Is the UK spending more than we thought on healthcare (and much less on social care)?
BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i3094 (Published 06 June 2016) Cite this as: BMJ 2016;353:i3094
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I was greatly encouraged to read that the OECD has identified that the distinction between “healthcare” and “social care” in the UK is an accounting convention which can confuse and undermine our understanding.
The OECD properly classifies social care, which is the nursing of the elderly and vulnerable (either in their own homes or care homes) as healthcare. In the UK payments for this healthcare fall to the patient or, following a stringent means test, the Local Authority.
Only about 80% of UK healthcare spending is by the NHS for care which is is provided free at the point of need. Indeed the UK spends about 10% (not 8%) of GDP on healthcare, and a significant part of this difference is made up by payments for privately funded care at home or in care homes.
This is the nursing care of elderly people, who often have limited means, who suffer dementia or other serious end of life conditions. These are vulnerable people who find it difficult to advocate for themselves. They often have no option but to pay up; sometimes significant amounts.
The OECD has made an important contribution to the debate on healthcare funding in the UK. Payments for healthcare are sometimes made by those who are most vulnerable and least able to pay. Healthcare for these patients is not free at the point of need. It should be.
Competing interests: No competing interests
Re: Is the UK spending more than we thought on healthcare (and much less on social care)?
Dear John,
I remember reading about the re-ranking of UK in OECD according to the 9.8% figure a year or so ago. As UK then moved substantially up the rankings, it was noted (I think by you) that many of the other countries had still to have their spending re-calculated similarly according to this new formula.
Has that re-calculation for the other countries now happened, such that there is now coherence in comparing the relative figures?
Thanks.
Competing interests: No competing interests