Bloody hell - how did NHS spending increase from just over £50bn to just over £100bn in just nine years from 1999?
There are lots of reasons. Here are some of them.
1. Population growth. The rate of population growth doubled between the 1990s and 2000s. This decade is likely to have the highest growth in population for fifty years. The overall population growth is due to:
i. Natural Change. The birth rate has exceeded the death rate every year since 1976. The net effect has increased almost every year since then and is currently roughly 200,000 per year. The number of births in 2014 was 776,352.
ii. Net migration. The difference between people moving to and from the UK. This has been positive every year since 1993. The number of migrants in 2014 was 632,000.
2. Ageing population. The age of the population is increasing, thus putting more people in the age-range that requires the most health care.
i. The median age for the UK population rose from 33.9 years in 1974 to 40.0 years in 2014, a rise of 6.1 years. This is its highest ever value and the figure shows that the UK population has been consistently getting older.
ii. The number of people aged 90 or over per 100,000 increased from 500 in 1994 to 853 by 2014.
3. Life expectancy. Planning for health care provision relies on an understanding of the population's life expectancy.
i. Life expectancy at ages 65 and 85 have been consistently rising since the early 1980s. Over the period between 1980 to 1982 and 2012 to 2014, male life expectancy at age 65 has risen by 42.1%, from 13.0 years to 18.4 years, compared with a rise of 23.4% for female life expectancy at age 65, from 16.9 years to 20.9 years. This means that the gap between life expectancy for males and for females at age 65 has fallen from 4.0 years to 2.5 years.
ii. Over the same period, male life expectancy at age 85 has risen by 34.1%, from 4.3 years to 5.8 years, compared with 26.4% for female life expectancy at age 85, from 5.4 years to 6.8 years.
We have undergone a significant structural change in terms of our population due to birth rates, death rates, net migration, longevity and life expectancy. All of which contribute to the cost increases for health care.
Some people will be frustrated when they realise that we can't blame everything on incoming migrants. And I suspect they'll be doubly furious when it's pointed out that working age net migration has a beneficial effect on the proportion of the population over 90.
And with the birth rate declining over the last few years, we are going to need to look somewhere to find the people who will contribute to the economy in order to keep funding the health service. Where are these people going to come from?
The boss at Centrica is moaning that such things should be left to the "free market"! The free market you tosser is where you have competition to drive bills down, not a cosy price-fixing regime where the customer has no idea who is offering the lowest tarrifs. Households been overcharged billions while this Tory regime has been in power, 7 years and counting, in the face of criticism from Ofgen and CMA who have been ignored.
If you want to know who is offering the lowest tariffs go on one of the numerous comparison sites and switch to the cheapest. It takes 30 mins max. If you don't know who is offering the lowest tariffs, I'm afraid that is your fault, not the govenment, whichever party is in power.
As far as the price fixing cartel goes, yes, it's outrageous, as are the Tory proposals to cap prices after having criticised Labour. It is hypocritical.
All the time Corbyn is the leader of Labour. The Tories can do as they please.
The British public will never vote for Corbyn and Abbott to govern us.
Regarding the influence of the press, that is undeniable, but wasn't it ever thus ?
Why all the whinging about it ?
Mail, Express, Telegraph have always been Tory. Mirror and Guardian always been Labour.
Precisely because it was ever thus. That makes it worse not better!
I understand the changing population trends, but in no way does that account for over a doubling of NHS expenditure in the under ten years.
The ageing population stat is a bit of a red herring - indeed the amount of treatment people require shouldn't change too much, just the time of life they receive it. Treatment people were receiving in their sixties a generation ago, they're still receiving now, just in their eighties. Sixty year olds now are a damn sight healthier and fitter than they were even 20 years ago.
NHS expenditure rose from 43.5bn to 125bn = 287% Private rose 10bn to 25bn = 250%.
Not sure the difference is that significant. Any chance there's any cherry picking?
No. That's why I said "hasn't so much". I actually don't think those two areas of expenditure are comparing like for like though (see below). But last time I looked a 250% increase is less than 287%.
In any event the main point of including the graph was to demonstrate that when things get difficult expenditure on private health care is one of the things that people are prepared to bin. The share of public healthcare expenditure increased from 80.7% on 2007 to 83.2% in 2009 following the economic downturn. So, an increase in tax to 20% on private health care (plus all the other taxes those earning £80k+ would be paying plus tax on school fees and Christ knows what else) would have that effect and place even more pressure on an already under strain NHS. The impact is two-fold - less income from the tax than the Labours anticipated and more costs to the NHS meaning they won't be able to spend the money how they intended. It's comedy politics. (But, in fairness the other lot are no better.)
BTW, I'd like to know how much of that "private health care" spend is on dental services. Would they be taxed by the Labours? Presumably so. Edited to add: okay 12% of private health care is dental. Not as much as I'd have thought. 19.7% was on "devices", by the graphic on the ONS site it seems much of this is down to glasses! As the Labours want no profit in the NHS, I take it they'll be nationalising Specsavers, etc as well?
Virginia Bottomly has a lot to answer for. Along with her cousin, Jeremy Hunt and their family history in the health sector and the gradual privatisation of the NHS for their benefit!
So, there is a suggestion in that article that individuals in the Commons and Lords should not be allowed to vote if there is a perceived conflict of interest. That's all good isn't it?
But hold on, surely, taken to its logical conclusion, that means that no Labours should be allowed to vote on anything as their party is funded to a great extent by the Unions and the Labours' policies are all about protecting the interests of its paymasters and puppet masters.
I think I would take that - voting to protect the rights and interests of the many - as opposed to someone voting for what could potentially be to their own substantial benefit.
I've been in the union since I started work in 1985. I don't agree with everything they do and I don't agree with the block vote and the power that McCluskey holds (I voted against him) over Corbyn, but I do believe that they have protected workers rights and those of the public who use their services over many decades.
Not sure how the self-gratification of the likes of Bottomly and Hunt stack up against that.
I don't know the answer but would be interested to know how much the NHS pays for the services of the private sector since the patient choice agenda was extended to include allowing treatment in private hospitals and clinics. Often by doctors, consultants etc., that they could have seen in a NHS on another day of the week.
Three other reasons why NHS spending has increased. 1. Social Care services have been cut leading to increased NHS spending. In my opinion a really stupid way to save money,cut something cheap so that something expensive has to cover it. 2. The amalgamation of Health and Social Care budgets under the NHS. 3. NHS trusts paying private sector companies to run services.
I would add that the total spend is irrelevant in this instance as an utter balls up has been made of the whole process. I don't think more money is the answer but if funds have doubled under the Tories and services are on the point of collapse how incompetent are the people running the country. If they had halved it and it would have been crap at least we could say we had saved money.
I would think most Private Health Care provision is through Employers Benefit.
Individuals would not pay all the 20% tax on this through their P11D
I didn't find it very clear on the ONS site but the indication was that 67.8% "final consumption expenditure" was by households. (I wondered when I looked whether that meant by households directly or by a third party on their behalf.)
Virginia Bottomly has a lot to answer for. Along with her cousin, Jeremy Hunt and their family history in the health sector and the gradual privatisation of the NHS for their benefit!
So, there is a suggestion in that article that individuals in the Commons and Lords should not be allowed to vote if there is a perceived conflict of interest. That's all good isn't it?
But hold on, surely, taken to its logical conclusion, that means that no Labours should be allowed to vote on anything as their party is funded to a great extent by the Unions and the Labours' policies are all about protecting the interests of its paymasters and puppet masters.
The trade unions should concentrate on the person in the workplace. In that context it is the right of a worker in most jobs to withdraw their labour. I can see a time looming where in the absence of any organised resistance to some employer or even institutional practices, that strikes will be the best way to express how people feel. The industrial action on Southern Rail has been devastating for some people, missing interviews, hospital appointments, and work. However the rail company is not run by slave labour and the workers can get organised and implement industrial action. One of the persistent activities of the Tories is to try to curb the power of the union's which has had some bite, but organic and unofficial action, and especially working strictly to rule can still have an impact. I think industrial action is a sign of a healthy society, we have examples recently where couriers I believe a have managed to established lawful employment practices in a previously exploitative industry. They got no help from the Tories. It won't be long before schools will be impacted in my view. OK for those in free or private or grammar schools maybe, but impactful for others who may have to stay at home to look after the kids. In a capitalist society running free I would expect the behaviour of the workforce to be part of the whole picture to be taken into account, like the price of oil or the shortage of coffee beans. If Theresa May glories in being a bloody difficult woman, then I would expect Unions to organise strong and stable industrial action.
And how could I forget the scum that is Iain Duncan Smith. His DWP condemned by the UN for "grave or systemic violations" of the UN's Disability Convention.
FOI request reveals more than 4,000 people died within 6 weeks of being found "fit to work" by IDS's DWP between December 2011 and February 2014. 1,360 of those died after losing an appeal against the Work Capability Assessment forcing them into work.
I've not lived in the UK for 5 years now, but the Missus used to work with the disabled and we have a few members of the family being heavily supported by the benefits system. Some of them I think could be doing more to get off the benefits, but some are genuine and deserving recipients.
Through her work and the family I have come across/heard enough incidents now to make me think that there is a blanket policy of turning down the first application for nearly all benefits, regardless of the strength of the claim. To me the policy seems to be designed to target the weakest and most vulnerable applicants who may not have the strength of will or intelligence to fight the decision and will therefore just go away and struggle on their own and be out of the hair of the DWP.
That leaves the few who are either strong willed enough or have a good advocate (this is where my wife came in through work and for some of her family) to fight it, or, unfortunately, those less deserving but who know how to play the system to their favour.
I don't think there are many people who wouldn't agree that the benefits system shouldn't be reformed, but I get the feeling sometimes with this lot that they'd simply rather it didn't exist and even if it is a genuine attempt to reform the system, it has been disastrous for so many very vulnerable people.
Staff were encouraged to automatically turn down incapacity claims. The way the contract had been structured Capita made more more money after an appeal even if their work on the intitial application was incorrect. It was another outsourcing scandal that was forgotten about in a week. I remember writing quite a substantial post on it in the how does Labour need to change thread but I had not seen those figures attached.
Quite frankly it is a national shame, these are deaths from profiteering and the level ambivalence is astonishing. Over a thousand deaths after being denied access to a system that is meant to be there to support those very people. At what point does it become unacceptable 2000? 5000? Because Capita are still running the assessments and are going to make £200 million more than was originally budgeted for the contract:
This article shows just how much we spend comparatively to other nations on health care as a proportion of GDP. Certainly not the picture most of the press portrays of how expensive the NHS is.
Excellent article from the Independent that talks about the value of private provision (Estimated spend of £250 billion for £57 billion worth of assets) within the NHS and the possible entry of hedge fund investment within the NHS:
When are we going to remove companies that have no interest in the service that they provide, only the profit involved, from the equation? 20 years of failings and a number of rackets that have cost the taxpayer billions, yet we are looking to expand its role.
It is insane to think what we, the customer and the private company providing the service, consider value for money to be the same thing. Inherently you interests are at odds as soon as enter private provision to public services or former national industries. From the Olympic stadium to the railways, from energy companies to the NHS it rarely feels like we get value for money.
Three other reasons why NHS spending has increased. 1. Social Care services have been cut leading to increased NHS spending. In my opinion a really stupid way to save money,cut something cheap so that something expensive has to cover it. 2. The amalgamation of Health and Social Care budgets under the NHS. 3. NHS trusts paying private sector companies to run services.
I would add that the total spend is irrelevant in this instance as an utter balls up has been made of the whole process. I don't think more money is the answer but if funds have doubled under the Tories and services are on the point of collapse how incompetent are the people running the country. If they had halved it and it would have been crap at least we could say we had saved money.
I guarantee number 3 has had a lot to do with it as well. IT systems, consultants, IT systems consultants, consultants to IT systems consultants, channel partners, adoption specialists and whoever else wants to put their head in the trough.
This article shows just how much we spend comparatively to other nations on health care as a proportion of GDP. Certainly not the picture most of the press portrays of how expensive the NHS is.
But this from the ONS paints a different picture by looking at the figures in a different way. And one in which the NHS spends a larger percentage of total healthcare spend than any other G7 countries on publicly-funded healthcare!
The ONS also says "the UK also had a higher share of healthcare expenditure by the public sector than most other member states of the Organisation for Economic Co-operation and Development, which had an average public sector share for healthcare spending of 71.8%".
So most other countries have a higher percentage of health care funded privately than we do?
The reaction from the 4 main parties to the news about the Tory election expenses has been, er, interesting.
Corbyn, Farron and Sturgeon have all heavily implied that the CPS was wrong not to prosecute, on the basis that to not prosecute would be politically inconvenient to them (it is much easier to fight an election if your opponent is being prosecuted). I'm not sure I like a system where the integrity of the CPS is being questioned for purely political reasons.
Some Tory MPs, on the other hand, are calling for the Electoral Commission to be abolished, presumably with the functions being absorbed into the government. More and more authoritarian everyday...
This article shows just how much we spend comparatively to other nations on health care as a proportion of GDP. Certainly not the picture most of the press portrays of how expensive the NHS is.
But this from the ONS paints a different picture by looking at the figures in a different way. And one in which the NHS spends a larger percentage of total healthcare spend than any other G7 countries on publicly-funded healthcare!
The ONS also says "the UK also had a higher share of healthcare expenditure by the public sector than most other member states of the Organisation for Economic Co-operation and Development, which had an average public sector share for healthcare spending of 71.8%".
So most other countries have a higher percentage of health care funded privately than we do?
So, confused? I know I am.
Interesting. I wonder if the other G7 countries have such generous PFI schemes? Whisper it, but I don't mind some private sector involvement so long as we get value out of it.
Bloody hell - how did NHS spending increase from just over £50bn to just over £100bn in just nine years from 1999?
There are lots of reasons. Here are some of them.
1. Population growth. The rate of population growth doubled between the 1990s and 2000s. This decade is likely to have the highest growth in population for fifty years. The overall population growth is due to:
i. Natural Change. The birth rate has exceeded the death rate every year since 1976. The net effect has increased almost every year since then and is currently roughly 200,000 per year. The number of births in 2014 was 776,352.
ii. Net migration. The difference between people moving to and from the UK. This has been positive every year since 1993. The number of migrants in 2014 was 632,000.
2. Ageing population. The age of the population is increasing, thus putting more people in the age-range that requires the most health care.
i. The median age for the UK population rose from 33.9 years in 1974 to 40.0 years in 2014, a rise of 6.1 years. This is its highest ever value and the figure shows that the UK population has been consistently getting older.
ii. The number of people aged 90 or over per 100,000 increased from 500 in 1994 to 853 by 2014.
3. Life expectancy. Planning for health care provision relies on an understanding of the population's life expectancy.
i. Life expectancy at ages 65 and 85 have been consistently rising since the early 1980s. Over the period between 1980 to 1982 and 2012 to 2014, male life expectancy at age 65 has risen by 42.1%, from 13.0 years to 18.4 years, compared with a rise of 23.4% for female life expectancy at age 65, from 16.9 years to 20.9 years. This means that the gap between life expectancy for males and for females at age 65 has fallen from 4.0 years to 2.5 years.
ii. Over the same period, male life expectancy at age 85 has risen by 34.1%, from 4.3 years to 5.8 years, compared with 26.4% for female life expectancy at age 85, from 5.4 years to 6.8 years.
We have undergone a significant structural change in terms of our population due to birth rates, death rates, net migration, longevity and life expectancy. All of which contribute to the cost increases for health care.
Some people will be frustrated when they realise that we can't blame everything on incoming migrants. And I suspect they'll be doubly furious when it's pointed out that working age net migration has a beneficial effect on the proportion of the population over 90.
And with the birth rate declining over the last few years, we are going to need to look somewhere to find the people who will contribute to the economy in order to keep funding the health service. Where are these people going to come from?
You can add to that the spiralling cost of health care technology.
It really wasn't very long ago that when a hospital invested in new equipment they could expect it to be usefully serviceable for a good few years at least. Not so the case now in many diciplines. Pretty much any service be it surgical, cancer, or any of the other areas of the NHS where equipment is important are now having to face the fact that the kit they buy is often in technology terms obsolete in just a few years and not only that it's becoming more expensive to purchase in the first place.
An example of this from an area of medicine that I can speak about with some authority is in cancer services and specifically radiotherapy. Treatments now are far more accurate and complicated and time consuming to provide than they were just ten years ago.
People rightly expect to receive the best treatment available. A modern plan for a radiotherapy treatment relies on a modern, fast in terms of acquiring images, CT scanner. Data from MRI, PET and other investigations. All using equipment that must be up to date in order to provide the necessary information. Plans for treatment for example a prostate ca. ten years ago took about an hour to produce using only CT data sets. Now it takes four times as long and has input from all of the modalities I've mentioned. Staff training to use this very specialised equipment and staff to take up the additional work involved.
It's not hard to see why the costs are rising and will continue to rise.
At some point an adult debate must be had. Without significant further investment our NHS will fail. That is a fact.
Bloody hell - how did NHS spending increase from just over £50bn to just over £100bn in just nine years from 1999?
There are lots of reasons. Here are some of them.
1. Population growth. The rate of population growth doubled between the 1990s and 2000s. This decade is likely to have the highest growth in population for fifty years. The overall population growth is due to:
i. Natural Change. The birth rate has exceeded the death rate every year since 1976. The net effect has increased almost every year since then and is currently roughly 200,000 per year. The number of births in 2014 was 776,352.
ii. Net migration. The difference between people moving to and from the UK. This has been positive every year since 1993. The number of migrants in 2014 was 632,000.
2. Ageing population. The age of the population is increasing, thus putting more people in the age-range that requires the most health care.
i. The median age for the UK population rose from 33.9 years in 1974 to 40.0 years in 2014, a rise of 6.1 years. This is its highest ever value and the figure shows that the UK population has been consistently getting older.
ii. The number of people aged 90 or over per 100,000 increased from 500 in 1994 to 853 by 2014.
3. Life expectancy. Planning for health care provision relies on an understanding of the population's life expectancy.
i. Life expectancy at ages 65 and 85 have been consistently rising since the early 1980s. Over the period between 1980 to 1982 and 2012 to 2014, male life expectancy at age 65 has risen by 42.1%, from 13.0 years to 18.4 years, compared with a rise of 23.4% for female life expectancy at age 65, from 16.9 years to 20.9 years. This means that the gap between life expectancy for males and for females at age 65 has fallen from 4.0 years to 2.5 years.
ii. Over the same period, male life expectancy at age 85 has risen by 34.1%, from 4.3 years to 5.8 years, compared with 26.4% for female life expectancy at age 85, from 5.4 years to 6.8 years.
We have undergone a significant structural change in terms of our population due to birth rates, death rates, net migration, longevity and life expectancy. All of which contribute to the cost increases for health care.
Some people will be frustrated when they realise that we can't blame everything on incoming migrants. And I suspect they'll be doubly furious when it's pointed out that working age net migration has a beneficial effect on the proportion of the population over 90.
And with the birth rate declining over the last few years, we are going to need to look somewhere to find the people who will contribute to the economy in order to keep funding the health service. Where are these people going to come from?
You can add to that the spiralling cost of health care technology.
It really wasn't very long ago that when a hospital invested in new equipment they could expect it to be usefully serviceable for a good few years at least. Not so the case now in many diciplines. Pretty much any service be it surgical, cancer, or any of the other areas of the NHS where equipment is important are now having to face the fact that the kit they buy is often in technology terms obsolete in just a few years and not only that it's becoming more expensive to purchase in the first place.
An example of this from an area of medicine that I can speak about with some authority is in cancer services and specifically radiotherapy. Treatments now are far more accurate and complicated and time consuming to provide than they were just ten years ago.
People rightly expect to receive the best treatment available. A modern plan for a radiotherapy treatment relies on a modern, fast in terms of acquiring images, CT scanner. Data from MRI, PET and other investigations. All using equipment that must be up to date in order to provide the necessary information. Plans for treatment for example a prostate ca. ten years ago took about an hour to produce using only CT data sets. Now it takes four times as long and has input from all of the modalities I've mentioned. Staff training to use this very specialised equipment and staff to take up the additional work involved.
It's not hard to see why the costs are rising and will continue to rise.
At some point an adult debate must be had. Without significant further investment our NHS will fail. That is a fact.
I spoke to the head of a trust in Scotland recently, who said the very same thing. There was an article in the BBC called something like "the NHS crisis in 7 graphs" or something like that which showed how the demographic and technological changes mean the cost is going through the roof, and the amount we spend will have to rise to match it. Either that, or there will need to be tougher decisions about what treatment people can expect to get
This article shows just how much we spend comparatively to other nations on health care as a proportion of GDP. Certainly not the picture most of the press portrays of how expensive the NHS is.
But this from the ONS paints a different picture by looking at the figures in a different way. And one in which the NHS spends a larger percentage of total healthcare spend than any other G7 countries on publicly-funded healthcare!
The ONS also says "the UK also had a higher share of healthcare expenditure by the public sector than most other member states of the Organisation for Economic Co-operation and Development, which had an average public sector share for healthcare spending of 71.8%".
So most other countries have a higher percentage of health care funded privately than we do?
So, confused? I know I am.
Most of the time and after the rise of Corbyn, Trump and Brexit, increasingly so.
Bloody hell - how did NHS spending increase from just over £50bn to just over £100bn in just nine years from 1999?
There are lots of reasons. Here are some of them.
1. Population growth. The rate of population growth doubled between the 1990s and 2000s. This decade is likely to have the highest growth in population for fifty years. The overall population growth is due to:
i. Natural Change. The birth rate has exceeded the death rate every year since 1976. The net effect has increased almost every year since then and is currently roughly 200,000 per year. The number of births in 2014 was 776,352.
ii. Net migration. The difference between people moving to and from the UK. This has been positive every year since 1993. The number of migrants in 2014 was 632,000.
2. Ageing population. The age of the population is increasing, thus putting more people in the age-range that requires the most health care.
i. The median age for the UK population rose from 33.9 years in 1974 to 40.0 years in 2014, a rise of 6.1 years. This is its highest ever value and the figure shows that the UK population has been consistently getting older.
ii. The number of people aged 90 or over per 100,000 increased from 500 in 1994 to 853 by 2014.
3. Life expectancy. Planning for health care provision relies on an understanding of the population's life expectancy.
i. Life expectancy at ages 65 and 85 have been consistently rising since the early 1980s. Over the period between 1980 to 1982 and 2012 to 2014, male life expectancy at age 65 has risen by 42.1%, from 13.0 years to 18.4 years, compared with a rise of 23.4% for female life expectancy at age 65, from 16.9 years to 20.9 years. This means that the gap between life expectancy for males and for females at age 65 has fallen from 4.0 years to 2.5 years.
ii. Over the same period, male life expectancy at age 85 has risen by 34.1%, from 4.3 years to 5.8 years, compared with 26.4% for female life expectancy at age 85, from 5.4 years to 6.8 years.
We have undergone a significant structural change in terms of our population due to birth rates, death rates, net migration, longevity and life expectancy. All of which contribute to the cost increases for health care.
Some people will be frustrated when they realise that we can't blame everything on incoming migrants. And I suspect they'll be doubly furious when it's pointed out that working age net migration has a beneficial effect on the proportion of the population over 90.
And with the birth rate declining over the last few years, we are going to need to look somewhere to find the people who will contribute to the economy in order to keep funding the health service. Where are these people going to come from?
You can add to that the spiralling cost of health care technology.
It really wasn't very long ago that when a hospital invested in new equipment they could expect it to be usefully serviceable for a good few years at least. Not so the case now in many diciplines. Pretty much any service be it surgical, cancer, or any of the other areas of the NHS where equipment is important are now having to face the fact that the kit they buy is often in technology terms obsolete in just a few years and not only that it's becoming more expensive to purchase in the first place.
An example of this from an area of medicine that I can speak about with some authority is in cancer services and specifically radiotherapy. Treatments now are far more accurate and complicated and time consuming to provide than they were just ten years ago.
People rightly expect to receive the best treatment available. A modern plan for a radiotherapy treatment relies on a modern, fast in terms of acquiring images, CT scanner. Data from MRI, PET and other investigations. All using equipment that must be up to date in order to provide the necessary information. Plans for treatment for example a prostate ca. ten years ago took about an hour to produce using only CT data sets. Now it takes four times as long and has input from all of the modalities I've mentioned. Staff training to use this very specialised equipment and staff to take up the additional work involved.
It's not hard to see why the costs are rising and will continue to rise.
At some point an adult debate must be had. Without significant further investment our NHS will fail. That is a fact.
I spoke to the head of a trust in Scotland recently, who said the very same thing. There was an article in the BBC called something like "the NHS crisis in 7 graphs" or something like that which showed how the demographic and technological changes mean the cost is going through the roof, and the amount we spend will have to rise to match it. Either that, or there will need to be tougher decisions about what treatment people can expect to get
What is the metric used to determine if permanently investing in the latest technology is cost effective?
This article shows just how much we spend comparatively to other nations on health care as a proportion of GDP. Certainly not the picture most of the press portrays of how expensive the NHS is.
But this from the ONS paints a different picture by looking at the figures in a different way. And one in which the NHS spends a larger percentage of total healthcare spend than any other G7 countries on publicly-funded healthcare!
The ONS also says "the UK also had a higher share of healthcare expenditure by the public sector than most other member states of the Organisation for Economic Co-operation and Development, which had an average public sector share for healthcare spending of 71.8%".
So most other countries have a higher percentage of health care funded privately than we do?
So, confused? I know I am.
The graph shows the share of total healthcare expenditure derived from the public sector. On that basis, it's no surpprise that the UK leads the chart: it's saying that 83.3% of the money spent on healthcare in the UK is spent by the public sector. By contrast, in the United States, the majority of healthcare services are paid for privately, ie by payments from patients and by health insurance payments.
Comments
1. Population growth. The rate of population growth doubled between the 1990s and 2000s. This decade is likely to have the highest growth in population for fifty years. The overall population growth is due to:
i. Natural Change. The birth rate has exceeded the death rate every year since 1976. The net effect has increased almost every year since then and is currently roughly 200,000 per year. The number of births in 2014 was 776,352.
ii. Net migration. The difference between people moving to and from the UK. This has been positive every year since 1993. The number of migrants in 2014 was 632,000.
2. Ageing population. The age of the population is increasing, thus putting more people in the age-range that requires the most health care.
i. The median age for the UK population rose from 33.9 years in 1974 to 40.0 years in 2014, a rise of 6.1 years. This is its highest ever value and the figure shows that the UK population has been consistently getting older.
ii. The number of people aged 90 or over per 100,000 increased from 500 in 1994 to 853 by 2014.
3. Life expectancy. Planning for health care provision relies on an understanding of the population's life expectancy.
i. Life expectancy at ages 65 and 85 have been consistently rising since the early 1980s. Over the period between 1980 to 1982 and 2012 to 2014, male life expectancy at age 65 has risen by 42.1%, from 13.0 years to 18.4 years, compared with a rise of 23.4% for female life expectancy at age 65, from 16.9 years to 20.9 years. This means that the gap between life expectancy for males and for females at age 65 has fallen from 4.0 years to 2.5 years.
ii. Over the same period, male life expectancy at age 85 has risen by 34.1%, from 4.3 years to 5.8 years, compared with 26.4% for female life expectancy at age 85, from 5.4 years to 6.8 years.
We have undergone a significant structural change in terms of our population due to birth rates, death rates, net migration, longevity and life expectancy. All of which contribute to the cost increases for health care.
Some people will be frustrated when they realise that we can't blame everything on incoming migrants. And I suspect they'll be doubly furious when it's pointed out that working age net migration has a beneficial effect on the proportion of the population over 90.
And with the birth rate declining over the last few years, we are going to need to look somewhere to find the people who will contribute to the economy in order to keep funding the health service. Where are these people going to come from?
The ageing population stat is a bit of a red herring - indeed the amount of treatment people require shouldn't change too much, just the time of life they receive it. Treatment people were receiving in their sixties a generation ago, they're still receiving now, just in their eighties. Sixty year olds now are a damn sight healthier and fitter than they were even 20 years ago.
In any event the main point of including the graph was to demonstrate that when things get difficult expenditure on private health care is one of the things that people are prepared to bin. The share of public healthcare expenditure increased from 80.7% on 2007 to 83.2% in 2009 following the economic downturn. So, an increase in tax to 20% on private health care (plus all the other taxes those earning £80k+ would be paying plus tax on school fees and Christ knows what else) would have that effect and place even more pressure on an already under strain NHS. The impact is two-fold - less income from the tax than the Labours anticipated and more costs to the NHS meaning they won't be able to spend the money how they intended. It's comedy politics. (But, in fairness the other lot are no better.)
BTW, I'd like to know how much of that "private health care" spend is on dental services. Would they be taxed by the Labours? Presumably so. Edited to add: okay 12% of private health care is dental. Not as much as I'd have thought. 19.7% was on "devices", by the graphic on the ONS site it seems much of this is down to glasses! As the Labours want no profit in the NHS, I take it they'll be nationalising Specsavers, etc as well?
Individuals would not pay all the 20% tax on this through their P11D
I've been in the union since I started work in 1985. I don't agree with everything they do and I don't agree with the block vote and the power that McCluskey holds (I voted against him) over Corbyn, but I do believe that they have protected workers rights and those of the public who use their services over many decades.
Not sure how the self-gratification of the likes of Bottomly and Hunt stack up against that.
I don't know the answer but would be interested to know how much the NHS pays for the services of the private sector since the patient choice agenda was extended to include allowing treatment in private hospitals and clinics. Often by doctors, consultants etc., that they could have seen in a NHS on another day of the week.
1. Social Care services have been cut leading to increased NHS spending. In my opinion a really stupid way to save money,cut something cheap so that something expensive has to cover it.
2. The amalgamation of Health and Social Care budgets under the NHS.
3. NHS trusts paying private sector companies to run services.
I would add that the total spend is irrelevant in this instance as an utter balls up has been made of the whole process. I don't think more money is the answer but if funds have doubled under the Tories and services are on the point of collapse how incompetent are the people running the country. If they had halved it and it would have been crap at least we could say we had saved money.
The industrial action on Southern Rail has been devastating for some people, missing interviews, hospital appointments, and work. However the rail company is not run by slave labour and the workers can get organised and implement industrial action. One of the persistent activities of the Tories is to try to curb the power of the union's which has had some bite, but organic and unofficial action, and especially working strictly to rule can still have an impact.
I think industrial action is a sign of a healthy society, we have examples recently where couriers I believe a have managed to established lawful employment practices in a previously exploitative industry. They got no help from the Tories.
It won't be long before schools will be impacted in my view. OK for those in free or private or grammar schools maybe, but impactful for others who may have to stay at home to look after the kids.
In a capitalist society running free I would expect the behaviour of the workforce to be part of the whole picture to be taken into account, like the price of oil or the shortage of coffee beans.
If Theresa May glories in being a bloody difficult woman, then I would expect Unions to organise strong and stable industrial action.
. Staff were encouraged to automatically turn down incapacity claims. The way the contract had been structured Capita made more more money after an appeal even if their work on the intitial application was incorrect. It was another outsourcing scandal that was forgotten about in a week. I remember writing quite a substantial post on it in the how does Labour need to change thread but I had not seen those figures attached.
Quite frankly it is a national shame, these are deaths from profiteering and the level ambivalence is astonishing. Over a thousand deaths after being denied access to a system that is meant to be there to support those very people. At what point does it become unacceptable 2000? 5000? Because Capita are still running the assessments and are going to make £200 million more than was originally budgeted for the contract:
itv.com/news/2017-04-14/dwp-rewarding-failure-with-benefit-assessors-payouts/
This article shows just how much we spend comparatively to other nations on health care as a proportion of GDP. Certainly not the picture most of the press portrays of how expensive the NHS is.
Excellent article from the Independent that talks about the value of private provision (Estimated spend of £250 billion for £57 billion worth of assets) within the NHS and the possible entry of hedge fund investment within the NHS:
independent.co.uk/voices/nhs-privatisation-hedge-funds-pfi-quantum-leap-a7725671.html
When are we going to remove companies that have no interest in the service that they provide, only the profit involved, from the equation? 20 years of failings and a number of rackets that have cost the taxpayer billions, yet we are looking to expand its role.
It is insane to think what we, the customer and the private company providing the service, consider value for money to be the same thing. Inherently you interests are at odds as soon as enter private provision to public services or former national industries. From the Olympic stadium to the railways, from energy companies to the NHS it rarely feels like we get value for money.
Not that I believed this would have made much difference anyway but yet more good news for Theresa May.
All in the name of efficiency
The ONS also says "the UK also had a higher share of healthcare expenditure by the public sector than most other member states of the Organisation for Economic Co-operation and Development, which had an average public sector share for healthcare spending of 71.8%".
So most other countries have a higher percentage of health care funded privately than we do?
So, confused? I know I am.
Corbyn, Farron and Sturgeon have all heavily implied that the CPS was wrong not to prosecute, on the basis that to not prosecute would be politically inconvenient to them (it is much easier to fight an election if your opponent is being prosecuted). I'm not sure I like a system where the integrity of the CPS is being questioned for purely political reasons.
Some Tory MPs, on the other hand, are calling for the Electoral Commission to be abolished, presumably with the functions being absorbed into the government. More and more authoritarian everyday...
#barnsleylife
It really wasn't very long ago that when a hospital invested in new equipment they could expect it to be usefully serviceable for a good few years at least. Not so the case now in many diciplines. Pretty much any service be it surgical, cancer, or any of the other areas of the NHS where equipment is important are now having to face the fact that the kit they buy is often in technology terms obsolete in just a few years and not only that it's becoming more expensive to purchase in the first place.
An example of this from an area of medicine that I can speak about with some authority is in cancer services and specifically radiotherapy. Treatments now are far more accurate and complicated and time consuming to provide than they were just ten years ago.
People rightly expect to receive the best treatment available. A modern plan for a radiotherapy treatment relies on a modern, fast in terms of acquiring images, CT scanner. Data from MRI, PET and other investigations. All using equipment that must be up to date in order to provide the necessary information. Plans for treatment for example a prostate ca. ten years ago took about an hour to produce using only CT data sets. Now it takes four times as long and has input from all of the modalities I've mentioned. Staff training to use this very specialised equipment and staff to take up the additional work involved.
It's not hard to see why the costs are rising and will continue to rise.
At some point an adult debate must be had. Without significant further investment our NHS will fail. That is a fact.