Health

Ten charts on why the NHS matters in this election

The NHS is a key battleground in the general election.

Whether it is extra money, tackling growing waiting lists or recruiting staff, politicians are keen to be seen championing the NHS.

But what shape is the NHS actually in?

1. We spend more on the NHS than ever before…

Last year more than £156bn was spent on health across the UK – about 12 times the figure that was spent 70 years ago.

And that's after you adjust it for inflation.

It means today around 30p out of every £1 spent on public services goes on health.

How the NHS budget has grown

UK health spending from 1949 to 2019

2. …but spending has slowed

Ever since the early 1950s the budget has been increasing, but the scale of those rises has varied quite considerably.

The average rise has been just over 4%. The biggest rises were seen under the Labour governments between 1997 and 2010 when the average annual rise was about 6%.

This dropped to 1% under the post-financial crisis coalition government between 2010 and 2015 – a figure which then rose under the majority Conservative government of recent years.

The NHS now has a five-year funding plan, which will see the budget rise by 3.4% a year on average until 2023.

Ministers have championed this as "record funding" for the NHS. They are right to say it is the highest it has ever been. But that claim could be made in any given year and it is certainly not the most generous government in the history of the health service.

However, it is worth mentioning that neither Labour nor the Lib Dems went into the last two elections with significantly higher funding pledges than the Tories.

3. Waiting times are getting worse

There are three key targets for hospitals: covering A&E, cancer care and routine operations, such as knee and hip replacements.

All parts of the UK have been struggling to hit them.

The way they are measured differs between the UK nations.

The A&E target is the most directly comparable – in that each nation expects 95% of patients to be treated or admitted in four hours.

A&E performance across UK

% of patients dealt with inside four hours

Performance is worse in Wales and Northern Ireland than it is in England and Scotland.

Scotland is the last nation to have hit the target – back in the summer of 2017.

Meanwhile, in cancer care patients are meant to start treatment within 62 days of an urgent GP referral. But that too is being missed, while waiting lists for routine treatments are rising.

In England it has topped 4.4 million – the highest on record. Some 15% have waited more than the target time of 18 weeks.

4. The population is ageing

The ageing population is certainly a major factor for the growing pressures – and it is one with which all health systems in the world are struggling.

Medical advances have meant that people are living longer. When the NHS was created, life expectancy was 13 years shorter than it is now.

This is something to celebrate. Infectious diseases are no longer a significant threat. Heart attacks do not claim the lives of people early in the same numbers.

Even cancer is not the death sentence it once was – half of people now survive for a decade or more.

But this progress has come at a cost. People are living with a growing number of long-term chronic conditions – diabetes, heart disease and dementia. These are more about care than cure – what patients usually need is support.

5. Care for older people costs much more

That level of ill-health means the average 65-year-old costs the NHS 2.5 times more than the average 30-year-old.

A 90-year-old costs more than seven times as much.

Relative cost of treating a 90-year-old compared to a 30-year-old

Relative cost in £

As the numbers of older people continue to rise so will the cost to the NHS.

This is compounded by other factors, including the rising cost of new drugs and high levels of obesity. A third of adults are so overweight they are risking their health significantly.

All this contributes to what health economists call health inflation – the idea that the cost of providing care outstrips the normal rise in the cost of living across the economy.

This is why health has tended to receive more generous rises than other areas of government spending.

6. The UK spends a lower proportion on health than some other EU countries

But despite this the UK has been left trailing some other parts of Europe when it comes to spending as a proportion of GDP, which is a measure of the size of the economy.

It is a gap that has widened since the previous Labour government was in power from 1997 to 2010.

How the UK compares to other EU countries

Comparison of spending on public and private health and care as a % of GDP, 2017

The result, as you would expect, is fewer beds, doctors and nurses per patient in the UK than the big spenders, which tend to tax people more.

Germany, for example, has almost twice as many nurses per capita than the UK.

7. The number of vacancies is high…

But the lack of staff in the NHS is not just because of less spending, the health service cannot even fill the posts for which it has got funding.

The NHS in England has nearly 100,000 jobs unfilled at the moment.

The total represents one in 12 of all the posts in the health service and would be enough to staff 10 large hospitals.

It includes around 40,000 nurse posts and nearly 10,000 doctor vacancies.

NHS vacancies by staff group

NHS England, Jan-Mar 2019

Some of the gaps are filled using overtime and agency staff, but some simply go unfilled.

There are various initiatives in place to recruit and retain staff.

And the number of training places for doctors and nurses are increasing.

8. …and building works are falling behind

While the government has been able to put more money into the NHS, one element of the budget that has been cut is the money set aside for capitRead More – Source

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