Comparative performance and useful suggestions from other countries
- From the viewpoint of most patients, the French health service is outstanding: they are free to go as often as they like to as many of the country's 94,000 GPs or 89,000 specialists as they like, ask for whatever treatment or medicines they like, and expect to get most of the cost reimbursed by the state. Guardian 21 June 2000
- The NHS is turning to Cuba for inspiration on how to improve its services. Officials from the Department of Heath and 100 GPs visited the Caribbean island which, despite being short of medicines and money after decades of a US-led economic embargo, manages to deliver excellent healthcare at a fraction of our cost. Guardian 2 October 2000.
- The NHS is one of the great failures of the Blair government. Are there better ways of achieving the NHS ideal of universal access? An open-minded appraisal of European systems would show that there are.
But instead of showing how social democratic France, Germany and the Netherlands have systems which combine consumer choice, health insurance and a measure of personal payment in different ways which guarantee the poorest people a higher standard of care than under the
NHS, the pusillanimous Tories have been paralysed by fear that Labour will unfairly accuse them of being ready to ride roughshod over the interests of the poor.
In which leading European country is there the widest gap between the standard of care available to the poor and that enjoyed by the rich? The answer is the UK: the rich can always take care of themselves, but the poor rely on the government and in this country the state provides only a low standard. Guardian 21 February 2001.
- Oh to be in England in 2011. Labour's 10-year plans for health, education and fighting crime, paint an ideal society: a health service tailored to patient needs, with no one waiting for any form of even non emergency treatment longer than three months.... In short a country with not just the world's fourth biggest economy, but world class public services too. Quite unlike now, where we languish at 18th in international league tables on health.
Guardian Leader
Tuesday May 22, 2001
- Sick of waiting for your NHS op? Then why not go abroad? Emily Wilson
offers a rough guide to health tourism.
Thursday May 31, 2001 The Guardian
- A league table produced by
World Health Organisation officials offered dismal news for the NHS
yesterday, showing the UK 24th globally in terms of healthcare efficiency.
Oman came first and Andorra and Saudi Arabia are in the top 10.
Guardian
Unlimited Friday August 10, 2001
We delude
ourselves if we think that the NHS is uniquely stricken or that raising
spending is a cure. Just look at the situation in Berlin. David
Walker
Guardian Thursday August 16, 2001
Government denies 'exporting' NHS patient Guardian
Society Thursday October 4, 2001
Tony Blair is wrong to state that spending could be upped in 2004 (Blair
hints at tax rises, October 17). NHS spending needs to be improved now. I
only realised how bad the NHS is when my wife, diagnosed with a positive
smear test and, despairing of the wait she would have, promptly booked an
airline ticket to her home country of Slovakia, where treatment is much
quicker. Guardian
Thursday October 18, 2001
Insurance policy for NHS. Guardian
letters Monday November 26, 2001
What are the highlights and problems of health care in France, Germany,
Spain and Sweden? Guardian
Unlimited Friday December 7, 2001
Tony's big idea on health needs some joined-up thinking. Andrew
Tylecote Guardian
Monday December 10, 2001
Don't be ill, French told as doctors strike. Jon Henley in Paris Guardian
Unlimited Wednesday January 23, 2002
Bottom of the cancer league. Observer
Sunday March 3, 2002
As ministers consider a radical scheme to slash hospital waiting lists,
the head of a Berlin-based clinic explains how it could be done. Kate
Connolly in Berlin Guardian
Monday March 4, 2002
German doctors plan. John Carvel, social affairs editor Guardian
Monday March 4, 2002
1 in 3 willing to go abroad to beat NHS waiting lists. Guardian
Monday March 25, 2002
Woman flies to Berlin for surgery after NHS delays. John Carvel,
social affairs editor Guardian
Saturday April 6, 2002
Doctors throughout the world are becoming demoralised because they are no
longer doing the job for which they trained, NHS managers said
yesterday. Guardian
Monday April 8, 2002
'French health officials should visit the UK to see the appalling
consequences of too many economies in public services'. Christopher
O'Hagan of Derby is concerned that British economic credos are infecting the
excellent hospital service he found in a small French town. Society
Thursday April 18, 2002
A Cambridge woman, name withheld, contrasts her smooth NHS treatment with
red tape in the German health system. Society
Thursday April 18, 2002
Donal Shanahan spent a gruelling six weeks in a South African hospital
where staff deal with up to 170 gunshot victims a month. Along the way he
hit the headlines in the UK for claiming that, statistically, Hackney was
more dangerous than Soweto. This is his diary. Guardian
Thursday May 2, 2002
The best healthcare system in the world is just a train ride away - but
the train is Eurostar. As patients and staff cross the Channel and 'health
tourism' grows, Jo Revill reports on what we can learn from the French.
Sunday
May 25, 2003 The Observer
Key statistics representing the health services in France and the UK.
Sunday May 25, 2003 The Guardian
How can the NHS match Europe's best? Is the most important issue
underfunding - or are cultural and organisational issues equally important?
What are the most important lessons to learn - and what are the areas where
the NHS outperforms the rest of Europe? The Observer asked leading health
experts and commentators for their views. Tom Singleton and Sunder Katwala
Sunday
May 25, 2003
Britain's NHS 'poachers' are making a world of difference. Overseas
doctors and nurses are happy to be recruited to work in our hospitals, but
leave their own countries short of healthcare. Jo Revill, health editor
Sunday August 10, 2003 The Observer
'Mugabe says we are being stolen. All we want is better pay.' The brain
drain has badly hit Zimbabwe's fragile health service. Andrew Meldrum in
Pretoria
Sunday August 10, 2003 The Observer
UK lags behind most of Europe for IVF. Ian Sample
Thursday July 3, 2003 The Guardian
Worlds apart. The NHS has long been unfairly compared with France's health
service, says Peter Davies. But examining the way each handled this summer's
heatwave reveals a different story.
Friday August 29, 2003
Patients who have major surgery in Britain are four times more likely to
die than those in America, according to a major new study. Jo Revill, health
editor
Sunday September 7, 2003 The Observer
Statistics showing that Britain has the worst cancer survival rates in
western Europe have been branded "out of date" by the Department of Health.
Tash Shifrin
Thursday September 25, 2003
Death rates fall but cancer survival drops to eastern European levels.
Sarah Boseley, health editor
Friday September 26, 2003 The Guardian
The UK has plummeted in rankings of the world's healthcare systems, coming
18th out of 19 industrialised countries, after researchers looked again at
what constitutes good performance.
Friday November 14, 2003
NHS in crisis? Patients in France also wait on trolleys. Paul Webster in
Paris
Sunday December 7, 2003 The Observer
French doctors face manslaughter charges. Paul Webster in Paris
Wednesday December 24, 2003 The Guardian
A government commission has warned that without fundamental reforms
France's national health service, rated the best in the world by the World
Health Organisation, will collapse within the next 15 years. Jon Henley in
Paris
Saturday January 24, 2004 The Guardian
$90m payout over child abuse drug. Jamie Doward, social affairs editor
Sunday February 8, 2004 The Observer
Thousands of doctors and airline pilots held a 24-hour strike in Italy
yesterday to protest about government cuts to healthcare and pay freezes.
Sophie Arie in Rome
Tuesday February 10, 2004 The Guardian
Czechs' crowning glory. Letters
Saturday February 21, 2004 The Guardian
In the Czech Republic we can access the basics - like healthcare and
dentists - on demand, and I've yet to hear of anyone having to wait for a
hospital bed (There's no need for Labour to panic over immigration, April 6).
Letters
Wednesday April 7, 2004 The Guardian
Residents of the Isle of Wight, who have endured some of the worst
shortfalls in NHS dentistry in the country, are planning to take a "tooth
ferry" to France for cheap dental treatment. A Cowes councillor, frustrated by
the lack of NHS dentists, is planning a form of dental tourism to address the
problem faced by people living in his area. Bernard Buckle, an independent
councillor, is organising a coach and ferry trip to Cherbourg. Up to 50 people
are due to travel on what has been dubbed the "tooth ferry" for urgent work on
cavities, crowns and fillings. Alexis Akwagyiram
Thursday April 15, 2004 The Guardian
France's centre-right government faced further trouble from a restive
public sector yesterday when 268 senior hospital doctors signed a petition
warning that the country's healthcare system was in crisis. Jon Henley in
Paris
Tuesday April 20, 2004 The Guardian
Eight Polish dentists have arrived in Norfolk to compensate for a lack of
practices in the region able to treat patients on the NHS. For the last year,
residents of Great Yarmouth have been unable to register for an immediate
check-up with an NHS dentist. Only one dentist, in the nearby town of
Gorleston, was able to accept NHS patients, but he had a three-month waiting
list. Laura Barton
Friday
January 21, 2005 The Guardian
This UK patient avoided the NHS list and flew to India for a heart bypass.
Is health tourism the future? Randeep Ramesh in Bangalore
Tuesday
February 1, 2005 The Guardian
Researchers today warned that over-use of antibiotics is boosting rates of
infection by drug resistant bugs in southern and eastern Europe. The results
of their study suggest that the time has come to consider whether it is
ethical to promote antibiotics in cases where they are unnecessary, they said.
Friday February 11, 2005
Fertility experts sharply criticised the lack of IVF provision in Britain
yesterday as new figures suggested it was near the bottom of the European
league. Only Croatia offered less treatment to couples desperate for children
among 11 countries which reported IVF cycles, while another list of nine
states put the UK last for the percentage of babies born using various
assisted reproduction techniques. James Meikle in Copenhagen
Thursday
June 23, 2005 The Guardian
A British mother is flying her fourteen-year-old son to India for
treatment after discovering he would have to wait months for an operation in
the NHS. Elliot Knott was told he would have to wait more than four months for
an appointment after being left housebound from an ice-skating injury, then
face a further wait of at least nine months for an operation. Elliott is
suffering from spondylolisthesis, a debilitating condition caused when a
vertebrae slips out of line in the spinal column and presses on a nerve.
Hélène Mulholland
Thursday August 4, 2005
My dentist says I
need two fillings and a crown. He will do NHS, but says it won't look as good
and recommends I go private. The price will be around £700 whereas on the NHS
it should be under £150. Is it worth paying the extra? Should I insist on NHS?
I'm worried I'll be struck off his list if I always go for the "cheap" NHS
option.
Friday
September 16, 2005
Up to 200,000 people will die from hepatitis C infection in Britain over
the next 20 to 30 years unless diagnosis and treatment of the disease improves
dramatically, doctors predicted yesterday. They warned that the government was
underestimating the looming public health disaster, comparing its record in
tackling the problems unfavourably with administrations in France, Germany,
Italy and Spain. James Meikle, health correspondent
Friday
September 30, 2005 The Guardian
The UK is lagging behind most of Europe in its access to cancer drugs,
alongside the Czech Republic, Hungary, Norway and Poland, according to a
report by Swedish economists published yesterday. Sarah Boseley, health
editor
Friday October 7, 2005 The Guardian
US primary care
is on verge of collapse, says doctors' body. The American College of
Physicians believes the US primary care system is nearing collapse, blaming
problems with payments to doctors and the fact that young doctors are choosing
more lucrative specialties over internal medicine. Summary by Keep our NHS Public
of
British Medical Journal 10 February 2006
NHS 'fails to
involve patients'. Patients in the UK play less of a role in decisions
about their own healthcare than those in other developed
nations, according to a report by the Picker Institute.
Summary by
Keep our NHS Public
of BBC
Online 24 April 2006
A close neighbour of ours, who is a US citizen, recently said that the
thing that bugs him most about this country is the way that nobody seems to
appreciate what we have in the NHS. "You should try the American way, that
will make you realise what you have," was his verdict. Extract from
letter
Friday April 28, 2006 The Guardian
Middle-aged people in Britain are healthier than their American
counterparts, despite healthcare costing nearly twice as much per person in
the US, according to a study released yesterday. James Randerson,
science correspondent
Wednesday May 3, 2006 The Guardian
Access to fertility treatment in Britain is among the worst in Europe,
according to an IVF league table published yesterday. Only three countries -
Croatia, Austria and Macedonia - offer less IVF treatment per head than
Britain, ranking it 12th among 15 countries that supplied data for all of
their clinics, according to a report by the European Society of Human
Reproduction and Embryology. Ian Sample in Prague
Thursday
June 22, 2006 The Guardian
Private
providers plan under attack. Leading academics have criticised Government
plans to allow
private providers to take on the work of primary care trusts. The DoH is
advertising a 'framework' deal for private providers, who will bid to become
commissioners of hospital and GP services. Health Minister Lord Warner said
competition 'could only be good news' for NHS patients. But Alan Maynard,
professor of health economics at York University, said: 'There is no evidence
that the private sector will do any better. The American
healthcare service is grossly inefficient - so why should big US insurers
and providers do any better when they come over here.' Health policy academic
Prof Allyson Pollock branded the move as 'catastrophic'. The news came as the
Government was urged to provide new guidance on consulting the public on
outsourcing local NHS services. The call, by the NHS Confederation, came after
a High Court judge criticised North Eastern Derbyshire PCT for failing to
sufficiently consult the public over plans to outsource local GP servi- ces to
a private company UnitedHealth Europe. There is confusion as to whether rules
on consultation apply to organisations outside the traditional NHS.
Summary by
Keep our NHS Public
of Hospital
Doctor 22 June 2006
Doctors' leader
attacks NHS
reforms. James Johnson, chairman of the BMA, has called on the medical
profession to "draw a line in the sand" over NHS reforms. He condemned the
government over its
marketisation agenda and its failure to consult more closely with doctors
over proposed changes in the NHS, which were being introduced at "breakneck
pace", and questioned whether the government was taking the UK away from a
"universal health service free at the point of use". He said: "In
America, people with health insurance have loads of
choice and lots of competition. But is it keeping prices down
? No, prices are rocketing up. Is it keeping quality high
? No. There is more variability in US healthcare than anywhere. The
very last thing the UK should do is go for the American model of healthcare."
The medical profession should draw a line in the sand and "say no" to private
companies commissioning treatment on behalf of the NHS. Summary by
Keep our NHS Public
of Guardian
27 June 2006
A doctor and two nurses have been charged with deliberately killing
patients stranded in a New Orleans hospital after
Hurricane Katrina ravaged the city. Cut off by the floodwaters, lacking food,
water and electricity, and enduring temperatures approaching 38C (100F), staff
at the New Orleans Memorial Medical Centre ended the lives of several
patients, the Louisiana attorney general's office said. "We're not calling
this euthanasia. We're not calling this mercy killings. This is
second-degree murder," Kris Wartelle, a spokeswoman for the attorney
general, Charles Foti, told reporters. Oliver Burkeman in New York
Tuesday
July 18, 2006 Guardian
The
extra billions invested in the NHS have been largely wasted, an
independent thinktank claims today, resulting in far less improvement in
services than might have been expected. A report from Civitas (the Institute
for the Study of Civil Society) says that while government spending on the NHS
has doubled in cash terms from 2000 - an increase of around a third in real
terms - productivity has gone down. "Service improvement has in too many areas
resembled a country stroll, whereas expenditure has increased at a sprint,"
says James Gubb, the author of The NHS and the NHS Plan. The high-profile
targets, such as waiting times and cancer care, have all been met, the
report concedes. But this has sometimes been done through "gaming": in one
trust, A&E patients were kept in ambulances until staff were confident they
could be treated within the four-hour government target. But beyond the areas
covered by such targets, the improvements are slight, says the report. The
UK lags behind in mental health and stroke care, it
says, and it is the only Organisation for Economic Cooperation and Development
country to register virtually no improvement in death rates from stroke
between 1999 and 2003. Sarah Boseley, health editor
Monday
August 14, 2006 The Guardian
Report blames bureaucracy for UK cancer deaths. UK cancer patients
are more likely to die from the disease than those in other developed
countries as they are being denied access to the latest drugs, researchers
said today. The study by the Karolinska Institute in Sweden found that the
"excessive bureaucracy" involved in approving drugs for use in the NHS
condemned British patients to an early death. Uptake in the UK of 67 drugs for
breast, lung and colorectal cancers launched since 1985 has been "low and
slow", according to the study, funded by the Swiss pharmaceutical giant Roche
and published in the latest Annals of Oncology. More than half (51% to 52%) of
patients in France, Germany, Italy and Spain have access to new drugs,
compared with just 40% in the UK. French women with cancer are more than a
third (34%) more likely to still be alive five years after diagnosis than
their UK counterparts - 71% compared with 53% respectively. Meanwhile French
men are nearly a quarter (23%) more likely to be alive after the same period -
53% compared to 43% respectively. David Batty
Thursday May 10, 2007 Guardian Unlimited
Urgent need for Alzheimer's care not being addressed, study says. The
steep rise in dementia in England is presenting a "significant and urgent
challenge" to health and care services, yet the condition is still given low
priority by the government and remains surrounded by misunderstanding and
stigma, according to a new report. A study published yesterday by the National
Audit Office (NAO) says that, despite predictions that dementia cases will
rise from at least 560,000 at present to over 750,000 by 2020 and 1.4 million
by 2051, too few people are being diagnosed early enough or at all, and early
interventions that can help are not being made widely available. The UK
lags behind the rest of Europe, falling into the bottom third of countries
providing patients with effective drugs, and taking up to twice as long on
average to diagnose the illness as other countries, says the report. It is
published just months after a landmark Alzheimer's Society study put the cost
of dementia to the UK at £17bn. The Department of Health, the NHS and social
care services have all failed to give dementia the "priority status" it
deserves, according to the NAO, which calls on the government to show
leadership and ensure improvements in dementia services, as well as changing
professional and public attitudes that little can be done to tackle the
disease. Lucy Ward, social affairs correspondent
Wednesday July 4, 2007 SocietyGuardian.co.uk
Late diagnosis blamed for lower child cancer survival rates in UK.
Children with cancer in Britain have lower survival rates than in other
western European countries because the NHS gives them low priority, research
reveals today. Experts in paediatrics and cancer research investigated why
only 30% of children in Britain survived neuroblastoma, a tumour of the
adrenal gland, compared with 46% in Germany, Belgium, the Netherlands,
Luxembourg and Switzerland. In a keynote comment for today's issue of The
Lancet Oncology, they said the most likely reason was late diagnosis caused by
inadequate medical monitoring. In Germany, most children have a primary care
paediatrician and those with cancer can be identified during routine health
checks. In Britain, NHS guidelines are less thorough with fewer routine
examinations recommended. John Carvel, social affairs editor
Wednesday August 1, 2007 The Guardian
Lower cancer survival rates for UK. Children suffering from cancer
in the UK have shorter survival rates than their European counterparts,
experts have claimed.
Care & Health 2 August 2007
Americans are living longer than ever, but not as long as people in 41
other countries. For decades, the United States has been slipping in
international rankings of life expectancy, as other countries improve health
care, nutrition and lifestyles. Countries that surpass the U.S. include Japan
and most of Europe, as well as Jordan, Guam and the Cayman Islands.
Care & Health 14 August 2007
UK cancer survival rates lagging most of Europe. Extra
funding not matched by results, says study. Solving problem would require big
NHS shake-up. Cancer survival rates in the UK are trailing behind much of the
continent and in some cases struggling to stay ahead of eastern European
countries despite significantly more funding, according to a study published
today. The government was left defending its cancer strategy last night after
a damning editorial published alongside the findings in the Lancet Oncology
medical journal suggested the cancer plans introduced in England in 2000 and
Scotland in 2001 are not working and that remedying the problem would take a
fundamental overhaul of NHS services. Cancer charities blamed the poor results
on deficient radiotherapy services and the fact that people are still waiting
too long after discovering a lump or another sign of cancer to see a doctor.
Polly Curtis, health correspondent
Tuesday
August 21, 2007 The Guardian
Angela Gorman writes of the thousands of US citizens who die each year for
want of adequate healthcare. Included in these numbers are many who America
rightly considers heroes (for their work in the wake of the 9/11 attacks for
example). Some are featured in Michael Moore's new film "SICKO" which opens in
the UK on 26 October. NHS
Support Federation
Last year 20,000 Britons went abroad for dental treatment. Lisa
Bachelor finds out the drill. Property investors and skiers have long
known about the advantages of a trip to Eastern Europe, but growing numbers of
Britons are now jetting off to the likes of Hungary, Poland and Bulgaria to
cut the cost of their dental bills. Fifty thousand people in the UK travelled
abroad for medical treatment last year and 20,000 of these did so for the sake
of their teeth. The average spend on dentistry was £2,500, according to
website Treatmentabroad, which
surveyed 300 clinics, medical tourism companies, hospitals, doctors, dentists
and healthcare providers overseas that are promoting their services to the UK
market. Cost is the biggest factor driving people overseas - savings of more
than 80 per cent can be made on some forms of treatment - but the rise in
dental tourists has also been due to changes in the NHS in the past year. 'The
biggest growth in dental tourism appears to have been fuelled by the changes
to NHS dental contracts, especially for people who want more complex
procedures carried out,' says Keith Pollard, spokesman for
Treatmentabroad. 'They are
either struggling to find a dentist to do it or when they do are being met
with costs of £10,000 to £15,000 in some cases.'
Sunday
September 23, 2007 The Observer
A picture of health?. Michael Moore's new film, Sicko, which is out
next month, contrasts the US's privatised healthcare system with Britain's
free NHS. It shows Americans without insurance dumped in the street; children
refused life-saving treatment because their parents can't pay; hospitals run
for profit, not for patients. The UK, meanwhile, is a glorious place where
everyone receives the treatment they need, whatever their income; where
doctors earn high salaries and are paid extra for preventative care; where the
public ethos is as strong as ever after almost 60 years. For this special G2
report we took 16 NHS workers to an advance screening of Sicko and asked them:
is the British way of medicine really that good? Interviews by Aida Edemariam,
Jon Henley and Homa Khaleeli
Monday September 24, 2007 The Guardian
What Sicko doesn't tell you ... Michael Moore's film hails the NHS
and condemns US healthcare. But behind the scenes the UK government has
already started adopting the American model of health provision. Allyson
Pollock reports.
Monday
September 24, 2007 The Guardian
Allergic Britain: 20 million will be affected as conditions approach
epidemic levels. Britain is lagging far behind the rest of Europe in its
efforts to tackle allergies, which are fast reaching epidemic proportions,
according to a report from an influential House of Lords committee. About a
third of the UK population will develop an allergy of some sort during the
course of their lives, says the report from the science and technology
committee, as allergic diseases have trebled in the last 20 years to the point
where the UK has one of the highest incidences in the world. Allergic food
reactions can kill, while hayfever, asthma and other debilitating conditions
can hold children back at school and cause lifelong difficulties. Yet Britain,
unlike other European countries, has failed to adopt treatments that can cure
some allergy sufferers and the UK is short of specialists, says the committee.
It is particularly critical of the guidance given to pregnant women and young
children not to eat peanuts - which it says should be immediately withdrawn.
Lady Finlay, who chaired the committee's year-long inquiry, said: "Academics
and clinicians have told us that a growing body of evidence has suggested this
guidance may not only be failing to prevent peanut allergy, but might even be
counter-productive." The evidence for avoiding peanuts is nine years
old. "We reviewed it carefully and we're not convinced it stood up," she said.
"We heard evidence that in some parts of the developing world where groundnuts
are used as a kind of soup for weaning, and in Israel where peanuts are
incorporated into a kind of rusk for weaning, they don't have the allergy that
is developing here." Some of the evidence heard by the committee suggested
that depriving children of peanuts in early life might actually cause an
allergic reaction later on. The committee was also concerned at the lack of
availability of immunotherapy - a treatment for allergies such as hayfever
which involves giving gradually increasing doses of the substance which
triggers an attack, such as grass pollen. Sarah Boseley, health editor
Wednesday September 26, 2007 Guardian
UK falls further down European health league despite rise in funding.
Britain's National Health Service remains a "mediocre" provider of healthcare,
performing much less well than almost all of the UK's peers in western Europe,
according to a European survey. The index of European health services, issued
yesterday in Brussels by Health Consumer Powerhouse, found Britain had slid
further down the European league table over the past year despite the
investment in the NHS under New Labour. Of 29 countries assessed, the EU's 27
plus Norway and Switzerland, Britain came 17th. Apart from Italy, all the
countries ranked worse than Britain were much poorer, mainly from eastern
Europe. Apart from Italy and Portugal, all the countries of western Europe and
Scandinavia scored much higher than Britain. The same survey last year put
Britain 15th. Ian Traynor in Brussels
Tuesday
October 2, 2007 The Guardian
Slovenia beats
Britain in safe births league. Britain comes only 19th in a worldwide
survey of the safest places to become pregnant and give birth. Although
Britain makes it into the "lowest risk" category in a new study by Population
Action International, it is bettered by some surprising nations, including
Cuba, Estonia, Slovakia, Croatia, Slovenia and Singapore. The league tables
compare the risks of dying in pregnancy and childbirth. Britain gets into the
lowest risk category with a score of five, the same as the US. What drags
Britain down is a less than 100% record in attendance at births by skilled
health personnel. Summary by
Keep our NHS Public of Times
18 October 2007
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