Questions about the health care system
- What's the NHS annual budget?
- How many primary care trusts and strategic health authorities are there?
- How many hospitals are there in England?
- How many available beds are there in the NHS? Is the number of beds falling or increasing?
- How many doctors, nurses and managers are there in the NHS in England?
- How many Secretaries of State for Health have there been under Labour?
- How much of the NHS budget is spent on the workforce?
- What's the cost of an operation?
- What percentage of GDP does the UK spend on health compared to other countries?
- Based on birth rates and rise in life expectancy, how will demand for health care change over the coming decades?
What's the NHS annual budget?
The total budget for the NHS in England for 2010/2011 is £105 billion. (Source: Department of Health annual report 2009 Annex A finance data tables table A:3). This figure represents around 18 per cent of current public expenditure.
How many PCTs and SHAs are there?
Strategic health authorities (SHAs) were created by the Labour government in 2002. They provide regional management for the NHS. Originally there were 28 SHAs but in 2006 the number was reduced to the following 10:
- East Midlands Strategic Health Authority
- East Of England Strategic Health Authority
- London Strategic Health Authority
- North East Strategic Health Authority
- North West Strategic Health Authority
- South Central Strategic Health Authority
- South East Coast Strategic Health Authority
- South West Strategic Health Authority
- West Midlands Strategic Health Authority
- Yorkshire and The Humber Strategic Health Authority
(Source: Office of the Strategic Health Authorities)
Primary care trusts (PCTs) were first set up in 2002.There are currently 152 PCTs in England, reduced from 303 in 2006.
At NHS Choices you can use your postcode to find your local PCT.
How many hospitals are there in England?
It's not that simple to arrive at the number of hospitals in England. NHS hospitals are managed by acute trusts of which there are 168 in England (Source: NHS Choices). But the number of acute trusts does not correlate to the number of hospitals as many acute trusts operate hospitals on more than one site. There are also private sector hospitals and hospitals run directly by primary care trusts.
How many available beds are there in the NHS? Is the number of beds falling or increasing?
There are currently 159,386 beds in the NHS. (Source: Department of Health 2009).
Graph 1 shows the change in the number of available beds over 20 years. Proportionally, the largest falls have been in learning disability, mental illness and geriatric beds.In all areas, care is increasingly being delivered with shorter stays in hospitals, so the number of beds needed has fallen.
(Source: Department of Health)
How many doctors, nurses and managers are there in the NHS in England?
There are 125,629 doctors, 329,372 qualified nursing staff (including midwives) and 37,937 managers in the NHS out of a total workforce of 1,125,131 (all figures are whole-time equivalent). Between 1998 and 2008 the number of doctors rose at an average rate of 3.8 per cent per year and the number of qualified nursing staff rose at an average rate of 2.5 per cent per year. The number of managers rose at an average rate of 5.7 per cent per year.
(Source: Information Centre, 2009)
Graph 2 shows the growth in doctors, nurses and managers (whole-time equivalent figures) between 1998 and 2008.
(Source: Information Centre, 2009)
How many Secretaries of State for Health have there been under Labour?
There have been six Secretaries of State for Health since 1997:
- Frank Dobson (3 May 1997 to 11 October 1999)
- Alan Milburn (11 October 1999 to 12 June 2003)
- John Reid (12 June 2003 to 11 May 2005)
- Patricia Hewitt (11 May 2005 to 28 June 2007)
- Alan Johnson (28 June 2007 to 10 June 2009)
- Andy Burnham (10 June 2009 to present)
How much of the NHS budget is spent on the workforce?
In 2007/8 the total cost of all NHS staff in England was £36.5 billion (Centre for Health Economics 2009) and the total budget for the NHS that year was £90.4 billion (HM Treasury 2007 pre-budget report table 1.3) – so staff costs amount to 40 per cent of the NHS budget.
What's the cost of an operation?
Procedures are paid for according to a national tariff and adjusted according to a market forces formula (MFF) that takes account of local circumstances, such as higher costs of staffing in London.
For example, in the financial year 2008/9 a tonsillectomy for a child without complications would on average cost £961, and the average cost of a coronary artery bypass graft was £7,959. The cost of a hip replacement varies from £5,485 to £11,795 depending on the complexity of the operation and the condition of the patient.
All the above figures are before the MFF is applied.
(Source: Department of Health)
What percentage of GDP does the UK spend on health compared to other countries?
Tony Blair promised in 2000 to bring total UK spending on health (both public and private) in line with the top EU-14 countries (Breakfast with Frost,16 January 2000).
Since the pledge was made, UK health expenditure has increased by nearly three percentage points to around 9 per cent, bringing it much closer to the EU average, which has also risen.
Graph 3 shows trends in UK and EU-14 total health care spending. Graph 4 shows where the UK ranks in terms of other EU-14 countries in 2006, the most recent year for which data is available. In 2006 the UK spent 8.4 per cent of GDP on health, compared to an EU-14 average of 9.3 per cent. In the same year, the United States spent 16 per cent of its GDP on health.
Based on birth rates and rise in life expectancy, how will demand for health care change over the coming decades?
The Office of National Statistics predicts that the population of the UK will increase from 61.4 million at mid-2008 to 65.6 million by mid-2018, rising to 71.6 million by mid-2033 which would be a total increase of 10.2 million over the next 25 years. The number of people aged 85 and over is projected to rise from 1.3 million in 2008 to 1.8 million in 2018 (an increase of 34 per cent), rising to 3.3 million by 2033, double the number in 2008.
There are also lifestyle factors that will have a big impact on the NHS, for example obesity, which will lead to greater incidence of obesity-related conditions such as stroke, cardiovascular disease and type 2 diabetes. Graph 5 shows the increase in the number of people classified as obese between 1993 and 2007.
(Source: The King's Fund analysis of HSE data presented in NHS Information Centre (2009)).
A report published in 2007 by the UK government's Foresight programme, part of the Government Office for Science, set out the scale of the obesity challenge facing the UK over the next 40 years. It predicted that without further action, by 2050 60 per cent of men and 50 per cent of women could be clinically obese.
Joint analysis carried out by The King's Fund and the Institute for Fiscal Studies estimated that 'demographic pressures up to 2017 are likely to cost the NHS around £1.1–1.4 billion extra each year at 2010/11 prices, and would require average real annual funding increases of around 1.1 per cent in order to maintain quality'.
None of the spending plans set out by the political parties allow for an increase in NHS funding; Alistair Darling said in the pre-budget report that the government will protect 95 per cent of the budget that 'supports patient care' while David Cameron announced in a speech that the Conservatives will protect health spending but will cut the cost of 'NHS administration' by one third. Nick Clegg has said that the current financial situation meant that the Liberal Democrats could not promise that the NHS would be immune from cuts in funding although he found it 'almost impossible' to think his party would not maintain health spending.