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Health Care Systems in Transition: the UK report

The United Kingdom has less than half the levels of hospital beds per 1000 population found in France and Germany, and only half the number of doctors per head of population compared with these two countries, according to a new report from the European Observatory on Health Care Systems.

Health Care Systems in Transition: The United Kingdom provides an up-to-date account of the reforms of the NHS under both the previous Conservative and the present Labour Government, along with data from international organisations, including the World Health Organization, which shows the comparative performance of the NHS.

Written by Professor Ray Robinson of the London School of Economics and Political Science, the UK report is one of a series from the European Observatory on Health Care Systems which focuses on current health sector reforms in European countries. It shows how UK expenditure levels on health - particularly private expenditure - lag behind European levels.

Professor Robinson said: 'The Prime Minister's public concession that expenditure on the NHS is too low and needs to be raised to European levels represents a significant shift in the politics of NHS funding. The Health Care Systems in Transition (HiT) profile reveals the scale of this task. It also shows how a constant stream of supply-side reforms launched over the 1990s have left the service in a state of 'reorganisation fatigue' that will need to be addressed if service improvements are to be realised.'

The HiT profile presents both national and comparative data on a number of indicators:

  • Spending on health care in the UK increased steadily until 1990. Between 1990 and 1992 there was a marked increase from 6% to 6.9% of GDP coinciding with the introduction of the internal market and GP fundholding. Since 1992 expenditure has stagnated as a percentage of GDP
  • The United Kingdom spends 6.7% of its gross domestic product (GDP) on health - less than any other European Union member state. Germany spends 10.4%, France 9.9% and the Netherlands 8.5% of GDP. These figures do not, however, indicate how resources are spent or what outcomes are achieved.
  • Spending on drugs in the UK consumes an increasing proportion of public expenditure - nearly 13% of public expenditure on health is spent on drugs. Hospitals still dominate accounting for 45% of public expenditure on health, whilst outpatient care accounts for 9% of public expenditure.
  • The UK population on average receive about 6 outpatient consultations per year; similar to France and Germany (6.5 consultations per person per year). In Switzerland the population receive as many as 11 consultations per year.
  • The United Kingdom has fewer hospital beds than the European Union average (4.5 beds per 1000 population). Bed numbers have declined across Europe throughout the 1980s and 1990s, the United Kingdom now has as few as two acute care beds per 1000 population. However, the United Kingdom has shorter average lengths of stay in hospital than in other European countries which indicates greater throughput per bed.

The UK report forms part of a series of reports covering all 51 states covered by the European Region of the World Health Organization. The series is being produced by the European Observatory on Health Care Systems, a partnership between the World Health Organization Regional Office for Europe, the Government of Norway, the Government of Spain, the European Investment Bank, the World Bank, the London School of Economics and Political Science and the London School of Hygiene & Tropical Medicine.

Available at http://www.observatory.dk| or additional printed copies may be ordered from European Observatory on Health Care Systems, WHO Regional Office for Europe, Scherfigsvej 8, DK-2100 Copenhagen 0, Denmark , alternatively email: observatory@who.dk|

Other reports currently available in the series: Albania, Bulgaria, Croatia, Germany, Kazakhstan, Luxembourg, Malta, Poland, Portugal and Switzerland.


For further comment contact:

Professor Ray Robinson on 020 7955 6233 (work) or 01273 565573 (home)
Anna Dixon on 020 7955 7594 (work) or 020 76090809 (home)
LSE Press Office on 020 7955 7060.

02 February 2000