2 - Casemix in the United Kingdom: From development to plans

Summary

Introduction to the UK healthcare system

UK healthcare is dominated by the National Health Service (NHS). This was established in 1948 and financed by general taxation. The OECD reported that in 2002 the UK spent 7.7 per cent of its GDP of which public expenditure accounted for 83.4 per cent of the total. The spending had increased from the 1993 figure of 6.9 per cent of GDP.

Under the UK government's NHS Plan, record levels of increased funding for the NHS were planned to rise over the period 2003/4 to 2007/8 by an average of 7.4 per cent a year in real terms. By 2004/5 total spend on the NHS totalled £82.5 billion (7.01% of GDP), up from £66.2 billion in 2002–3 (6.26% of GDP).Figure 2.1 shows the increase in government health expenditure and the percentage of GDP from 1987/8 to 2004/5.

The public healthcare sector in the UK is divided into four principal National Health Services (NHS) for England, Scotland, Northern Ireland and Wales. Each of these services, whilst following the founding principle of the NHS to provide healthcare free at the point of service to all, has differences in policy dictated by the four different legislative and political assemblies for each of the member countries. These differences include free prescription charges in Wales, free elderly personal nursing care in Scotland, and differences in the strategic structures of hospitals and commissioning organisations.