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Price levels in the healthcare sector, 2021 (OECD average = 100): 101
Population coverage for a core set of services, 2021
– Total public coverage: 100%
– Primary private health coverage: 0%

Source: OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, doi.org/10.1787/7a7afb35-en.

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Universal Health Coverage: Service coverage index, 2021: ≥80
Population with household expenditures on health > 10% of total household expenditure or income (%), 2015-2021: 2.36%
Population with household expenditures on health > 25% of total household expenditure or income (%), 2015-2021: 0.56%

Source: World health statistics 2025: monitoring health for the SDGs, Sustainable Development Goals. Tables of health statistics by country and area, WHO region and globally. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO.

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“A founding principle of the NHS is that health care is accessible to all legal United Kingdom residents, based on clinical need, regardless of their ability to pay. This major strength of the NHS means that United Kingdom residents enjoy one of the highest levels of protection against the financial consequences of ill-health in the world (see Section 7.3, Financial protection) Any resident can use NHS health care services, usually without paying at the point of access. Rules vary slightly across the United Kingdom in the definitions, but generally, ‘ordinarily’ resident people can access health care anywhere in the United Kingdom. “Ordinarily” means that the residence is not temporary and that the individual is in the country legally. “Overseas visitors” can receive emergency medical treatment for free, but subsequent care is usually charged. Other services provided free of charge irrespective of residence status include primary care services, family planning services, treatment for some infectious diseases and compulsory psychiatric treatment (UK Government, 2021e). Despite lobbying by the Royal College of Midwives (Wise, 2019), maternity care results in charges for non-ordinarily residents, creating barriers for many vulnerable and pregnant women to access cost-effective and preventive care.

“Before the United Kingdom leaving the EU, members of the EEA were able to access all NHS services free of charge, with reciprocal arrangements in place for United Kingdom nationals living abroad. However, after 31 December 2020, EEA nationals are subject to the same rules as non-EEA nationals when accessing NHS services (UK Government, 2020e). Certain groups are exempt from charges when accessing NHS services irrespective of their nationality, including refugees, asylum seekers, children looked after by a local authority and victims of modern slavery or human trafficking (UK Government, 2021e). Barriers exist for undocumented migrants accessing NHS services, such as the fear that their data would be shared with immigration authorities. However, in 2018, after significant public backlash, the United Kingdom Government suspended a memorandum of understanding with the NHS Digital whereby patient data were being shared with the Home Office to track people breaking immigration rules (Campbell, 2018).”

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“All individuals, irrespective of their nationality or immigration status, are eligible to access primary, emergency and compulsory psychiatric care, free of charge. Whether someone is covered by the NHS for secondary care services is determined by whether they are classified as “ordinarily resident”. The United Kingdom law defines this as any person, which is “normally residing in the United Kingdom (apart from temporary or occasional absences), and their residence here has been adopted voluntarily and for settled purposes as part of the regular order of their life for the time being, whether for short or long duration” (UK Government, 2021f ). This means that undocumented migrants are left without access to many NHS services, including maternity care services, a policy that has been described by Maternity Action as undermining trust and creating a climate of fear among vulnerable pregnant women (Wise, 2019). It is not known exactly how many undocumented migrants are in the United Kingdom. Estimates from the Greater London Authority report 594 000–745 000 undocumented migrants in the United Kingdom in 2017 (Jolly, Thomas & Stanyer, 2020), whereas the Pew Research Center estimates between 800 000 and 1.2 million undocumented migrants in the same year (Pew Research Center, 2019).”

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“The NHS does not have an explicit list of benefits; instead there is legislation that outlines broad categories of health care services that should or could be provided in the NHS (Mason, 2005). As discussed, there are benefits that are explicitly excluded, including prescription charges in England, dental care and optometry (NHS England, 2021p). However, exemptions exist for young and older people, and for those on low incomes. The NHS Constitution for England in 2009 established a set of rights for people working for and using the NHS, but this constitution mostly pulled together laws and rights that were already established (see Section 2.8.3, Patient rights). Similar constitutions do not exist in Scotland, Wales or Northern Ireland. Instead, a set of published core principles and values are intended to guide governance and service delivery in these countries. Increasingly as ICSs and sustainability transformation partnerships have been developed across England, there have been calls to clarify and strengthen legislation regarding their responsibilities and patient rights.

“Through delegation, the various health boards in England, Scotland, Wales and Northern Ireland decide what treatments will be funded when commissioning (purchasing) and delivering (providing) services. At the local level, commissioning bodies or health boards also have some autonomy in making decisions about what services they will provide to their populations, given budgetary constraints. This has led to complaints of postcode lotteries, wherein some areas will cover certain services or treatments that are not available in a neighbouring region. This is the case for services such as fertility treatment (Fertility Fairness, 2021), and some elective surgical procedures (Royal College of Surgeons of England, 2014). Several initiatives have been developed, which aim to even out postcode lotteries, address unwarranted clinical variation and improve equity between regions. From the health technology assessment perspective, NICE provides NHS organisations in England, Northern Ireland and Wales with cost-effectiveness analyses that can serve as guidance on how to allocate resources most efficiently (see Section 2.7.2, Regulation and governance of provision). Scotland refers to the Scottish Intercollegiate Guidelines Network for such guidance. Initiatives to address unwarranted clinical variation and reduce provision of low-value care, include the Getting it Right the First Time (NHS England, 2021h) and the Evidence-Based Interventions programme in England (NHS England, 2020c), Realistic Medicine in Scotland (NHS Scotland, 2018) and Prudent Healthcare in Wales (NHS Wales, 2019b).”

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“Private medical insurance or voluntary health insurance (VHI) can be purchased by individuals or by employers for their employees. Approximately 2 million people are covered by employer-paid private medical insurance, and 1 million are covered by independently purchased policies (Blackburn, 2020). People who are covered by private medical insurance cannot opt out of the public system, and private medical insurance is usually used to finance a few select services not offered by the NHS or to access NHS-covered services more quickly. Coverage and utilisation of VHI is predominantly concentrated in London and the South East of England, accounting for nearly half of the total United Kingdom spending on VHI (Blackburn, 2020). Insurance companies charge premiums based on the scope of coverage, product options such as fixed-price or excess-charge policies, the nature and degree of risk the insurer takes on, and the loading charge related to the insurer’s profits.

“The Prudential Regulation Authority regulates financial institutions and is the overall regulator of private insurance companies in financial matters. The Prudential Regulation Authority’s approach to failing insurers is to allow them to fail in a way that has as little impact as possible on policyholders. The Financial Conduct Authority seeks to protect consumers by ensuring that relevant markets function well and that consumers are treated fairly.”

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

Page last updated June 12, 2025 by Doug McVay, Editor.