Great Britain Health System

By Aditya Sood, Aasim Riyaz Khan,Achint Kumar Post Graduate Diploma In Health Management at Institute of Health Management Research, Jaipur , India

Health Indicators
Total Population=62.6 million

Urban Population (%)=80

Population Growth Rate(%)=0.5 Total Fertility Rate=1.9 Crude Death Rate(Per 1000 population)=10 Crude Birth Rate(Per 1000 Population)=12

Source=World Bank Data 2011

 U5 Mortality Rate(1000)=5 per thousand live births MMR=12 per lakh live births IMR=4 per thousand live births Life Expectancy at Birth -80 Male- 78.3 Female-82.5

Health expenditure per capita = US $ 3,503

Manpower in health Infrastructure

Medical and dental staff- 187/100000 population Nursing and mid wife staff-786/100000 population Hospital beds- 33/10000 population Nearly 1.3 million people are employed in NHS hospital community service in GB In 2009 there were over 117,000 medical and dental staff and over 507,000 nursing and midwifery staff working in hospital and community health services in the GB In addition, there were over 302,000, 184,000, and 154,000, administration and clerical, professional and technical, and domestic ancillary staff respectively working in hospital and community health services in the GB in 2009. Source( OHE Guide to UK Health and Health Care Statistics, July 2011)

HEALTHCARE EXPENDITURE
According to World bank Data, Health (2011), Great Britain is spending 9.6% of its GDP on health.
10 9.8 9.6

9.5
PERCENTAGE 9 8.5 8 7.5 2007 2008 YEAR 2009 2010 8.4 8.9

Categories of Great Britain healthcare expenditure

Category 1
Publicly funded healthcare expenditure scheme-National Health Service(NHS).
Health expenditure, public (% of total health expenditure),Great Britain, 2007-2010 , World Bank Data, Health (2011)
86 84 82 80 78 PERCENTAGE 84.1 83.9

81.3

82.4

2007

2008 YEAR

2009

2010

Category 2 Private Health Expenditure. It is 16% of the total Health Expenditure. Out of Pocket expenditure as percentage of private expenditure on health is 62%
OUT OF POCKET EXPENDITURE (World Bank Data, Health 2011)
PERCENTAGE 62.06 62.04 62.02 62 61.98 2007 2008 YEAR 62 62 2009 62 2010 62.04

Category 3 Private Health Insurance Accounts for 2 % of the total Health Expenditure. Around 12 % of Great Britain citizens are covered by private health insurance
PER CAPITA HEALTH EXPENDITURE ON HEALTH IN Great Britain$, 2007-2010,World Bank Data, Health 2011
PER CAPITA HEALTH EXPENDITURE US$ 4000

3881

3800
3600 3400 3200 2007

3801 3440 3503

2008 YEAR

2009

2010

NATIONAL HEALTH SERVICE

Launched on 5th July 1948. Due to financial burden Prescription charge was introduced in 1952,which was abolished in 1962 but re-introduce again in 1968. The NHS Health and Social Care Act 2012 sets out a largescale program for reform to be implemented by the end of 2014. Major aim of reform is decentralization. NHS Commissioning Board will be established which will be independent from the day to day control of Secretary of state.

NHS Aims: To provide medical care free at point of use To rich and poor alike in accordance with medical need

2 beliefs: Those who need care will come forward Those who provide care know what is required and how to provide it

FUNDED BY
General taxation 76% National Insurance contributions 19% User charges 5% (G.B. department of Health, 2010) ** Apart from these, NHS earns from prescription of drugs & dental treatments to general population.

COVERAGE
It is universal, all those who are resident or citizens of the Great Britain are entitled to health care. Only treatment in an emergency department and for certain infectious diseases is free to people not ordinarily resident, such as visitors or illegal immigrants.

SERVICES OFFERED
Preventive Inpatient & Outpatient

 Inpatient & Outpatient drugs Dental care, mental health care Disabilities & rehabilitation Hospital care Physician

COST SHARING
Out patient prescription drugs are subject to a copayment currently US$12.23 per prescription, drugs prescribed in NHS hospitals are free. NHS Dental services are subject to copayment of upto US $ 334/ per course of treatment Discount through pre payment certificates-people using large amount of prescription drugs. Transport costs to and fro from provider sites-low income group people.

People exempted from prescription drug co-payments

Citizens of GB < 16 years of age.
Citizens of GB > 60 years of age Low income groups Pregnant women Those in fulltime education aged 16, 17, or 18. Those who had a baby in the last 12 months

STRUCTURE
Secretary of State

Department of Health NHSE Regional Offices

Strategic Health Authorities

NHS trusts

Local authorities

Primary care groups

PRIMARY CARE

TYPES OF HEALTH SERVICES IN Great Britain

SECONDARY CARE

TYPES OF TRUSTS

Primary care

NHS

Foundation

GPs Dentist

Opticians
NHS direct NHS walk in centres

Acute Care Mental Health Ambulance

Pharmacist

PRIVATE HEALTHCARE Private Health Insurance Private Hospitals Out of Pocket Expenditure

REGULATORY BODIES
National Institute of Clinical Excellence publishes guidelines for healthcare professionals Private hospitals do not have to follow these Healthcare Commission Monitoring Healthcare standards and efficiency Responsible for publishing NHS performance ratings and indicators

KEY CHALLENGES
Coronary heart diseases and stroke continue to be leading cause of death in UK Approximately 1 in 6 of all deaths in the UK in 2008 were due to coronary heart disease. Deaths from strokes accounted for 1 in 14 of all UK deaths. Crude death rate from liver disease and diabetes continue to rise Rising alcohol related hospital admissions and alcohol related deaths Prevalence of adult obesity in Great Britain is highest in the EU
( OHE Guide to UK Health and Health Care Statistics, July 2011)

 Rising demand and treatment cost Long waiting periods for elective surgeries Variations in quality of care across Great Britain Lack of accountability of trusts and Primary Care centers. Economic downturn in the country Lack of control by central regulatory bodies over private healthcare.