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A brief history of NHS funding over the last ten years… Prof John Appleby 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 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 £ 130 billion… From £ 44 billion… A real increase of 110%

…to £ 1 in 12 From £ 1 in 20 in the entire economy …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 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 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? The £ 64 billion question: Where did the money go?

…higher costs Inflation absorbed £ 18+billion…. …leaving around 56% of the cash increase to …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 …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 …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 …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 patients 11% increase in elective admissions….

…more, more! • Virtually all NHS Plan ‘shopping list’ targets met: – 100 new …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 …. 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…. …greater satisfaction? Net satisfaction with NHS overall highest it has been since 1980 s…. (sham e about NHS dentistry…)

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