No other country has copied the NHS, despite having over 60 years to do so, which leaves me wondering if it is very efficient or underfunded or both or neither.
This country as always been able to afford a quality NHS ----why is it that in the last few years emphasis as been on TAX money in our pockets is the most inportant -------We as a so called caring NATION should be spending more on health we will all need health care sometime in our lives ---how can people compare having more tax money in there pockets to quality of care when needed ---
even those with a good income family, friends aunts,and uncles will at some time require A/E or social care
The Answer is INCREASING NI by a penny or two WILL stop tax dodgers and help rearrange the NHS without hurting everyone to much in there pocket
In a Board of NHS where nearly 80% of Board leaders are non-clinical and only 20% are clinical (Medical and Nurse Directors) sadly finance and targets dominate and in such a culture patients and staff suffer. Sadly it is also true that none of the Board members including Medical and Nurse Directors are trained in leadership. They may have attended some courses but not properly trained as to how to be leaders and many do not get any feedback about their own values, behaviours and leadership.
In such a culture both Medical and Nurse Directors become the part of the same culture of achieving targets and trying to balance the book at any cost! This is the fundamental problem in our NHS.
Where there are good Board level leaders who put patients at the heart and also care for staff (all staff and not simply White staff - also BME, GLBS, disabled, women and so on) and appoint right leaders and promote a culture of staff happiness, staff engagement; these Trusts do well and if this is done across the NHS we can have safest, best and if we stop working in silos can probably save £20 Billion which can be re-invested to transform Health and social care in this country.
It is not that NHS needs more money but also need good leaders, culture, clinical engagement and staff support to transform the NHS.
To me ( and I am not an economist I freely admit) to look at a % of GDP is misleading because we may have a stronger economy so that our GDP is greater but that does not mean we spend less than another Country.
1) a GDP (PPP) basis
2) population growth rates
3) Age distribution of the population
4) The net input costs of both direct and indirect labour ( ie what is the actual cost of labour( its primary cost) in the NHS given that the government recoups 45 -55% of labour costs in Tax and NI contributions)
5) capital expenditure plus PP I finance repayments
6) what services are encompassed by the said health services
7) Resource distribution between gatekeepers and medical experts
8) management overheads
9) productivity ( albeit difficult to measure in any real sense )
In addition those health systems that are paid for by a compulsory insurance scheme have the benefit of the gains derived from financial investments
In my opinion that visit was a waste of money.
I had a common cold, so no need to bother a GP with that, but I need to proof to my boss that I'm not well enough to work. €25 wasted on healthcare.
Peanuts compared to the billions that will be wasted in the NHS on PFI contracts in the coming decades (The Guardian, Datablog) Of 118 current NHS PFI contracts with a total capital value of £11,6bn, the total amount of repayments will be £79,1bn. Is the NHS money wisely spent by its overpayed managers? Those £67,5bn spent on the cost of PFI will not go to direct patientcare. And there will probably be a lot more spending on overhead in the NHS that could be cut out with surgical precision without harming the patient.
I once attended a course held by an American business guru, who stated " You cannot shrink your way to greatness". He further stated "That once you start counting the photo copy paper you use, the end is close". This actually occurred at one company I worked in.
The NHS is showing a similar trend, CCG's, public relation companies, none medical managers but more importantly an ongoing drive to reduce real spending on our health service.
We need to be aware and drive for proper financing and use medical management systems, lose the baggage.
To suggest that the UK govnt can just print its own money to fund the NHS is delusional. Our abiity to deliver healthcare depends to a large degree on ability to buy equipment, supplies and drugs - much of which is imported. If we don't justify money printing with increased productivity (which we never do), the pound falls and our ability to buy those essentials diminishes.
"Keep politicians off the NHS !" you say. I agree. Furthermore.keep GPs, nurses and surgeons off the NHS. It is often said that we should leave the NHS to those who are working at the front line. Of course, within their sphere they know more than others, just as a petroleum engineer knows more about operating an oil platform than an investor. But oil companies are not run by the engineers operating the platforms - they are too busy and need to focus on their own priorities, just as a GP needs too. Oil companies are runs a a series of business units, each with its own objectives, budgets and authorities, organised to achieve overall business goals. So should the NHS be run, allowing as much outsourcing of services as needs be to deliver results to we the investors. Part of that solution, of course, should also involve we the consumers making partial payments at point of service, accordng to ability to pay, and also allowing we the customers to make top-up insurance payments to gain access to private treatment if we wish, using our basic NI entitlement as a base contribution.
health insurance costs a 20 something around £10 - £15/week
we need a culture of young people starting insurance at this age to maintain low premiums and thus be able to free up operating theatre etc from elective surgery and the like.
ps with growing and raging population, should fertility treatment really be tax payer funded?
As a 70yr old, thank you! Phew!
I did not realise that our % GDP spending on health was so low compared to say France. The NHS clearly isnt working well enough to meet demands. Perhaps we should copy the French, increase funding and introduce some charges for some treatments.
I just read on wiki that the French spend about 11.6% of GDP on the health service. UK spends under 7% I believe.
Actually the numbers provided are divisive and manipulative. Only a fwit would fall for such moronic rhetoric. Nearly all the countries on the list saw there GDPs fall dramatically in the gfc, on top of this their GDPs, in all but 2 cases, are far smaller than the UKs. The fact is we pay much more pro rata then any of the countries. Why is that? Simply put doctors going to agencies to perform the same job on locum wages has cost billions in the last 10 years. Sorry won't be long before ai gets shot of 50% of them anyway.
You read wrong. As a proportion of GDP UK spends 9.7% of GDP on healthcare. That's above the OECD average http://www.oecd.org/els/health-systems/health-data.htm The Kingsfund data in this article is in error (it fails to include social care, unlike other countries, for example) and it should have been corrected. Scotland spends a further 15% extra, making it nearly the highest spending nation in the EU as a proportion of GDP. And Scotland's outcomes? Worse even than England's. And, in turn, England's outcomes in terms of cancer survival and stroke survival rates rival Latvia, not France or Germany.
Deliberately misleading. There are 28 countries in the EU selectively choosing countries to manipulate figures.
Using a weighted average manipulates the comparison even more as 1-2 large will distort figures.
Also its not just about money it is about values for money take America it spend a lot more but it doesn't mean theire healtcare is better. Moving to a private marketplace model (like Singapore and Switzerland) is shown to be the best value for money which is what the government id doing
Of course, every economist understands that unlimited printing of money is a great idea. The Weimar Republic proved it, and recent case studies in Venezuela and Zimbabwe just reinforce the lesson.
I don't give a single flying rat about what percetage our GDP you believe should be spent on socialised medicine. This money is NOT yours to spend. Keep your hands in your own pockets. The only thing you should be conrned about is quality of services provided to customers. Central planning is like locking the steering wheel in your car. That is precisely why some very wealthy countries (like Canada) have absolutely appalling healthcare system. If you think goverment should control every aspect of your life I strongly suggest you move to North Korea, since most of British people are fed up and tired of reinacting soviet union in Western Europe.
Thank you for the great and informative article. Maybe it is a very hard to understand but thank you for the important details you shared.
It would be interested to see the relative number of admin staff as I fear that one of the reasons we have no doctors, nurses or equipment is because we have no IT and an army of admin and non medical management staff
It would be interesting to know how much money is spent by our nhs avoiding treating patients. Clinics run by physios or nurses whose role it is to prevent a patient (where scans etc have already been done) from obtaining a surgeons opinion for example. Ways of avoiding targets for treatment times such as patients who suffer a complication but are already in the system, who don't count for targets. Clinic and surgery appts that they have no intention of keeping and cancel at short notice.
The statistics also do not include the number of people who are no longer economically active due to delays in nhs treatment. Many conditions if treated swiftly will mean the patient remains in work and paying taxes. The time wasted jumping through hoops before treatment starts can mean they end up on benefits and will struggle to get new employment after treatment finally commences. There are far too many people in the nhs whose job is making it look like people are receiving some sort of attention,but if instead, the money was spent on treatment, that would speed recovery and the saving to both nhs and state would be huge
Very right wing government ? Hardly . We are the only country with a “ National Health Service “ funded by taxes . Nearly all the rest of Europe uses an insurance based system , funded in many varieties of ways . Whenever any discussion arises , the N H S lobby points to the American system as if that’s what is being planned . We need to raise our lowly ranking on the WHO efficiency table of 18 th . France ranks number one with both Spain and Portugal ranking above the U K . Interestingly , the Americans have virtually the same sacred cow status in their privately insured system . I’ve lived there and never found an American who wanted to copy our system , and that included Democrat voters . Even President Obama dare not mess too much with it , just disallowing higher premiums for pre existing conditions and introducing fines for not having a “ plan “ This did achieve a jump from 85% to 91% of Americans with a plan but many young people are still winging it as they don’t think they will get ill .For the avoidance of doubt as the lawyers say , I am not advocating the U S system . I just thought i’d throw that in out of interest as I lived there for five years In my opinion we need to look at the best performing countries on that table and try to learn some lessons . I’m not holding my breath though !
I’ve lived in France for the last eight years and feel infintely more comfortable in the French health system than I ever did in the NHS.
My wife suffered a severe gash to her leg a year ago which because of not being treated quickly enough (our fault!) eventually meant 10 days in hospital followed by nearly a month of hospitalisation à domicile with a drain in the leg, daily visits from the “district nurse” and equipment supplied by prescription, all at no charge.
I was recently diagnosed with early stage prostate cancer and immediately transferred to the AFD (affection de longue durée - long-term illness) system which by-passes the usual 2:1 split of costs for treatment.
All treatments connected with this will be paid for by the state, including the cost of transport to/from the hospital for the radiotherapy that starts next month. And all this is controlled through the patient’s carte vitale, a system which appears to be near-foolproof while the NHS seems incapable of operating any sort of efficient workable computer system.
And there is no political falling out over the health system here. It is not seen s macho to decry or to support it or seek to change it except where it can be improved for the patient. It is literally not of any political significance. It just is!
And the longesr I have ever had to wait for an appointment was four weeks for an MRI scan — some specialists are obsessed with the things! — and that included Christmas and New Year!
Clearly it's underfunded and, in accountancy bottom line terms, it's "efficient".
By not distinguishing between public and private spending you have greatly diminished the usefulness of this analysis
Compares Apples to Cucumbers.
Other OECD countries have completely different systems to the NHS, many of them funded privately by insurance. Those schemes that are funded through taxation, e.g. the NHS, directly affect the nation's GDP, the amount of money spent in the nation. The more money spent by government, e.g. on the NHS, the bigger the GDP. This effect skews the percentage and IS NOT a reliable indicator of, well, anything.
Any measurement needs to be standardised, e.g. typical hospital budgets against outcomes. Comparing disparate systems will not provide enough commonality to be useful.
The NHS is funded by tax payers but is used by everyone...
Comparing wages is only useful if you also compare the average cost of living, any additional benefits either from the employer or from the state and the work (responsibilities etc).
I know nothing about the work of nurses in France (for example), but do they have an equivalent to Health Care Assistants, who in the UK do much of the work nurses used to do but are paid significantly less?
I think you would also have to compare the number of Doctors, Nurses, Health Care Assistants, Cleaners and Administrators (for example) employed.