Unemployment 'increasing strain on NHS'

RISING unemployment is placing growing strains on NHS budgets, with most medicines being prescribed to people living in areas of worst deprivation, according to a survey of health trends published yesterday.

People in Liverpool received an average of 10 prescription items last year, double the number prescribed to those living in Kensington and Westminster, reflecting sharp variations in unemployment levels, according to the Compendium of Health Statistics, published by the Office of Health Economics (OHE).

Rates of long-term illness were also 3 per cent higher in areas of high unemployment, than those with average levels of joblessness, the report said. 'The relationship is statistically significant, suggesting that for a 1 per cent increase in unemployment rate, a corresponding rise in the number of prescription items per person of between 0.2 and 0.5 might be expected,' the report stated.

In absolute terms, the impact of high unemployment rates on the demand for prescriptions - indeed the NHS medicines bill - could be substantial, particularly as a result of the recent expansion in the number of jobless, from 1.6 million in 1990, to 2.3 million in 1991.

However, the additional health costs of unemployment appear to be partly offset by cheaper prescription preparations in the most economically-deprived areas. In the Oxford and South West Thames regions, the average prescription item cost pounds 7.30, compared with pounds 6.40 in the Mersey and North Western regions.

The total cost of NHS prescriptions rose to pounds 3.3bn last year, nearly 10 per cent of the health service budget.

The survey from the OHE, a research organisation funded by the pharmaceuticals industry, confirmed the findings of previous studies that the UK spends far less on health than most other Western countries. Britain devotes 6.1 per cent of GDP to state and private health care, compared with an average of 9 per cent for countries belonging to the Organisation for Economic Cooperation and Development and 7.6 per cent within the EC.

Private health spending is rising three times as fast as NHS expenditure, with more than 7 million people now having some form of private health cover. The number has almost doubled over the past 10 years.

Robert Chew, author of the report, said that Britain's low spending on health was reflected in a relatively high infant mortality rate - a key indicator of medical welfare - compared to the rest of Europe. The number of infant deaths, before one year, per thousand live births in the UK is 7.9, compared with 5.9 in Sweden, 7.2 in France, 7.4 in Spain and 7.1 in Germany.

Compendium of Health Statistics, 8th Edition 1992; Office of Health Economics, 12 Whitehall, London SW1A 2DY; Price pounds 60

Leading article, page 16