Health inequalities will determine NHS spending
Strong social gradients are seen in health status, deaths from major diseases and poor lifestyle factors, Derek Wanless has found in a review of population health trends in the United Kingdom. Addressing these
health inequalities will form part of his recommendations to the Government
about how public health activities should be funded in the future.
Before the Government’s spending review in 2002, Mr Wanless, a
former chief executive of NatWest, was asked to examine future health
trends and suggest how much funding the National Health Service would
need in future. His work paved the way for large increases in the NHS
budget (PJ, 20 April 2002, p522). In particular, Mr Wanless recommended
that the public be encouraged to take a much greater responsibility for
their own health, potentially saving billions of pounds over a 20-year
period.
Mr Wanless is currently preparing a second report on securing good health
for the whole population which is to be published in February 2004. As
part of this, a background document on current population health trends
in the UK and eight comparable developed countries was published by the
Department of Health and the Treasury last week.
“The UK (and England) perform poorly compared with other countries
on some key measures of health outcomes and chronic disease such as coronary
heart disease, cancer and particularly on respiratory diseases,” the
document notes. “Chronic diseases, such as CHD and cancer, are
also strongly related to lifestyle factors such as smoking, poor diet,
physical inactivity and alcohol consumption. There is a strong social
gradient to the prevalence of many of these risk factors; for example,
it is estimated that half the difference in survival to 70 years of age
between social class I and V is due to higher smoking prevalence in class
V.”
In England in 2001, life expectancy at birth for women was lower than
in all but one of eight comparator countries. For men, life expectancy
was lower than for women but on average was relatively better, ranking
fifth out of nine.
British health spending
tops £80bn Spending on health in
the United Kingdom in 2002 was £80.6bn or 7.7 per cent of gross
domestic product, according to figures from the Office of National Statistics. Public spending on the NHS rose by 8 per cent over 2001
to £67.2bn while private spending, including non-prescription
medicines, private medical care and funds from charities, rose by
5 per cent to £13.4bn.
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