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Discussing in brief bout the latest statistics of Health Financing in UK, with emphasis on National Health Services (NHS) model and the key challenges being faced by the UK health system financing.
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United Kingdom Health Financing System
By Dr Aditya Sood
Post Graduate Diploma In Health Management at Institute of Health Management Research, Jaipur , India
Email id- [email protected]
HEALTHCARE EXPENDITURE
According to World bank Data, Health (2011), UK is spending 9.6% of its GDP on health.
2007 2008 2009 20107.5
8
8.5
9
9.5
10
8.4
8.9
9.89.6
YEAR
PERC
ENTA
GE
Categories of UK healthcare expenditure
Category 1Publicly funded healthcare expenditure scheme-National Health Service(NHS).
2007 2008 2009 201079808182838485
81.382.4
84.1 83.9
Health expenditure, public (% of total health ex-penditure),UK, 2007-2010 , World Bank Data, Health
(2011)
YEAR
PERC
ENTA
GE
Category 2Private Health Expenditure.• It is 16% of the total Health Expenditure.• Out of Pocket expenditure as percentage of private
expenditure on health is 62%
2007 2008 2009 201061.98
62
62.02
62.04 62.04
6262
62
OUT OF POCKET EXPENDITURE OF THE TOTAL HEALTH EXPENDITURE (World Bank Data, Health 2011)
YEAR
PERC
ENTA
GE
Category 3Private Health Insurance• Accounts for 2 % of the total Health Expenditure.• Around 12 % of UKs citizens are covered by private health
insurance
2007 2008 2009 2010320033003400350036003700380039004000
38813801
34403503
PER CAPITA HEALTH EXPENDITURE ON HEALTH IN US $, 2007-2010,World Bank Data, Health 2011
YEAR
PER
CAPI
TA H
EALT
H E
XPEN
-D
ITU
RE U
S$
NATIONAL HEALTH SERVICE
Launched in 1948NHS Aims:• To provide medical care free at point of use• To rich and poor alike• in accordance with medical need
2 beliefs:• Those who need care will come forward• Those who provide care know what is required and how to
provide it
FUNDED BY :-
General taxation 76%National Insurance contributions 19%User charges 5%(UK department of Health, 2010)
** Apart from these, NHS earns from prescription of drugs & dental treatments to general population.
COVERAGE
It is universal, all those who are resident or citizens of the UK are entitled to health care.
SERVICES OFFERED
• Preventive • Inpatient & Outpatient• Hospital care• Physician• Inpatient & Outpatient drugs• Dental care, mental health care• Disabilities & rehabilitation
COST SHARING
• 88% of prescriptions are exempt from charges.• Dental services subject to copayment of upto US $ 400/ year.• Discount through pre payment certificates-people using large
amount of prescription drugs.• Transport costs to and fro from provider sites-low income group
people.
• People exempted from prescription drug co-payments:- < 16 years of age. > 60 years of age Low income Pregnant women Those in fulltime education aged 16, 17, or 18. Those who had a baby in the last 12 months
STRUCTURE
Secretary of State
Department of HealthNHSE
Regional Offices
Strategic Health Authorities
Primary care groups NHS trustsLocal authorities
TYPES OF HEALTH
SERVICES IN UK
PRIMARY CARE SECONDARY CARE
TYPES OF TRUSTS
Primary care GPs
DentistPharmacist
OpticiansNHS direct
NHS walk in centres
Acute Care
Mental HealthAmbulance
NHS Foundation
PRIVATE HEALTHCARE
Private Health Insurance Private Hospitals Out of Pocket
Expenditure
REGULATORY BODIES
• National Institute of Clinical Excellence publishes guidelines for healthcare professionals Private hospitals do not have to follow these
• Healthcare Commission Monitoring Healthcare standards and efficiency Responsible for publishing NHS performance ratings and
indicators
KEY CHALLENGES
• Rising rate of Diabetes• Rising alcohol related hospital admissions and alcohol related
deaths• Prevalence of adult obesity in UK is highest in the EU• Rising demand and treatment cost• Long waiting periods for elective surgeries• Variations in quality of care across UK• Lack of accountability of trusts and Primary Care centres.• Economic downturn• Lack of control by central regulatory bodies over private
healthcare.
