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The UK spends less on health per person compared to other countries and underperforms significantly on many key health outcomes such as cancer survival rates and life expectancy, according to a new report from The King’s Fund.
The report, How does the NHS compare to the health care systems of other countries? compared the health care systems in 18 similar higher income countries, including France, Germany, Italy, Sweden, Japan, Singapore and the USA.
It found that the UK has strikingly low levels of key clinical staff, with fewer doctors and nurses per head than most of its peers, and a heavier reliance on internationally trained staff. The UK has just three doctors per 1,000 people, while Greece has more than twice as many, with 6.3 doctors per 1,000 people.
The UK health service is, however, among the most efficiently run health care systems, for example by spending relatively little budget on administration and keeping medicines costs low.
It also spends less than many of its peers on physical resources such as buildings and equipment and comes bottom out of 19 countries for the number of CT and MRI scanners per person. The US has five times as many scanners per person and Germany has four times as many.
The independent report, commissioned by the Association of the British Pharmaceutical Industry, analysed data in three main domains:
- the context the health system operates in (eg, the health status and behaviours of the population)
- the resources a health system has (eg, levels of staffing, equipment and health care spending)
- how well the health care systems uses its resources and what it achieves as a result (eg, measures of efficiency in delivering services, quality of care, financial protection from the costs of ill health, and health care outcomes).
Key health outcomes and deaths from treatable diseases
Out of the 19 countries assessed, the UK also has among the lowest levels of life expectancy for men and women, with falls in life expectancy being particularly striking since the pandemic. It also has higher levels of deaths from treatable diseases such as heart attack and stroke than the majority of its peer countries, and below average survival rates for many major cancers.
Another key finding was that it has relatively few hospital beds: 2.5 beds per 1,000 people compared to an average of 3.2, placing the UK second to last out of 19 peer countries.
The waiting times in the UK for common procedures like knee, hip and cataract operations were broadly middle of the pack compared to similar countries. Like in the UK, many countries in the analysis had rising waiting lists before the Covid-19 pandemic, but the fall in planned operations like these was dramatically sharper in the UK in the first year of the pandemic.
Siva Anandaciva, Chief Analyst at The King’s Fund and author of the report, said: “As the NHS turns 75, the much-loved British institution has sadly seen better days. While the UK stands out in removing most financial barriers to accessing health care and the NHS is run relatively efficiently, it trails behind its international cousins on some key markers of a good health care system.
“The pressures of the Covid-19 pandemic on our health service compounded the consequences of more than a decade of squeezed investment in staff, equipment and wider services that keep us well. This leaves the NHS delivering performance that is middling at best and the UK must do much more to reduce the number of people dying early from diseases such as heart disease and cancer.”
She added that there was no evidence that an alternative funding model for the NHS would resolve these challenges, but it was also not an excuse to accept the current state of the UK health service.
“Working to improve our existing health system while providing it with the adequate resources, political support and long-term planning it desperately needs would give the NHS the best chance of delivering the timely, high-quality care and outcomes it is capable of,” she said.