Death rates fall but cancer survival drops to eastern European levels

Britain is no longer the sick man of Europe, according to statistics released yesterday which show mortality in England and Wales on a steady decline and dropping below that in France for the first time in 30 years.

Figures published yesterday by the Office of Health Economics (OHE) show that the male mortality rate in England and Wales in 2000 was 835 deaths for every 100,000, and that the rate had fallen 14% between 1990 and 1999, compared with a 10% fall in France.

Death rates are falling among women too, but at the slower rate of 10% over the 10 years.

In France the death rate for women showed an upturn towards the end of the period, though France spent 9.5% of its GDP on health in 2001 compared with 7.6% in the UK.

The figures appear to dispel the theory, advanced by the pharmaceutical industry, which set up the OHE, that greater government spending on health, especially on medicines, is vital in reducing death rates.

The decreases resulted from a significant lowering of mortality rates in people suffering coronary heart disease, stroke, breast cancer and lung cancer, the OHE said.

It also acknowledged that the prevention of disease through lifestyle improvements, such as stopping smoking, taking exercise and keeping weight down played a part.

"We seem no longer to be the sick man of Europe, both in terms of death rates in the killer diseases that the government has identified and in our spending levels," the OHE's director, Adrian Towse, said.

The health secretary, John Reid, said the figures were encouraging but should be complacent. "It's good to see the hard work of staff in the NHS is being recognised, but there's still a long way to go and no one should allow these figures to conceal the scale of the challenge we still face in improving the lives of the nation."

The government was less pleased with another study published yesterday which showed that the UK's cancer survival rates were below the European average.

Eurocare-3, presented at the European cancer conference in Copenhagen, looked at the percentage of cancer patients who survived longer than five years after diagnosis. It found that Britain was poor at treating cancers, except skin cancer, testicular cancer and Hodgkin's disease.

England, Scotland and Wales ranked with Denmark, Malta and Portugal and five eastern European countries for below-average overall five-year survival. Sweden, France and Switzerland did well. The average European survival rate was 53.6% of women and 40.5% of men.

The government argues that the figures apre-date its cancer reforms and its big investment in healthcare three years ago.

"Patients treated for cancer in the NHS today face shorter waiting times, have access to new drugs and are diagnosed and treated using the most modern equipment," the Department of Health said.

But Michel Coleman of the London School of Hygiene and Tropical Medicine, one of Eurocare-3's authors, said increased spending would not necessarily give longer survival.