Health Care Reform and the NHS

1
Health Care Reform and the NHS

• UK health care expenditure (HCE)
• How NHS compares with other countries
• Health care reform
• Past, and current, reforms in the UK
• The future?

2
Health Care Industry

• Annual sales of approximately 60bn - more than
  defence, education or local govt.
• Equivalent to approximately 7 GDP or 1,000 per
  capita
• Employs approximately 800,000 people - of whom
  around 60 (500,000) are nurses

3
Three issues in interpreting HCE

• Health care expenditure is influenced by
• Changes in national income (GDP)
• Population growth demographic profile
• Inflation

4
Why might HCE increase?

• Aging population?
• Spread of private health insurance?
• Advances in technology?
• Increased income?

5
Why does HCE ? GDP?

• Need
• Tastes and preferences
• Efficiency

6
What HCE ignores

• Distribution - equity
• Outcomes/quality of care/benefits
• Mix of services
• Technical efficiency

7
Summary

• UK historically low HCE w.r.t OECD
• Levels of health broadly comparable
• Relatively equitable, although threatened
• Problems? Waiting lists/time, geog. variations

8
Health Care Reform

• Would you tell me, please, which way I should go
  from here? Alice asked the Cheshire Cat.
• That depends a good deal on where you want to
  get to, said the Cat.
• Lewis Caroll, Alice in Wonderland