What is the right level of spending needed for health and care in the UK?

[John Short]

Interesting article with international comparisons of public and private health care spending

Anita Charlesworth, Michael Anderson, Cam Donaldson, Paul Johnson, Martin Knapp, Alistair McGuire, Martin McKee, Elias Mossialos, Peter Smith, Andrew Street, Michael Woods

Lancet 2021; 397: 2012–22 Published Online May 6, 2021 https://doi.org/10.1016/ S0140-6736(21)00230-0

Summary
The health and care sector plays a valuable role in improving population health and societal wellbeing, protecting people from the financial consequences of illness, reducing health and income inequalities, and supporting economic growth. However, there is much debate regarding the appropriate level of funding for health and care in the UK. In this Health Policy paper, we look at the economic impact of the COVID-19 pandemic and historical spending in the UK and comparable countries, assess the role of private spending, and review spending projections to estimate future needs. Public spending on health has increased by 3•7% a year on average since the National Health Service (NHS) was founded in 1948 and, since then, has continued to assume a larger share of both the economy and government expenditure. In the decade before the ongoing pandemic started, the rate of growth of government spending for the health and care sector slowed. We argue that without average growth in public spending on health of at least 4% per year in real terms, there is a real risk of degradation of the NHS, reductions in coverage of benefits, increased inequalities, and increased reliance on private financing. A similar, if not higher, level of growth in public spending on social care is needed to provide high standards of care and decent terms and conditions for social care staff, alongside an immediate uplift in public spending to implement long-overdue reforms recommended by the Dilnot Commission to improve financial protection. COVID-19 has highlighted major issues in the capacity and resilience of the health and care system. We recommend an independent review to examine the precise amount of additional funds that are required to better equip the UK to withstand further acute shocks and major threats to health.

[John Short]

Related material from the LSE–Lancet Commission on the future of the NHS: re-laying the foundations for an equitable and efficient health and care service after COVID-19

Executive Summary
In 2018, to mark the 70th anniversary of the UK National Health Service a major new Commission was established by The Lancet and London School of Economics to independently evaluate the NHS and its role in health in the UK.

Reporting after 3 years, the Commission describes how although the NHS is internationally held up as a leading example of universal health care, the health of the UK population lags behind that of other high-income countries. The authors highlight the comparatively low funding for the health service, as well as the long-standing impact of poorly resourced social care and public health programmes on the health of the nation and its role in driving inequalities.

Describing the current time as a historic opportunity to strengthen the NHS and improve health and care for all the Commission report makes seven core recommendations, setting out a long-term vision for the NHS which re-lays the foundations for a better, fairer health and care service.

Reports
The changing health needs of the UK population
Securing a sustainable and fit-for-purpose UK health and care workforce
What is the right level of spending needed for health and care in the UK?
Health information technology and digital innovation for national learning health and care systems
Lessons from the NHS for UHC and health security


https://www.thelancet.com/commissions/future-NHS