Published: 03/10/2002 Volume II2, No.5825 Page 8 9

A leading think tank which was attacked by the Department of Health for suggesting that NHS spending was spiralling out of control has issued a robust defence of its conclusions.

Last week, the DoH accused the Office of Health Economics of delivering a 'partial and crude' analysis of NHS spending which 'overlooks some important steps that we are taking to increase capacity and improve quality'.

OHE had said there was an 'unexplained gap' between the government's planned extra spending on the NHS and projected increases in staffing and resources.

This week, OHE associate director Jon Sussex said he was concerned at the DoH's response.

'By partial, do they mean biased? We are not at all. But if they mean it leaves out some things, then yes of course - there is a lot of information that we are not privy to. But with the best will in the world, staff numbers are not going to rise as fast as [government] expectations with the amount of money that is being pumped in.'

The OHE report said that since 1975 NHS pay rates and prices have grown by 700 per cent - significantly faster than the rate of general inflation in the rest of the UK economy. Once this figure is taken into account, it shows that the volume of NHS resources has only increased by 30 per cent since 1975.

Some of the new investment in the NHS is going on more staff.

OHE says that if the government achieves its English targets for 2008, there would be 30 per cent more GPs and consultants, 10 per cent more nurses and midwives and five per cent more hospital beds.

While OHE says these are 'substantial increases', even taking account of NHS pay and price inflation, it states that in percentage terms they are 'much less' than the planned growth in expenditure of over 60 per cent in real terms between 2001-02 and 2008-09.

Mr Sussex said the DoH had recognised this and were trying to do something to about recruiting more GPs, consultants and nurses but was neglecting the 'real issue' of skill mix.

'Nurses have to do more of the work of doctors, and healthcare assistants have to do more of the work of nurses. That was recognised by the Treasury-commissioned Wanless report.'

Mr Sussex called on the government to set out what it would do in the next five years to address these skill-mix issues'.

'If the money is there then they will pay doctors and nurses more - nobody is against that - but if in turn that means there is less money to meet targets, then the taxpayer will feel cheated.'

The DoH says capacity is being boosted by 54 per cent more training places for doctors and 60 per cent for nurses, new hospital facilities, more and better drugs, and a£1bn investment in IT.

A DoH spokesperson said: 'All this will ensure the record extra investment in the NHS translates into capacity growth, not inflation.'