Performance of UK National Health Service compared with other high income countries: observational study (original) (raw)
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It is well-established that for a considerable period the United Kingdom has spent proportionally less of its gross domestic product (GDP) on health-related services than almost any other comparable country. Average European spending on health (as a % of GDP) in the period 1980 to 2013 has been 19% higher than the United Kingdom, indicating that comparable countries give far greater fiscal priority to its health services, irrespective of its actual fiscal value or configuration. While the UK National Health Service (NHS) is a comparatively lean healthcare system, it is often regarded to be at a 'crisis' point on account of low levels of funding. Indeed, many state that currently the NHS has a sizeable funding gap, in part due to its recently reduced GDP devoted to health but mainly the challenges around increases in longevity, expectation and new medical costs. The right level of health funding is a political value judgement. As the data in this paper outline, if the UK 'afforded' the same proportional level of funding as the mean average European country, total expenditure would currently increase by one-fifth.
Expenditure on healthcare in the UK: A review of the issues
Fiscal Studies, 2001
This review examines the performance of the UK healthcare system. After presenting data on the level and distribution of resources, three topics are examined. The first is the lessons from international comparisons of evidence on expenditure, equity and healthcare outcomes. The second is the lessons from the recent internal market reforms. The third is the lessons from an analysis of the role for private finance in UK healthcare. The review concludes that economists and policymakers need to focus more attention on the relationship between healthcare inputsexpenditure -and health outcomes, and, within this, on the incentives facing suppliers and demanders of healthcare.
How the NHS measures up to other health systems
BMJ, 2012
The NHS outperforms other high income countries on many measures despite spending much less than most of them • It enjoys the highest levels of public confidence and satisfaction of all the countries studied • The effects of increased investment and policy improvements over the past decade are clearly visible
Achieving Quality Healthcare for All: A Comparison of Healthcare Systems in the U.S. and England
In this paper, we examine the healthcare systems of two developed countries: the United States (ranked 11th of 11 countries surveyed in international comparison surveys) and the United Kingdom (ranked number 1). Our discussion begins with an overview of each country’s healthcare system and concludes with a discussion of the similarities and differences between the two systems. Specifically, the following topics will be addressed: 1) the government’s role; 2) the key governing entities; 3) who and what is covered; 4) how the system is financed; and 5) how health care services are organized, financed, and delivered (Thomson, Osborn, Squires, and Jun, 2013). The goal of this comparison is to enhance our understanding of healthcare in the United States and another developed country (Holtz, 2013; Thomson et al., 2013).
What is the right level of spending needed for health and care in the UK?
The Lancet, 2021
The health and care sector plays a valuable role in improving population health and societal wellbeing, protecting people from the financial consequences of illness, reducing health and income inequalities, and supporting economic growth. However, there is much debate regarding what is the appropriate level of funding in the UK. In this paper we look at the economic impact of the COVID-19 pandemic, historical spending in the UK and comparable countries, assess the role of private spending, and review spending projections to estimate future needs. Public spending on health has increased by 3•7% a year, on average, since the NHS was founded in 1948, and has assumed a larger share of both the economy and government expenditure. Over the last decade, except during the pandemic, the rate of growth of government spending for the health and care sector has slowed. We argue that without average growth in public spending on health of at least 4% per year, in realterms, there is a real risk of degradation of the NHS, reductions in coverage of benefits, increased inequalities and increased reliance on private financing. COVID-19 has highlighted major issues in the capacity and resilience of the health and care system. We recommend an independent review to examine what additional funds are required to better equip the UK to withstand further acute shocks and major threats to health. A similar, if not higher, level of growth in public spending on social care is needed in order to provide high standards of care and decent terms and conditions for
Productivity of the English National Health Service: 2016/17 Update
2019
Background to series CHE Discussion Papers (DPs) began publication in 1983 as a means of making current research material more widely available to health economists and other potential users. So as to speed up the dissemination process, papers were originally published by CHE and distributed by post to a worldwide readership. The CHE Research Paper series takes over that function and provides access to current research output via web-based publication, although hard copy will continue to be available (but subject to charge).
What Can We Afford For the National Health Service?
Social Policy & Administration, 1992
The annual Gross Domestic Product (GDP) is here used as a standard measure against which to compare expenditure on Health & Welfare and Defence budgets, between Conservative and Labour governments and the four largest EC countries I 973/4-1993/4. An analysis of Mrs Thatcher's governments' expenditure shows that proportionately less GDP went to General Government Expenditure (GGE) than all the other European Community countries. Mrs Thatcher's first government maintained the unprecedented level of GDP devoted to Health reached in I 978179, but successive administrations began to reduce, and, plan further reductions of GDP for the NHS. Relative decreases of GDP were also found in relation to expenditure on Social Security, Housing, and Personal Social Services and Defence. The governments of France, Germany and Italy provided more of their GDP to health than Britain, whilst at the same time we spent more on Defence and Law & Order & Public Safety. This raises the question: what can we afford for the NHS? A review of demographic changes shows that the British infant and elderly population, who are associated with demands for health, were proportionately more numerous than in France, Germany and Italy. This suggests the need for more UK health expenditure if Britain is to meet current and future needs.
Hospital and community health service costs: England and Scotland compared
BMJ, 1988
In publications which have compared the health expenditure in the component parts of the United Kingdom by applying the Resource Allocation Working Party (RAWP) formula to the health budget of England, Scotland, Wales, and Northern Ireland it has been previously concluded that Scotland's hospital and community health services expenditure is more than 19% above what would be a fair distribution. It has also been implied that Scotland's allocation should be cut substantially to improve services in England. On the assumption that the purpose of examining the distribution of the health and community health service budget is to ensure "equal opportunity of access to health care for people at equal risk" it is concluded that simple RAWPing of the United Kingdom budget is flawed and a conclusion based on this is therefore untenable.