Despite the financial crisis, healthcare in Europe continues to improve, with consumer empowerment driving improvements in quality and access - but the deployment of cancer drugs in the UK is still "deplorable," says a new 34-nation review.

The Netherlands comes top of the latest Euro Health Consumer Index (EHCI) survey of European health care systems, which ranks them on 42 indicators covering five key areas: - patient rights and information; - accessibility of treatment (waiting times); - medical outcomes; - range and reach of services provided; and - pharmaceuticals.

The Dutch system - which leads the latest rankings for the third consecutive time and with a growing margin - scored 872 points out of a potential 1,000, and was followed by Denmark, Iceland, Luxembourg and Belgium.

The UK has risen to 12th position from 14th in 2009 (when the last EHCI was compiled), on 721 points, ranking level with Ireland and Austria. The UK now provides some of the best access to healthcare information and use of e-health services in Europe, and there have been significant improvements in both the range and reach of services, and in healthcare equity. "Increased government spending on the NHS has paid off," says the EHCI, which is compiled by Sweden-based think tank Health Consumer Powerhouse (HCP).

However, although waiting times have improved to some degree, the UK remains in "healthcare waiting time territory," while medical outcomes are still insufficient for a highly-developed country and infant vaccinations seem to have fallen behind, the study finds. Moreover, access to medicines is seen as generally good, but the UK's deployment of new cancer drugs is still "deplorable," it says.

In the successful parts of "healthcare Europe," there has been a gradual build-up of consumer influence, notes HCP. Patients' rights are improving in more countries, information to help consumers navigate healthcare is developing and methods to simplify access, such as e-prescriptions and Internet booking of appointments, are becoming more frequent.

The power gap between medical professionals and patients/consumers is closing, and reliable pharmaceutical websites for the public have spread to most European countries, "undermining the Big Brother attitude that information about medicines from manufacturers is a dangerous thing," says HCP, adding:  "our conclusion is that user-friendliness has become a major quality performance driver in healthcare." 

But despite this general improvement, the study also reports evidence of longer waiting times for elective surgery among countries most affected by the economic downturn, "somewhat" increased out-of-pocket contributions by consumers to their healthcare services, and a lack of improvement and even deterioration in access to new medicines.

Moreover, the study also finds a large group of under-performing countries where access is far behind, not only to heart surgery and new cancer drugs but also to basic services such as infant vaccination and mammography. Here, investments by the European Union (EU) have so far had little equalising effect, says HCP.