Dear Mr David Cameron MP and Mr Andrew Lansley MP,

I am writing to you regarding the recently published leaflet Working Together for a Stronger NHS. I would like to contest a number of the statements made within the leaflet, and based on a number of untruths feel the leaflet should be immediately retracted.

Firstly, the leaflet states “Every year we could save 750 lives from heart disease... and there is no good reason for Britain to lag behind” (1). Despite searching the Hansard, Pubmed and asking the Department of Health and NHS Future Forum (who made the leaflet) I cannot find a source for this claim. I contest that the UK is not lagging behind in the case of heart disease. The data from the last thirty years shows that the death rates from heart attacks in the UK have fallen more than in any other European country (2). Indeed, if current trends continue death rates from heart attacks will be lower than that of France (to which the UK is often compared) by 2012 (2). This is not ‘lagging behind’ by any stretch of the imagination.

Secondly, the leaflet states “Every year we could save... 5000 lives from cancer”(1). This figure is from the series of EUROCARE studies. These studies looked at data from 1985 – 1999, however one year later the massive NHS Cancer Plan 2000 was rolled out and services changed significantly. The data from EUROCARE therefore is not relevant to the debate on current services since they have changed since the study finished.  There were also serious methodological issues with the study; many countries submitted less than a quarter of all their cancer deaths to the registry, whereas the UK submitted 100%, and important differences in death certification make drawing meaningful comparisons challenging. In any case, the conclusion of the EUROCARE is that the Britain in 1999 was making “steady progress”(3) in cancer related mortality. Of course there are always improvements to be made, but death rates from lung cancer and breast cancer, two of the biggest killers, are falling at a good rate (2), the NHS is not lagging behind in cancer care.

Finally, your leaflet states “95% want more choice over their healthcare"(1). This is cited as the British Social Attitudes Survey, however the survey asked no such question. It asked “how much choice do you think NHS patients should have?”. The survey you cited in does not back up your claim that “more choice” is wanted. In fact the survey shows that 64% of Britons are “quite satisfied” or “very satisfied” with the NHS - the highest rate of satisfaction since the survey began nearly thirty years ago (5).

I request that you retract the leaflet on the grounds that the above claims are made inappropriately. We need informed debate on this issue, not propaganda based on old data and half truths.

Yours sincerely,

Erica Pool


1. HM Government. 2011. Working together for a stronger NHS. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_125848
2. Appleby. 2011. Does poor health justify NHS reform? http://www.bmj.com/content/342/bmj.d566.long
3. Abdel-Rahman et al. 2009. What if cancer survival in Britain were the same as in Europe: how many deaths are avoidable? http://www.nature.com/bjc/journal/v101/n2s/full/6605401a.html
4. Goldacre. 2011. I’d expect this from UKIP, or the Daily Mail. Not from a government leaflet. http://www.badscience.net/2011/04/id-expect-this-from-ukip-or-the-daily-mail-not-from-a-government-leaflet/
5. Appleby. 2011. How satisfied are we with the NHS? http://www.bmj.com/content/342/bmj.d1836.full?sid=7f1fb4c7-234f-4e8e-bd3f-4e588088362a