UK and Twenty Comparable Countries GDP-Expenditure-on-Health 1980-2013: The Historic and Continued Low Priority of UK Health-Related Expenditure

Document Type : Short Communication

Authors

Faculty of Health & Social Sciences, Bournemouth University, Dorset, UK

Abstract

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 averageEuropean country, total expenditure would currently increase by one-fifth.

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  1. Dean H. Social Policy. 2nd ed. Polity Press, 2015.
  2. Demianyk G. Michael Gove Promises Just £100m For NHS, and Dismisses Unpopularity in Bid for Tory Leadership. Secondary Michael Gove Promises Just £100m for NHS, and Dismisses Unpopularity in Bid for Tory Leadership. http://www.huffingtonpost.co.uk/entry/michael-gove-nhs_uk_577641bae4b0c946080087b9. Published 2016.
  3. Dominiczak P. Budget 2015: George Osborne slashes welfare but gives Britain a pay rise. The Telegraph. July 8, 2015. http://www.telegraph.co.uk/finance/budget/11727751/Budget-2015-George-Osborne-slashes-welfare-but-gives-Britain-a-pay-rise.html.
  4. Dixon J, Harrison B, New B. Funding the NHS. Is the NHS underfunded? BMJ. 1997;314:58. doi:10.1136/bmj.314.7073.58
  5. Mladovsky P, McKee M, Ingleby D, Rechel B. Greater public investment is needed to fund the NHS at a level considered normal in other high income countries. LSE Health and Social Care, London School of Economics; 2016.
  6. Ingleby D, McKee M, Mladovsky P, Rechel B. How the NHS measures up to other health systems. BMJ. 2012;344:e1079. doi:10.1136/bmj.e1079
  7. Roberts A, Thompson S, Charlesworth A, Gershlick B, Stirling A. Filling the Gap: Tax and Fiscal Options for a Sustainable UK Health and Social Care System. London: The Health Foundation; 2015.
  8. Faden RR, Chalkidou K, Appleby J, Walters HR, Leider J. Expensive cancer drugs: A comparison between the United States and the United Kingdom. Milbank Q. 2009;87:789-819. doi:10.1111/j.1468-0009.2009.00579.x
  9. Department of Health. Improving Outcomes: A Strategy for Cancer. London: Department of Health; 2011.
  10. Jonsson L, Justo NM, Krinshna A, et al. Cost of treatment in patients with metastatic soft tissue sarcoma who respond favourably to chemotherpy. The SArcoma treatment and Burden of Illness in North America and Europe (SABINE) study. Eur J Cancer Care (Engl). 2015;25(3):466-477. doi:10.1111/ecc.12322
  11. Pritchard C, Hickish T, Rosenorn-Lanng E, Wallace M. Comparing UK and 20 Western countries’ efficiency in reducing adult (55–74) cancer and total mortality rates 1989–2010: Cause for cautious celebration? A population-based study. JRSM Open. 2016; Forthcoming. doi:10.1177/2054270416635036
  12. Francis R. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationary Office; 2013.
  13. Dreaper J, Triggle N. NHS finance problem being ignored, says former boss. Secondary NHS finance problem being ignored, says former boss. http://www.bbc.co.uk/news/election-2015-32325490. Published 2015.
  14. Campbell D. NHS deficit soars to £1.6bn. The Guardian. November 20, 2015. https://www.theguardian.com/society/2015/nov/20/nhs-deficit-soars-to-16bn.
  15. Triggle N. NHS to get above-inflation £3.8bn cash boost next year. Secondary NHS to get above-inflation £3.8bn cash boost next year. http://www.bbc.co.uk/news/health-34905801. Published 2015.
  16. Appleby J. How does NHS spending compare with health spending internationally? Published 2016.
  17. Watt N. Blair’s £12bn pledge to NHS. The Guardian. 2000. https://www.theguardian.com/society/2000/jan/17/futureofthenhs.health1.
  18. Gershlik B, Charlesworth A, Taylor A. Public Attitudes to the NHS: An analysis of responses to questions in the British Social Attitudes Survey. London: The Health Foundation and National Centre for Social Research; 2015.
  19. Harding AJE, Sanders F, Medina Lara A, et al. Patient Choice for Older People in English NHS Primary Care: Theory and Practice. ISRN Fam Med. 2014;2014: 742676. doi:10.1155/2014/742676
  20. Healthcare Choices: NHS versus Private. YouGov website. https://yougov.co.uk/news/2013/06/17/healthcare-choices-nhs-versus-private/. Published 2013.
  21. The Organisation for Economic Co-operation and Development (OECD). OECD Health Statistics 2015. Published 2015.
  22. US Bureau of Statistics. Statistical Abstract of the United States. Secondary Statistical Abstract of the United States 2014. http://www2.census.gov/library/publications/2011/compendia/statab/131ed/tables/12s1346.xls
  23. The World Bank. Health expenditure, total (% of GDP). Secondary Health expenditure, total (% of GDP). http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS. Published 2015.
  24. Bambra C, Fox D, Scott-Samuel A. Towards a politics of health. Health Promot Int. 2005;20(2):187-193. doi:10.1093/heapro/dah608
  25. Pritchard C, Hickish T. Comparing cancer mortality rates in England & Wales with other major developed countries 1979-2006. Br J Cancer. 2011;105(11):1788-1794. doi:10.1038/bjc.2011.393
  26. Pritchard C, Wallace MS. Comparing the USA, UK and 17 Western countries’ efficiency and effectiveness in reducing mortality. JRSM Short Rep. 2011;2(7):60. doi:10.1258/shorts.2011.011076
  27. Pritchard C, Wallace MS. Comparing UK and other Westerns countries’ health expenditure, relative poverty & child mortality. Are British children doubly disadvantaged? Child Soc. 2015;29(5):462-472. doi:10:111/chso.12079
  • Receive Date: 24 November 2015
  • Revise Date: 22 February 2016
  • Accept Date: 04 July 2016
  • First Publish Date: 01 September 2016