This project was completed in September 2007.
In brief
- In 2001, Gordon Brown, then Chancellor, commissioned a major review of health care funding needs for the next 20 years. The aim was to close unacceptable gaps in performance both within the UK and between the UK and other developed countries. A team led by Sir Derek Wanless produced Securing our Future Health: Taking a Long-Term View in 2002, followed by a further report in 2004, Securing Good Health for the Whole Population: Final Report, exploring public health interventions in more depth.
- The 2002 review outlines three possible spending scenarios: solid progress, slow uptake, and fully engaged (the most ambitious and least costly option). But it also makes it clear that money alone is not going to be enough. There will need to be major changes in the way resources are used to tackle issues such as waiting times, access to services, quality of care and health outcomes – and in particular the productivity of the NHS.
- It concludes that spending on the NHS needs to rise from around £68 billion in 2002/3 to between £154 and £184 billion in 2022/3. In the first decade, this extra spending would allow the UK to ‘catch up’ with the top-class health care service provided in other developed countries, and in the second decade, it would allow the standard to be maintained.
- The review reinforces the government’s decisions at that time to increase levels of spending on the NHS. But what impact have those decisions had?
- One of the 2002 review’s main recommendations – that there be another review of spending and future needs after five years – was not taken up by the government. To fill this gap, The King's Fund commissioned Sir Derek Wanless to look back on NHS spending.
- Our Future Health Secured? A review of NHS funding and performance was published in 2007. It set out to answer some key questions.
- Was government spending on health care in line with the recommendations of the 2002 review? And what are the funding prospects for the next 15 years (up to 2022/3)?
- Where did the extra money go and what results did it achieve?
- Were the extra funds used wisely, and if not, why not? Have policies helped bring about the desired changes?
- What lessons can be learned to inform future spending reviews? It makes recommendations about what needs to happen next to get the UK’s health care system back on track to be a world-class service.
- The review is in two main sections.
- Part 1 looks at NHS funding and performance since 2002. It also includes a summary of the findings of the 2002 review and the 2004 report on the public health aspects of the review’s recommendations, Securing Good Health for the Whole Population: Final Report. It considered how far the policy framework has supported improvements in health care.
- Part 2 presents key findings about what has been spent on the NHS since 2002, and what results have been achieved in terms of resources, services, productivity, and of course, people’s health.
- Real spending was up by nearly 50 per cent, while spending on health care (including private health care) as a percentage of GDP (gross domestic product) stood at 9–10 per cent – very close to the EU average as it stood in 2002.
- This extra funding had undoubtedly helped to deliver some much-needed improvements: more staff and equipment; shorter waiting times and better access to services; and improved care for patients with heart disease, cancer, stroke and mental health problems.
Also in this project
- In brief
- Approach »
- Findings »
