UK health spending over the past decade lags Europe by £40bn a year

The UK spent around 20% less per person on healthcare each year than similar European countries over the past decade, according to new research that shows how the NHS has historically been starved of funding.

Data from the Health Foundation, which was shared with the Financial Times, revealed that healthcare spending in the UK would have had to rise by an average of £40billion a year over the past decade to match spending health per capita in 14 EU countries.

It comes as the government prepares to reveal its spending plans in Thursday’s autumn statement and sheds new light on how a decade of austerity has affected the NHS, which is collapsing as it unravels preparing for its toughest winter ever.

Last month, the NHS finance chief warned the service would face a £7billion black hole next year, in part due to the impact of inflation, which is eating away at health regulations. hard-earned funding.

Steve Barclay, Health and Social Care Secretary, hinted in a speech to the annual NHS providers conference on Wednesday that the health service would receive more money in the statement to help it cope with the price increase. “I can absolutely confirm that we need support to deal with these inflationary pressures.”

Meanwhile, the lag between the UK and similar countries in spending levels revealed in Health Foundation data is offset by a chasm in survival rates for some conditions. In the UK, only 13% of people diagnosed with lung cancer live at least five years, according to 2014 data, the most recent available. This is the lowest among the countries surveyed, with Japan leading with 33%.

Meanwhile, 9% of people in the UK who suffered the most common type of stroke died within 30 days in 2019, compared to 6.2% in Germany.

“Either we’re going to have lower quality health care compared to other countries, or we’re spending more,” said Anita Charlesworth, director of research for the Foundation, who led the work.

Bar chart of age-standardized lung cancer 5-year survival rate, 2010-14* (%) showing that UK survival rates for certain diseases are lower than in other developed countries

In the decade before the pandemic, the UK spent on average around a fifth less on daily healthcare costs than the main EU countries surveyed. During the Covid crisis, spending increased by 14% compared to the EU14 average which is just under 6%. However, this high level of spending had been necessary to offset years of attrition on the eve of the crisis, Charlesworth said.

The UK’s total healthcare budget was £187bn a year, on average, between 2010 and 2019. £227bn would have had to be spent to match the EU14 average during the pre-pandemic decade.

The increase in funding allowed other countries to benefit from years of greater investment when the pandemic hit. In Germany, for example, more beds and higher staff ratios than in the NHS have helped ensure the crisis does not disrupt other healthcare.

Chart showing UK had to spend more during Covid to make up for underfunding in the decade before the pandemic – change in public health spending per person, 2019-20 compared to average spending 2010-19

Professor Heyo Kroemer, chief executive of Berlin’s Charite Hospital, one of Europe’s largest academic medical centres, said that although some elective work has been postponed and other activities curtailed, there is no hadn’t had a total stoppage of non-Covid treatments and long waiting lists hadn’t built up like they had in the UK.

He added that although a significant number of employees were currently sick with Covid, the wait for a hip replacement, for example, was no more than a few weeks: “It’s still in a period where you can bear,” he said. In contrast, the median wait time for patients waiting to start such elective treatment in England at the end of September was 14 weeks.

Health Foundation research shows the UK would have had to spend an extra £73bn, or 39% more, every year between 2010 and 2019 to match Germany.

Only four of the countries studied – Spain, Portugal, Italy and Greece – spent less per person than the UK over the same period. However, Charlesworth pointed out that this shortfall was mainly the result of a lack of spending on social care, reflecting a southern European tradition of families caring for loved ones.

Anita Charlesworth
Anita Charlesworth: “Either we are going to have lower quality health care compared to other countries or we are spending more” © Richard Gardner / Shutterstock

The researchers also looked at Britain’s capital health expenditure on buildings, technology and equipment compared to its European neighbours. Although the data available only allowed comparisons to be made for eight countries, it found that between 2010 and 2019 an additional £33bn of cumulative UK investment in health infrastructure would have been needed to match to the total EU average invested over the period. This would have required an investment 55% more than it actually was.

The picture is not entirely gloomy. Praising NHS testing services and the small amount it has spent on administration, Charlesworth said: ‘Our system has real structural strengths which allow us to use precious resources more efficiently than many other countries and to try to get good health outcomes for that expense. .”

However, she added that there is “only how far efficiency can take you”.

The Department of Health and Social Care said the NHS budget had risen from £123.7bn in 2019-20 to over £162bn in 2024-25.

He added that he planned to spend more than £8billion over three years to support elective recovery and £5.9billion of NHS capital ‘to deliver new beds, equipment and technology’.

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