NHS investment: what's been achieved?

They've had billions of pounds in extra cash - but the National Health Service is still struggling to become world class.

The former Nat West boss Sir Derek Wanless has painted a bleak picture of progress in the National Health Service, five years after his original report was commissioned by the then Chancellor, Gordon Brown.

Is our future health secured?

Sir Derek gave what he called a guarded tick to improved waiting times, more staff, better pay and equipment and and better care in heart disease, cancer, stroke and mental health.

But, and it is a very big but, the massive extra investment (£43.2 billion since 2002) has not seen increased productivity - put simply, money was wasted.

Sir Derek puts a cross beside the huge pay increases for GPs and consultants, saying the benefits have not been enough to justify them.

He also added that there has been too much reorganisation, slow progress on the IT system and and a large rise in emergency and a&E admissions.

The review for the Kings Fund suggests this could be because of pressure to reach the 4- hour wait target or because of a poor GP out-of-hours service - something the Government has promised it will deal with.

Change not always a good thing

Sir Derek was especially critical of all the changes and upheavals in the NHS and said we now need some stability.

He also said the Treasury and the Department of Health needed to start producing 20-year forecasts so they know how much the money the NHS will need in the future.

He also issued a strong warning over the Government's failure to deal with obesity which affects - 23 per cent of men and 25 per cent of women - this is way over the health department's 2002 predictions.

There will not be a comprehensive, high-quality NHS if this is not tackled, Sir Derek added.

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