)It seems likely to me that waiting lists will have a vicious circle - with a long waiting list, the average treatment is carried out on a sicker person (because they've waited longer for treatment), and is therefore more complicated and takes more resources, so the number of treatments that can be carried out falls, so waiting lists lengthen. If this is true then the cause of the big increase in 1996 may well be several years earlier.
no subject
Date: 2010-02-01 04:20 pm (UTC)Yeah, that sounds pretty plausible, especially given those OECD numbers.
It seems likely to me that waiting lists will have a vicious circle - with a long waiting list, the average treatment is carried out on a sicker person (because they've waited longer for treatment), and is therefore more complicated and takes more resources, so the number of treatments that can be carried out falls, so waiting lists lengthen. If this is true then the cause of the big increase in 1996 may well be several years earlier.
Fair enough, but then we have to wonder what caused the equally sharp drop in 1998. A change in clinical priorities such that the number of treatments increased, a change in recording/classification practices such that people were removed from these figures without necessarily being treated, or something else?