April 15, 2010 • 11:33 pm

David Cameron went into the first of the three leaders’ debates with many expecting him to perform well. However he was dogged throughout the first week of campaigning by accusations from his opponents of playing “fantasy politics”, and failing to substantiate his policies with cold, hard facts. Would tonight be any different? Full Fact stood ready to check any claims made.

David Cameron made his first substantial claim on the issue of immigration, the first of the topics raised for discussion. According to the Leader of the Opposition “under the last Conservative government we never had net inward migration of more than 77,000 per year, under the present Labour government we’ve never had fewer than 140,000 coming in per year”. Is this a fair and accurate portrayal of the facts?

The immigration figures under Thatcher and Major were indeed lower than today, and according to the office of National Statistics, Cameron is justified in claiming that they fell below the 77,000 mark, with the exception of 1981, when they peaked at 79,500.

Inward immigration rose to the 140,000 level in 1999 and has consistently stayed above that mark since. Whilst Cameron is technically wrong to include the first two years of the Blair government in his analysis, the underlying trend he identifies is legitimate.


When it came to the NHS, Mr Cameron raised a few eyebrows by noting that in Britain “our death rate from cancer is actually worse than Bulgaria’s.” The comparison with a country that has only existed in its present state since 1991 was clearly meant to be less then glamorous, but is it a fair representation of the UK’s record on cancer treatment?

The latest figures from the World Health Organisation certainly seem to back Mr Cameron up. In its 2009 annual report , the WHO found that on average 147 people died per year from cancer per 100,000 people. This compared to 129 deaths per 100,000 heads in Bulgaria.

However Mr Cameron did fail to put these figures into any kind of context: is the comparison with Bulgaria a fair one when placed into a global context?

When compared to other G20 countries, Britain fares little better. The average number of deaths per 100,000 people across the G20 was 117.8, with Britain placing 17th in a league table of these nations, above only South Africa, France and South Korea. Of the G20 nations, Mexico fared best in the WHO report, with 92 deaths per 100,000, with South Korea bringing up the rear with 161.

Is this the best measure of the quality of cancer care under the NHS however, the attack to which Mr Cameron pinned this claim? A more generally acknowledged measure of cancer care quality is the survival rate amongst those contracting the disease. This was the subject of a Lancet report widely trailed in the media which also placed the UK at the lower end of Europe. However this report was criticised in two follow up publications, leading to the original authors conceding that they agreed that many aspects of the data was ‘encouraging’ for the UK.

It is also worth noting that the original Lancet report made a connection between the success in raising survival rates and investment in the health service. This would seem to undermine Cameron’s claim that he could raise standards whilst finding efficiency savings.

Here, as with education, Mr Cameron cited bureacracy as an area wherein efficiency savings could be made. To illustrate his point, he claimed that “the number of managers in the NHS is going up five times faster than the number of nurses”.

This claim can be traced to the most recent NHS Workforce Survey, which shows that over the course of 2009, the number of nurses in the NHS rose by 7,080 (1.9 per cent), whilst the health service recruited 4,750 managers, up 11.9 per cent. On the basis of these figures, David Cameron has underestimated the disparity in recruitment, which would seem to be nearer 6 per cent. The survey notes that this is due to the restructuring of the NHS in response to increasing number of health authorities applying for Foundation Trust status.


David Cameron perhaps didn’t rely on the use of facts and statistics to as great a degree as Gordon Brown. However when he did bring them into play, he seems to have sourced them well. The main point of contention will undoubtedly be with his claim on the relative ‘death rates’ for cancer in the UK and Bulgaria, where it is possible that the academic debate has overtaken him.

Further criticisms may focus on a lack of context in his use of figure, as with the NHS management figures, where a recognition of the changes undergone in the NHS structure would have helped to ground the numbers used. That said it is difficult to find too much fault with the facts themselves, barring the odd slip up.


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