Population Insurance Coverage For A Core Set Of Healthcare Services* (%) (2019):
Public Coverage: 100%; Primary Private Health Coverage: 0%; Total: 100%

*”Population coverage for health care is defined here as the share of the population eligible for a core set of health care services – whether through public programmes or primary private health insurance. The set of services is country-specific but usually includes consultations with doctors, tests and examinations, and hospital care. Public coverage includes both national health systems and social health insurance. On national health systems, most of the financing comes from general taxation, whereas in social health insurance systems, financing typically comes from a combination of payroll contributions and taxation. Financing is linked to ability-to-pay. Primary private health insurance refers to insurance coverage for a core set of services, and can be voluntary or mandatory by law (for some or all of the population.”

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.

Annual household out-of-pocket payment in current US$ per capita (2019): $685

Source: Global Health Expenditure Database. Health expenditure series. Geneva: World Health Organization. Last accessed July 21, 2022.

Out-of-Pocket Spending as Share of Final Household Consumption (%) (2019): 2.6%

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.

“Historically, the U.K. has not systematically excluded benefits (it rather provides services to such extent as [considered] necessary to meet all reasonable requirements [14]. This means that the relatively high growth in OOP [Out-Of-Pocket spending] (2nd after the Netherlands) in 2004–2014 must be mostly ascribed to increased cost sharing requirements. Still, per capita OOP spending has been very low by international standards, with only those in France spending less. Inpatient and outpatient services are received free at point of service in most cases, but there are co-payments for prescription drugs that have been growing and amounted to £8.40 per prescription in 2016. These co-payments were capped at £104 annually in 2009 and remain the same today. Furthermore, although the co-payment maximum was lowered in 2006 (from £384 to £189), there have been regular increases since then. Similarly, there are co-payments for dental services (the amount of which varies by service). Both drug and dental co-payments have risen by 2% per year since 2005. Children and students, those age 60 and above, people with specific medical conditions and those on low-income schemes are exempted from co-payments for drugs and dental services, and are covered for vision services (which is normally not covered). Unsurprisingly, the market for VHI [Voluntary Health Insurance] is rather small. Individuals buy VHI to avoid waiting lists, have some choice over the physician they visit, and for more comfortable rooms [15]. “

Source: Rice, Thomas et al. “Revisiting out-of-pocket requirements: trends in spending, financial access barriers, and policy in ten high-income countries.” BMC health services research vol. 18,1 371. 18 May. 2018, doi:10.1186/s12913-018-3185-8.

“The archetypal Beveridge model is the traditional system of the United Kingdom, of a single payer, financed by national taxation, with a National Health Service in which providers of publicly financed services are owned publicly, and access to hospital specialists is typically by referral via a general practitioner (GP).”

Source: Bevan G, Helderman JK, Wilsford D: Changing choices in health care: implications for equity, efficiency and cost. Health Econ Policy Law. 2010, 5 (3): 251-67. 10.1017/S1744133110000022.

“The United Kingdom’s health care system is largely funded by taxes and is mostly free at point of access. Legal residents of the United Kingdom may use the services of the National Health Service (NHS), and they are also free to purchase private health insurance if they wish. Health care in the United Kingdom is mainly a devolved matter, meaning that Scotland, Wales and Northern Ireland make their own decisions about the way in which health services are organized. The United Kingdom government allocates a budget for health care in England, and allocates block grants to Scotland, Wales and Northern Ireland which in turn decide their own policies for health care. The health ministers of Scotland, Wales and Northern Ireland are responsible for public health and health services in their nation.

“Each health department funds organizations which arrange services on behalf of patients. In England and Northern Ireland there is a split between the purchasers and providers of services, whereas in Scotland and Wales this split has been abolished.

“England, Scotland, Wales and Northern Ireland each have their own performance framework for the health care system. One of the main goals at the moment is to better integrate health and social care, in order to be more cost-effective and efficient, and to provide higher quality services to patients.

“There are various health technology assessment and information gathering systems in place. A range of regulators monitors the NHS and associated organizations; some regulators oversee all of the United Kingdom (such as health professional groups), while others are specific to one nation (such a quality of care providers). Several patient empowerment strategies are in place, including specific rights for patients.”

Source: Cylus J, Richardson E, Findley L, Longley M, O’Neill C, Steel D. United Kingdom: Health system review. Health Systems in Transition, 2015; 17(5): 1–125.

“The NHS provides cover for a wide range of benefits to individuals ordinarily resident in the United Kingdom – overseas visitors and illegal immigrants are not normally entitled to receive NHS care, with some exceptions (emergency care, care to children and treatment for infectious diseases). The publicly financed benefits package, while comprehensive, is not clearly defined and there is a degree of variation across regions. User charges are applied to ophthalmic care, most dental care and outpatient prescriptions, as well as to certain products. There is a system of exemption from prescription charges for children, people aged 65 years and older, pregnant women, people with chronic illnesses and some lower-income groups. Scotland, Wales and Northern Ireland have abolished the prescription charge for medicines, but in England it remains in place, at pound sterling (GBP)
8.20 per prescription in 2015.”

Source: Thomas Foubister and Erica Richardson. “United Kingdom.” In Voluntary health insurance in Europe: Country experience [Internet]. Sagan A, Thomson S, editors. Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2016. Observatory Studies Series, No. 42.

“Primary care increasingly means not only a GP but a whole team of doctors, nurses, midwives, health visitors and other health care professionals in a community setting. There is also an increasing use of the voluntary sector in some situations, such as those involving mental health or long-term conditions. Primary care nurses include both practice and district nurses; practice nurses work in GP practices, while district nurses work for community health service providers to provide care in patients’ homes.

“People ordinarily resident in the United Kingdom can register with a GP and consult their GP practice without charge. GPs can reject an applicant (unless the applicant has been assigned to them), but they can only do so if it is not discriminatory, or if the patient is out of the practice boundary and the practice has no capacity or feels it would not be clinically appropriate (NHS Choices, 2015). Most GP consultations take place on GP premises, which are called surgeries. GP surgeries provide a range of services, including routine diagnostic services, minor surgery, family planning, on-going care for patients with chronic conditions, antenatal care, preventive services, health promotion, outpatient pharmaceutical prescriptions, sickness certification and referrals for more specialized care. Not all surgeries provide all of these services.

“Efforts have been made to have an equitable distribution of GPs, but some areas of the country have a lower ratio of doctors to patients than is desired, such as rural areas in the north of England and Scotland.

“The average number of GP consultations per person per year rose from 3.9 in 1995 to 5.5 in 2008 (Royal College of General Practitioners, 2013). Historically, GPs were responsible for out-of-hours (OOH) care, but starting in the early 2000s responsibility for commissioning out-of-hours care shifted to commissioning (i.e. purchasing) bodies, with services provided by GP cooperatives or private sector providers. Out-of-hours care consists of call handling, phone assessment and triage, and in-person consultations. GPs who work for a practice that does not provide out-of-hours care may provide out-of-hours care as part of a cooperative or private scheme.”

Source: Cylus J, Richardson E, Findley L, Longley M, O’Neill C, Steel D. United Kingdom: Health system review. Health Systems in Transition, 2015; 17(5): 1–125.

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

Page last updated August 24, 2022 by Doug McVay, Editor.