Asking for better value from the NHS is fine – but people aren’t products

We are now spending pretty much the same level of GDP as other advanced economies

Share
Related Topics

So the NHS has to be more like PC World or Dixons – and that from the chap who is supposed to be in charge? It is enough to make patents’ knees knock together in the GP’s waiting room – the “not worth fixing, you’d better buy a new one” approach of PC vendors does not quite apply when it’s your body that needs patching up.

Actually, Sir Bruce Keogh is making a narrower point: that the culture of doing more with less applies to almost every economic activity and that healthcare cannot be an exception. He does however highlight – perhaps inadvertently – one crucial distinction between high street retailing and healthcare. Demand for one service is in long-term decline as retailing shifts online, whereas demand for the other is rising fast and, given the changing age structure of the population, will inevitably continue to do so.

Every country faces the same problem. Britain is now spending pretty much the same level of GDP as other advanced economies: 9.4 per cent of GDP, just above the Organisation for Economic Co-operation and Development average of 9.3 per cent. The US is exceptional, spending nearly 18 per cent of GDP on health, not necessarily efficiently. Of the rest, we spend rather less than France and Germany (11.6 per cent and 11.3 per cent) but a little more than Italy and Spain (9.2 per cent and 9.3 per cent). We are unusual in the high proportion of the money coming from public funds, 82 per cent – in Germany, France and Italy it is 76-77 per cent. So in terms of the public contribution to healthcare we are pretty much the same as other large European economies.

Are we getting good value for that spending? It is very hard to know. Some studies show the UK towards the top of “value for money” leagues; others are less enthusiastic. It depends on what you are measuring. For example, we seem not to be doing as well as we should at treating cancers, but are doing well on diabetes. What we do know is that health outcomes in the UK are not bad, but not particularly good: life expectancy is rising but is still lower than much of Western Europe, or Japan.

That points to perhaps the greatest issue of all: to what extent  should healthcare be about how you treat illness. Or should it be about how you improve the general health of the population? It must be both, but of course the more healthy people are, the less likely they are to need medical intervention. That is the direction that medical care will increasingly go: nudging people to change their lifestyles and hence improve their overall health. Then the inevitably limited resources can go where they are most needed.

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Senior Java Developer/Designer

£400 - £450 Per Day: Clearwater People Solutions Ltd: My client are looking fo...

Domino Developer and Administrator

£40000 - £45000 Per Annum + benefits: Clearwater People Solutions Ltd: Domino ...

Systems Build Engineer (Development) - Peterborough

£35000 - £45000 per annum + benefits: Ashdown Group: A highly successful, inte...

SEN Teacher

£36000 - £37000 per annum: Randstad Education Group: Experienced SEN Teacher n...

Day In a Page

Read Next
 

Daily catch-up: Cameron’s speech, his place in history, and the Pedant Club

John Rentoul
 

Why Facebook won't be feeling threatened by Ello...yet

Ed Rex
Italian couples fake UK divorce scam on an ‘industrial scale’

Welcome to Maidenhead, the divorce capital of... Italy

A look at the the legal tourists who exploited our liberal dissolution rules
Tom and Jerry cartoons now carry a 'racial prejudice' warning on Amazon

Tom and Jerry cartoons now carry a 'racial prejudice' warning on Amazon

The vintage series has often been criticised for racial stereotyping
An app for the amorous: Could Good2Go end disputes about sexual consent - without being a passion-killer?

An app for the amorous

Could Good2Go end disputes about sexual consent - without being a passion-killer?
Llansanffraid is now Llansantffraid. Welsh town changes its name, but can you spot the difference?

Llansanffraid is now Llansantffraid

Welsh town changes its name, but can you spot the difference?
Charlotte Riley: At the peak of her powers

Charlotte Riley: At the peak of her powers

After a few early missteps with Chekhov, her acting career has taken her to Hollywood. Next up is a role in the BBC’s gangster drama ‘Peaky Blinders’
She's having a laugh: Britain's female comedians have never had it so good

She's having a laugh

Britain's female comedians have never had it so good, says stand-up Natalie Haynes
Sistine Chapel to ‘sing’ with new LED lights designed to bring Michelangelo’s masterpiece out of the shadows

Let there be light

Sistine Chapel to ‘sing’ with new LEDs designed to bring Michelangelo’s masterpiece out of the shadows
Great British Bake Off, semi-final, review: Richard remains the baker to beat

Tensions rise in Bake Off's pastry week

Richard remains the baker to beat as Chetna begins to flake
Paris Fashion Week, spring/summer 2015: Time travel fashion at Louis Vuitton in Paris

A look to the future

It's time travel fashion at Louis Vuitton in Paris
The 10 best bedspreads

The 10 best bedspreads

Before you up the tog count on your duvet, add an extra layer and a room-changing piece to your bed this autumn
Arsenal vs Galatasaray: Five things we learnt from the Emirates

Arsenal vs Galatasaray

Five things we learnt from the Gunners' Champions League victory at the Emirates
Stuart Lancaster’s long-term deal makes sense – a rarity for a decision taken by the RFU

Lancaster’s long-term deal makes sense – a rarity for a decision taken by the RFU

This deal gives England a head-start to prepare for 2019 World Cup, says Chris Hewett
Ebola outbreak: The children orphaned by the virus – then rejected by surviving relatives over fear of infection

The children orphaned by Ebola...

... then rejected by surviving relatives over fear of infection
Pride: Are censors pandering to homophobia?

Are censors pandering to homophobia?

US film censors have ruled 'Pride' unfit for under-16s, though it contains no sex or violence
The magic of roundabouts

Lords of the rings

Just who are the Roundabout Appreciation Society?