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?
No idea. I'm sure there is one though! Is there an issue in the UK of defensive medicine, as in the US, when loads of stuff gets done just to avoid a lawsuit later?
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?
No idea. I'm sure there is one though! Is there an issue in the UK of defensive medicine, as in the US, when loads of stuff gets done just to avoid a lawsuit later?
The point I am making is that presumably there is analysis showing that this continual investment in the latest technology increases lives of patients with certain types/stages of cancer by 3, 6 ,12 months or more. What is the number that should be deemed 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.
Thanks v much for your input. But I'm afraid I'm still confused! The other data from The King's Fund tell a different story. They say we pay a lower percentage of GDP than most. (If I read it right.)
So either both can't both be right; or our GDP per capita is well out of kilter with everyone else's (which might be the case if separate commentary on UK productivity levels is to be believed); or they are both wrong. The King's Fund while a not-for-profit organisation still has an agenda, as it's stated aim is "working to improve health and care in England". So, for example saying the percentage spend in the EU had moved on to 10% of GDP by 2009, might not be because EU countries had spent more actual folding stuff, it might be because their GDP had faired less well than ours. (I don't know but that's a possibility if you factor in Portugal, Ireland, Greece and Spain).
Hopefully the ONS is not in a position where it could be accused of bias. BUT and it's a big but, according to reports like this pnhp.org/news/2016/january/government-funds-nearly-two-thirds-of-us-health-care-costs-american-journal-of-pub Most healthcare in the US is paid for by the State and indeed (presumably because of their higher health care costs) the US Govt. pays more in actual money per capita than ours does! Which puts that ONS figure for the US well out of kilter.
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?
No idea. I'm sure there is one though! Is there an issue in the UK of defensive medicine, as in the US, when loads of stuff gets done just to avoid a lawsuit later?
The point I am making is that presumably there is analysis showing that this continual investment in the latest technology increases lives of patients with certain types/stages of cancer by 3, 6 ,12 months or more. What is the number that should be deemed cost effective?
Gotcha! Well, these decisions are made by The National Institute for Health and Care Excellence ("NICE") who make the assessment using tools such as the "quality of life adjusted year", as well as evidence on the efficacy of the treatment, and also considerations from physicians, patient groups etc.
I guess if there is no improvement, or the improvement is not deemed significant enough, the treatment is not allowed. I couldn't tell you what the actual figures are though which could make a particular treatment "worth it"
Sure everybody has an agenda but GDP gives a comparison against countries that have far smaller populations and the increased/decreased GDP goes both ways.
If you look at the Kings Fund data it shows that we have pretty much been in the relegation zone since the comparison started.
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.
And more people are working into later years and continuing to contribute income tax and employer's national insurance after the age of 65.
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?
Not sure that there is one but by way of a further example.
New radiotherapy planning computers only work if the data that's put into them is of a sufficiently high quality. CT scanners provide data and every generation of new CT's or in fact manufacturer led advances provide greater levels of data acquisition. If eg you need a new planning system then the CT must be of sufficient quality to provide the data sets required by the planning system. Conversely if you need a new CT it is likely to require at the very least a significant upgrade in your planning system. This for a few years will probably be catered for by software updates but only for so long. Each update is under licence for the number of terminals you own. It's extremely expensive.
It like the beast leads the beast. It's not an option to say well we'll stick with what we've got. Advances in treatment technique giving better outcomes for patient survival and morbidity require the latest or at least very new equipment.
Patients are also now far more savvy as to what treatment they should get and expect. And so they should be.
5, 10 and 15 year survival rates are continuing to improve pretty much year on year.
The reason is fairly obvious mainly down to one thing, and that is leadership approval ratings - May's is stratospheric, Corbyn's subterranean, until that changes the Tories can and will get away with murder
So why and how is May delivering a landslide with a 100+ majority? And what might change over the next couple of years?
Quite simply she has swallowed UKIP whole off the back of her "Brexit means Brexit" mantra. Did UKIP retain a single seat the other week? Nuttall is toast! Recent analysis shows the Tories can win 60 more seats without capturing a single Labour vote! This because the UKIP vote in 2015 was bigger than the majority in target seats. Four million UKIP voters and she has gone after each and every one.
Ironically this has no long term impact on policies for the next five years nor on the Brexit outcome. May still has the potential to simply pivot back to the centre after the election and slide an EEA style deal back on the table. There really are only two possible Brexit outcomes: no deal or a Norway style EEA interim deal. There is no bespoke deal - for the EU cannot and will not discuss that option - they have their own concerns such as banks, Euro, growth and immigration so they will not waste time nor dilute their internal debates by discussing concessions to the UK. They are adamant that they will not divide the four freedoms nor should they have to for these are the basis of peace and prosperity and not the causes of the issues which the West faces today.
Regarding all the other main challenges such as the NHS, housing, new technologies, social care, immigration, foreign policy, I'm afraid to say that this country is unable to hold an adult debate. Posters such as @ShootersHillGuru can detail the ever increasing cost of modern medical technology, and we can research a potted history of the doubling of NHS budgets under Blair/Brown (including PFI). We should also note that the 13% devaluation in sterling since the vote last year will add to the import costs of pharma and medical equipment.
But there is no adult debate at the national level. Perhaps one conclusion is that we need an all party body to manage health. And one for education too instead of letting the latest minister deliver his/her pet ideas and burn all the cash on transformation programmes. Yes, that's right, put a technocratic elite in charge and take the politicians away from serious decisions for which they simply are not qualified. For sure, this is somewhat counter intuitive and runs against the "taking back control" mantra but our society is simply too valuable and too complex. So put the bloody experts back in charge and stop with this populist nonsense!
As for Labour? It's an early call but perhaps they are finished!
Should Corbyn, McDonnell and the rest of the far left determine to hold on after a massive defeat then that is surely the catalyst to jump ship? Burnham and Khan are now Metro mayors - they have sidestepped the PLP bloodbath. Khan has one of the biggest mandates in Europe. And the Lib Dems are simply not making the progress they needed to in order to restore credibility. Meanwhile, in the background, Macron is showing what is possible for the centre in France.
One year ago Macron was in the Socialist party - we will soon see if his version of "third way" goes down well in their legislative elections in June. If he wins a large chunk and perhaps a majority (?) then that opens the door to massive change over here. For those not familiar, Macron is fundamentally a social democrat and he also happens to be economically literate. He has a big vision for France and the EU - it remains to be seen whether he is given the mandate to deliver.
In short Corbyn is attracting new members with issue and identity politics while Macron has won two thirds of the vote with a vision. As he develops that vision with candidates and policy statements it will become clear whether he can win a ruling majority from a standing start. If he can then that might provide a route map for replacing Labour with a force which actually wants to govern and run the country.
I would imagine talks are happening about a new party should Corbyn try to cling on after losing the election. I have predicted a new party will emerge for some time and I think it will make the Tories suffer as much as Labour in the long run. If we had a party that brought in proportional representation, it would kill the Tory Right and the Labour Left at a stroke. The Labour left and Tory right have always had more in common than others in their own party.
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.
Thanks v much for your input. But I'm afraid I'm still confused! The other data from The King's Fund tell a different story. They say we pay a lower percentage of GDP than most. (If I read it right.)
So either both can't both be right; or our GDP per capita is well out of kilter with everyone else's (which might be the case if separate commentary on UK productivity levels is to be believed); or they are both wrong. The King's Fund while a not-for-profit organisation still has an agenda, as it's stated aim is "working to improve health and care in England". So, for example saying the percentage spend in the EU had moved on to 10% of GDP by 2009, might not be because EU countries had spent more actual folding stuff, it might be because their GDP had faired less well than ours. (I don't know but that's a possibility if you factor in Portugal, Ireland, Greece and Spain).
Hopefully the ONS is not in a position where it could be accused of bias. BUT and it's a big but, according to reports like this pnhp.org/news/2016/january/government-funds-nearly-two-thirds-of-us-health-care-costs-american-journal-of-pub Most healthcare in the US is paid for by the State and indeed (presumably because of their higher health care costs) the US Govt. pays more in actual money per capita than ours does! Which puts that ONS figure for the US well out of kilter.
The Kings Fund data shows the proportion of each country's GDP that is made up of public and private sector healthcare. In the case of the UK it's 8.5%. So, in other words, if you add up all the money spent in the UK on healthcare, including public money spent by the Government (mostly NHS) and money spent on private health (a mix of individuals' payments for healthcare and health insurance "payouts" used for healthcare) it comes to 8.5% of the UK's total GDP. This percentage is more than the equivalent percentage for some countries (eg Finland and Ireland) and less than several others.
The ONS data shows that, if you take that total amount spent on healthcare, a bit more than two-thirds is public money (71.8%). For many other countries in the G7, that figure is much less, because much more of their healthcare spend has to be found from private sources (eg individuals and insurance).
The two sets of data don't conflict at all. In short, we spend less (as a proportion of GDP) on healthcare than many countries; and most of what we do spend comes out of public money (ie the Government uses Treasury money) as opposed to each of us having to pay for our own healthcare. In even shorter... we all chip in a bit so we all get healthcare, and by doing so it works out better value.
CPS will not be prosecuting any Tories in relation to 2015 election expenses.
Not that I believed this would have made much difference anyway but yet more good news for Theresa May.
I think the reason they were not prosecuted was because it couldn't be proven they knew they were breaking the law - that the law was broken has already been established and the Conservative party has had to pay large fines because of it. The judgement makes sense, but May's comments make me a bit sick to the stomach. Her party still acted against the law! It is true other parties have done similar in the past, but there is still a foul smell here!
One of the reasons why we appear to spend more from direct taxes on healthcare than France and Germany may that they operate an insurance based system for getting the citizens to cough up. I don't pretend to understand in detail how this all works, but it could well be that the insurance companies invest directly in private health facilities. However i would bet a lot of money that even if they do it will be likely limited in terms of the fields which they can invest in. Certainly my niece who works as a junior doctor in a small town German hospital assures me that the average German citizen wants for nothing in terms of the healthcare expected of a civilised country. Patients waiting in corridors on trollies? She gave me a blank look.
I would imagine talks are happening about a new party should Corbyn try to cling on after losing the election. I have predicted a new party will emerge for some time and I think it will make the Tories suffer as much as Labour in the long run. If we had a party that brought in proportional representation, it would kill the Tory Right and the Labour Left at a stroke. The Labour left and Tory right have always had more in common than others in their own party.
Welcome to the liberal democrats, and no, they've only made the problem worse.
With PR we would currently have a conservative/ukip coalition..
I had to take my mother for some tests last week and I was very impressed and surprised with the hospital in Hertford in terms of efficiency and cleanliness.
I would imagine talks are happening about a new party should Corbyn try to cling on after losing the election. I have predicted a new party will emerge for some time and I think it will make the Tories suffer as much as Labour in the long run. If we had a party that brought in proportional representation, it would kill the Tory Right and the Labour Left at a stroke. The Labour left and Tory right have always had more in common than others in their own party.
I think a break away centerist party is looking more and more likely daily.
I would imagine talks are happening about a new party should Corbyn try to cling on after losing the election. I have predicted a new party will emerge for some time and I think it will make the Tories suffer as much as Labour in the long run. If we had a party that brought in proportional representation, it would kill the Tory Right and the Labour Left at a stroke. The Labour left and Tory right have always had more in common than others in their own party.
Welcome to the liberal democrats, and no, they've only made the problem worse.
With PR we would currently have a conservative/ukip coalition..
I don't think so - it would change the way people vote for starters. A lot of votes in our system, are cast against a party rather than for one!
If I remember correctly, the last time we had free tuition fees, everyone went to university for a jolly, studying Casino Management and as a result, degrees on a CV were totally devalued.
If I remember correctly, the last time we had free tuition fees, everyone went to university for a jolly, studying Casino Management and as a result, degrees on a CV were totally devalued.
You have to get a masters now!
Er, no. Universities were a lot more exclusive for two reasons:
1) Less universities as they were seen as institutions of education, not businesses to make profit from people looking for something to put on their CV.
2) Due to universities having to fund courses themselves, they had to be more discerning in who they admitted. If everyone is paying £27,000 then it allows them to lower entry standards accordingly.
"A Conservative spokesman said: "This is a total shambles. Jeremy Corbyn's plans to unleash chaos on Britain have been revealed. "The commitments in this dossier will rack up tens of billions of extra borrowing for our families and will put Brexit negotiations at risk. Jobs will be lost, families will be hit and our economic security damaged for a generation if Jeremy Corbyn and the coalition of chaos are ever let anywhere near the keys to Downing Street." "
I can't believe I actually once voted for these cunts.
I will benefit. My family will benefit. My unborn child will benefit. My friends will benefit. My work colleagues will benefit. My community will benefit.
I had to take my mother for some tests last week and I was very impressed and surprised with the hospital in Hertford in terms of efficiency and cleanliness.
Christ. I'm not having a pop here Mutts but what you describe as being happy with should be a given every time, everywhere. Nothing less is acceptable.
The sad reality is that about 5% of the electorate will actually read party manifestos. Instead they will consume the tabloids and politicians sound bites.
It's a manifesto of investment in "ordinary working people", rather than more failed austerity that only continues to increase national debt while corporation tax continues to be cut under the Tories.
Vote Labour. I'm *hoping* they fulfil all those pledges but as long as they do a decent job of most, it'll be a damn sight better than the bloody difficult woman.
Comments
http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror
The second says that we spend the second least of the G7.
http://visual.ons.gov.uk/how-does-uk-healthcare-spending-compare-internationally/.
The last from the always interesting Kings Fund explains and shows via graphs where the UK sits in healthcare spending. Public and private combined.
https://www.kingsfund.org.uk/blog/2016/01/how-does-nhs-spending-compare-health-spending-internationally
So either both can't both be right; or our GDP per capita is well out of kilter with everyone else's (which might be the case if separate commentary on UK productivity levels is to be believed); or they are both wrong. The King's Fund while a not-for-profit organisation still has an agenda, as it's stated aim is "working to improve health and care in England". So, for example saying the percentage spend in the EU had moved on to 10% of GDP by 2009, might not be because EU countries had spent more actual folding stuff, it might be because their GDP had faired less well than ours. (I don't know but that's a possibility if you factor in Portugal, Ireland, Greece and Spain).
Hopefully the ONS is not in a position where it could be accused of bias. BUT and it's a big but, according to reports like this pnhp.org/news/2016/january/government-funds-nearly-two-thirds-of-us-health-care-costs-american-journal-of-pub Most healthcare in the US is paid for by the State and indeed (presumably because of their higher health care costs) the US Govt. pays more in actual money per capita than ours does! Which puts that ONS figure for the US well out of kilter.
I guess if there is no improvement, or the improvement is not deemed significant enough, the treatment is not allowed. I couldn't tell you what the actual figures are though which could make a particular treatment "worth it"
If you look at the Kings Fund data it shows that we have pretty much been in the relegation zone since the comparison started.
New radiotherapy planning computers only work if the data that's put into them is of a sufficiently high quality. CT scanners provide data and every generation of new CT's or in fact manufacturer led advances provide greater levels of data acquisition. If eg you need a new planning system then the CT must be of sufficient quality to provide the data sets required by the planning system. Conversely if you need a new CT it is likely to require at the very least a significant upgrade in your planning system. This for a few years will probably be catered for by software updates but only for so long. Each update is under licence for the number of terminals you own. It's extremely expensive.
It like the beast leads the beast. It's not an option to say well we'll stick with what we've got. Advances in treatment technique giving better outcomes for patient survival and morbidity require the latest or at least very new equipment.
Patients are also now far more savvy as to what treatment they should get and expect. And so they should be.
5, 10 and 15 year survival rates are continuing to improve pretty much year on year.
Quite simply she has swallowed UKIP whole off the back of her "Brexit means Brexit" mantra. Did UKIP retain a single seat the other week? Nuttall is toast! Recent analysis shows the Tories can win 60 more seats without capturing a single Labour vote! This because the UKIP vote in 2015 was bigger than the majority in target seats. Four million UKIP voters and she has gone after each and every one.
Ironically this has no long term impact on policies for the next five years nor on the Brexit outcome. May still has the potential to simply pivot back to the centre after the election and slide an EEA style deal back on the table. There really are only two possible Brexit outcomes: no deal or a Norway style EEA interim deal. There is no bespoke deal - for the EU cannot and will not discuss that option - they have their own concerns such as banks, Euro, growth and immigration so they will not waste time nor dilute their internal debates by discussing concessions to the UK. They are adamant that they will not divide the four freedoms nor should they have to for these are the basis of peace and prosperity and not the causes of the issues which the West faces today.
Regarding all the other main challenges such as the NHS, housing, new technologies, social care, immigration, foreign policy, I'm afraid to say that this country is unable to hold an adult debate. Posters such as @ShootersHillGuru can detail the ever increasing cost of modern medical technology, and we can research a potted history of the doubling of NHS budgets under Blair/Brown (including PFI). We should also note that the 13% devaluation in sterling since the vote last year will add to the import costs of pharma and medical equipment.
But there is no adult debate at the national level. Perhaps one conclusion is that we need an all party body to manage health. And one for education too instead of letting the latest minister deliver his/her pet ideas and burn all the cash on transformation programmes. Yes, that's right, put a technocratic elite in charge and take the politicians away from serious decisions for which they simply are not qualified. For sure, this is somewhat counter intuitive and runs against the "taking back control" mantra but our society is simply too valuable and too complex. So put the bloody experts back in charge and stop with this populist nonsense!
As for Labour? It's an early call but perhaps they are finished!
Should Corbyn, McDonnell and the rest of the far left determine to hold on after a massive defeat then that is surely the catalyst to jump ship? Burnham and Khan are now Metro mayors - they have sidestepped the PLP bloodbath. Khan has one of the biggest mandates in Europe. And the Lib Dems are simply not making the progress they needed to in order to restore credibility. Meanwhile, in the background, Macron is showing what is possible for the centre in France.
One year ago Macron was in the Socialist party - we will soon see if his version of "third way" goes down well in their legislative elections in June. If he wins a large chunk and perhaps a majority (?) then that opens the door to massive change over here. For those not familiar, Macron is fundamentally a social democrat and he also happens to be economically literate. He has a big vision for France and the EU - it remains to be seen whether he is given the mandate to deliver.
In short Corbyn is attracting new members with issue and identity politics while Macron has won two thirds of the vote with a vision. As he develops that vision with candidates and policy statements it will become clear whether he can win a ruling majority from a standing start. If he can then that might provide a route map for replacing Labour with a force which actually wants to govern and run the country.
In the case of the UK it's 8.5%. So, in other words, if you add up all the money spent in the UK on healthcare, including public money spent by the Government (mostly NHS) and money spent on private health (a mix of individuals' payments for healthcare and health insurance "payouts" used for healthcare) it comes to 8.5% of the UK's total GDP. This percentage is more than the equivalent percentage for some countries (eg Finland and Ireland) and less than several others.
The ONS data shows that, if you take that total amount spent on healthcare, a bit more than two-thirds is public money (71.8%). For many other countries in the G7, that figure is much less, because much more of their healthcare spend has to be found from private sources (eg individuals and insurance).
The two sets of data don't conflict at all. In short, we spend less (as a proportion of GDP) on healthcare than many countries; and most of what we do spend comes out of public money (ie the Government uses Treasury money) as opposed to each of us having to pay for our own healthcare. In even shorter... we all chip in a bit so we all get healthcare, and by doing so it works out better value.
With PR we would currently have a conservative/ukip coalition..
independent.co.uk/news/uk/politics/general-election-2017-labour-mps-oust-jeremy-corbyn-new-parliamentary-group-progressives-independent-a7727241.html
You have to get a masters now!
This might have an effect.
1) Less universities as they were seen as institutions of education, not businesses to make profit from people looking for something to put on their CV.
2) Due to universities having to fund courses themselves, they had to be more discerning in who they admitted. If everyone is paying £27,000 then it allows them to lower entry standards accordingly.
"The commitments in this dossier will rack up tens of billions of extra borrowing for our families and will put Brexit negotiations at risk. Jobs will be lost, families will be hit and our economic security damaged for a generation if Jeremy Corbyn and the coalition of chaos are ever let anywhere near the keys to Downing Street." "
I can't believe I actually once voted for these cunts.
I will benefit.
My family will benefit.
My unborn child will benefit.
My friends will benefit.
My work colleagues will benefit.
My community will benefit.
What's not to like
Vote Labour. I'm *hoping* they fulfil all those pledges but as long as they do a decent job of most, it'll be a damn sight better than the bloody difficult woman.