Analysis

Keeping up with the Johanssons: How does UK health spending compare internationally?

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3568 (Published 03 August 2017) Cite this as: BMJ 2017;358:j3568
  1. John Appleby, director of research and chief economist1,
  2. Ben Gershlick, economics analyst2
  1. 1Nuffield Trust, London, UK
  2. 2Health Foundation, London, UK
  1. Correspondence to: J Appleby john.appleby{at}nuffieldtrust.org.uk

Decisions about the appropriate amount to spend on health require more than a simple comparison with what other countries spend, argue John Appleby and Ben Gershlick

The latest data published by the Office for National Statistics (ONS) for the UK1 and the Organisation for Economic Cooperation and Development (OECD) for other countries, 2 suggest that previous figures have underestimated how much the UK spends on health compared with other countries.234

The changes in accounting make no material difference to actual spending on health. Nonetheless they raise important questions, not least on the implications for arguments about the appropriateness of the level of health spending in the UK. Although the new data help us understand the UK’s relative health spending, they do not imply that the UK is spending the “right amount” any more than the previous data meant that the UK was not spending enough. Decisions about the appropriate amount to spend on health require more than a simple comparison with what other countries spend.

Here we describe the new spending figures, the reasons for the revisions, and the extra detail the new accounts provide about spending on different types of healthcare.

What’s new?

The latest internationally agreed revisions—the System of Health Accounts 20115—show that rather than a total (public plus private) spend of 8.7% of gross domestic product (GDP) in 2014, the UK spending was in fact 9.8%.

As table 1 shows, total spending was 12.4% (£19.8bn (€22bn; $26bn)) higher in 2014 than estimated under the previous definition. Current public spending was 13.4% (£16.8bn) higher and private spend 31.0% (£8.6bn) higher.

View this table:
Table 1

Comparison of UK healthcare spending in 2014 estimated using old and new (System of Health Accounts 2011) definitions

The reasons for these increases are shown in figure 1, which breaks down …

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