A brief history of NHS funding over the

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A brief history of NHS funding over the last ten years… Prof John Appleby Chief Economist King’s Fund

Bust, boom, bust? • 1997 -2000: Stick to Conservative spending plans • 1999/2000: Blair announces NHS funding boost • 2002: Derek Wanless forecasts future funding needs • 2007 CSR: slow down in NHS funding growth…

…to £ 130 billion… From £ 44 billion… A real increase of 110%

…to £ 1 in 12 From £ 1 in 20 in the entire economy spent on the NHS…

After years of parsimony… …political decision to spend more… …but growth slows (it will feel like a cut)…

On target for Wanless recommendations? … Historically, UK has lagged behind EU-15 countries… …but now catching up…

The £ 64 billion question: Where did the money go?

…higher costs Inflation absorbed £ 18+billion…. …leaving around 56% of the cash increase to buy extra things

…higher pay costs Pay inflation: up 80% in ten years…. Large pay awards for doctors in particular as a result of new contracts ….

…more staff A quarter of a million new NHS staff over ten years…. But last few years have seen minimal increases as NHS deals with deficits and plans for a tighter financial future

…shorter waiting times Waiting list now at its lowest since 1974…. …and waiting times reduced massively: virtually no one waiting more then 6 months….

…more patients 11% increase in elective admissions….

…more, more! • Virtually all NHS Plan ‘shopping list’ targets met: – 100 new hospitals – Modernising 3, 000 GP premises – 75% of all MRI/CT scanners and linear accelerators now new… – But, problems with ICT investment – …backlog maintenance…single rooms…

…. value for money? • Higher unit costs • Lower admissions per consultant and per nurse…. • Official productivity measures show downward trend… • Poor financial control (deficits…)

…greater satisfaction? Net satisfaction with NHS overall highest it has been since 1980 s…. (sham e about NHS dentistry…)

www. kingsfund. org. uk

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