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World Health Systems Facts

UK: Health System Financing and Expenditures

UK: Health System Financing and Expenditures

UK Health System Overview
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Coverage and Consumer Costs
UK COVID-19 Policy

Health System Financing and Expenditures
Medical Personnel
Health System Physical Resources and Utilization
Long-Term Care
Medical Training
Pharmaceuticals

Political System
Economic System
Population Demographics
People With Disabilities
Aging
Social Determinants & Health Equity
Health System History and Challenges


Total Health Spending, USD PPP Per Capita (2019): $4,653

(Note: “Health spending measures the final consumption of health care goods and services (i.e. current health expenditure) including personal health care (curative care, rehabilitative care, long-term care, ancillary services and medical goods) and collective services (prevention and public health services as well as health administration), but excluding spending on investments. Health care is financed through a mix of financing arrangements including government spending and compulsory health insurance (“Government/compulsory”) as well as voluntary health insurance and private funds such as households’ out-of-pocket payments, NGOs and private corporations (“Voluntary”). This indicator is presented as a total and by type of financing (“Government/compulsory”, “Voluntary”, “Out-of-pocket”) and is measured as a share of GDP, as a share of total health spending and in USD per capita (using economy-wide PPPs).”

Source: OECD (2021), Health spending (indicator). doi: 10.1787/8643de7e-en (Accessed on 20 January 2021).


Current Health Expenditure Per Capita (USD) (2019): $4,313

Source: Global Health Observatory. Current health expenditure (CHE) per capita in US$. Geneva: World Health Organization. Last accessed July 26, 2022.


Current Health Expenditure As Percentage Of Gross Domestic Product (2019): 10.15%

Source: Global Health Observatory. Current health expenditure (CHE) as percentage of gross domestic product (GDP) (%). Geneva: World Health Organization. Last accessed July 26, 2022.


Out-Of-Pocket Expenditure As Percentage Of Current Health Expenditure (2019): 17.07%

Source: Global Health Observatory. Out-of-pocket expenditure as percentage of current health expenditure (CHE) (%). Geneva: World Health Organization. Last accessed July 26, 2022.


Out-Of-Pocket Expenditure Per Capita (USD) (2019): $736.4

Source: Global Health Observatory. Out-of-pocket expenditure (OOP) per capita in US$. Geneva: World Health Organization. Last accessed July 26, 2022.


Domestic General Government Health Expenditure as Percentage of General Government Expenditure (%) (2019): 19.7%
Population with household expenditures on health greater than 10% of total household expenditure or income (2012-2020) (%): 2.3%
Population with household expenditures on health greater than 25% of total household expenditure or income (2012-2020) (%): 0.4%

Source: World health statistics 2022: monitoring health for the SDGs, sustainable development
goals
. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.


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.


“In line with the EU average, health services are predominantly financed from general taxation and in 2017, 78.8 % of total health expenditure came from public sources. Voluntary Health Insurance plays a marginal, supplementary role in the system (3.1 % of total health expenditure) and out-of-pocket (OOP) spending is low (16 %) compared to most other EU countries. Financial protection is stronger in the United Kingdom than in many other EU countries, as most NHS services are free at the point of use for legal residents (Section 5.2). Fixed charges are applied to dental care and prescription pharmaceuticals (in England only), although several groups (such as children, pregnant women, people on low incomes and others) are exempted (see Section 5.2).

“Most spending on health services goes towards outpatient (or ambulatory) care (31 %) but this is closely followed by inpatient services (29 %), both of which are comparable to EU averages. Per person, pharmaceutical expenditure lies below the EU-wide average (Figure 8) as a greater share of pharmaceutical spending is on generics (Section 5.3), while considerably more is spent on preventive services than in other countries (EUR 165 or over 5 % of health spending in 2017, compared with 3 % across EU countries).”

Source: OECD/European Observatory on Health Systems and Policies (2019), United Kingdom: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“In 2017, health expenditure in the United Kingdom was slightly higher than the EU average per person – EUR 2,900 (adjusted for differences in purchasing power) compared to EUR 2,884, and slightly lower as a proportion of GDP (9.6 % compared with 9.8 % for the EU). However, as shown in Figure 7, health expenditure is considerably lower than similarly wealthy countries such as Germany (EUR 4,300 per capita, 11.2 % GDP) and France (EUR 3 626, 11.3 %). This level of spending has been relatively stable over time, but it has not kept pace with growing demand for health services (European Commission, 2019a) (see Section 5.2).”

Source: OECD/European Observatory on Health Systems and Policies (2019), United Kingdom: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“In 2014, public spending accounted for 83.1% of total spending on health, with OOP [Out Of Pocket] payments and VHI [Voluntary Health Insurance] accounting for 9.7 and 3.4%, respectively (WHO, 2016). Public spending on health has dominated since the founding of the NHS in 1948 (Boyle, 2011).”

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.


“Health services are mainly funded through general taxation, with the remainder coming from private medical insurance and out-of-pocket payments. In the early 2000s the United Kingdom government committed to increasing health care spending as a share of GDP to a level that corresponded with the average of the EU members at that time. Health expenditure as a share of GDP grew from 6.9% in 2000 to 9.4% in 2010, which was similar to the EU average, but below the average for the EU-15 countries. The implementation of austerity measures in 2010 following the financial crisis of 2007–2008 has meant a cut in total health expenditure in real terms in 2010 and 2011; in 2013 health spending accounted for 9.1% of GDP.

“Once administrations in Scotland, Wales and Northern Ireland and the Department of Health have their health care allocation, they distribute to their commissioners (in England and Northern Ireland) or providers (in Scotland and Wales), and to public health organizations, according to their own formulas, which all include some form of weighted capitation.

“Most services are provided free of charge at the point of use, but there are some that can involve cost-sharing (like dental care and pharmaceuticals) or direct payments (like most social care). Only England has prescription drug charges.”

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.


“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.


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 Sept. 22, 2022 by Doug McVay, Editor.

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