Press briefing Securing the future: funding health and social care to the 2030s

Transcription

1 Press briefing Securing the future: funding health and social care to the 2030s Paul Johnson, Director, Institute for Fiscal Studies Anita Charlesworth, Director of Economics and Research, The Health Foundation Niall Dickson, Chief Executive, NHS Confederation

2 Securing the future: funding health and social care to the 2030s Paul Johnson, Director, Institute for Fiscal Studies

3 Real spending ( bn, prices) % of national income Health spending has grown by 3.7% a year over last 70 years 160 8% % of GDP (right axis) Real spending (left axis) 7% 6% 5% 4% 3% 2% 1% 0%

4 % real change With recent growth easily lowest in 60 years 12% 10% 8% Annual % change Five-year average 6% 4% 2% 0% -2% -4% -6%

5 UK health spending ( = 100) Especially on an age adjusted per capita basis 115 Total Per-capita Age-adjusted per-capita

6 % of public / public service spending Though health spending has recently grown especially fast as a proportion of public service spending 35% 30% 25% % of public service spending 20% 15% 10% 5% % of total public spending 0%

7 Real spending ( bn, prices) % of national income By contrast social care spending has fallen % % 15 Real spending (left axis) 1.5% 10 5 % of GDP (right axis) 1.0% 0.5% 0 0.0%

8 % increase, per person ( ) Staff are biggest element of NHS spending Composition has changed a lot over past 20 years 80% 70% 60% 50% 40% 30% 20% 10% 0% -10% Hospital doctors GPs Nurses, midwives and health visitors Other staff

9 % of population (at least one admission) The extra money has bought a lot of extra activity Proportion of population with an inpatient admission by age Age

10 CVD mortality rate per 100,000 people Performance is far better than in the past Age-standardised mortality per 100,000 from cardiovascular disease

11 As are satisfaction rates Satisfied Neither Dissatisfied

12 Securing the future: funding health and social care to the 2030s Anita Charlesworth, Director of Economics and Research, The Health Foundation

13 The number and percentage of the population aged over 65 and over 85 Population size (million) Total Aged Aged Aged Aged Aged million 4.4 million

14 Growth in chronic conditions for patients aged 65 and over Any chronic condition Multiple chronic conditions

15 Activity growth NHS acute activity growth in England Financial year Acute No growth

16 Contribution of different demand and cost pressures to overall spending projections for England under the status quo scenario, to Health care budget Demographic pressures Input cost pressures Productivity Capital Total spending pressures

17 NHS spending pressures in England: status quo and modernised NHS Status quo Modernised NHS to to to to to to Total spending pressures 28bn 53bn 81bn 36bn 67bn 106bn Annual average growth 4.0% 3.5% 3.3% 5.0% 4.3% 4.1%

18 Health expenditure ( bn) Projected UK health expenditure under the status quo and modernising scenarios Growth rate 4.0% Difference 124bn Growth rate 3.3% Difference 95bn Financial year Constant funding Status Quo Modernise

19 A modernised NHS in Shifting the share of resources spent on mental health, capital and public health 13bn, 9% 32bn, 12% 7bn, 5% 5bn, 3% 16bn, 6% 11bn, 4% 128bn, 83% 219bn, 79% Mental health expenditure ( bn) Public health expenditure ( bn) Capital expenditure ( bn) Remainder of UK health budget ( bn) Mental health expenditure ( bn) Capital expenditure ( bn) Public health expenditure ( bn) Remainder of UK health expenditure ( bn)

20 Annual average growth Historical and projected health care 6.0% 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% UK healthcare spend growth Status quo growth Modernised NHS growth

21 NHS spending as a share of GDP Healthcare share of GDP under status quo Healthcare share of GDP under modernised NHS % 7.3% % 8.6% % 9.3% % 9.9%

22 Spend ( bn) Projections of adult social care spending in the UK UK adult social care spending projections Estimated UK budget up to bn; 3.9% annual growth Financial year

23 Securing the future: funding health and social care to the 2030s Paul Johnson, Director, Institute for Fiscal Studies

24 NHS status quo Modernised NHS Social care Spending in billion Spending as % of GDP Funding gap 20 billion 29 billion 3 billion Spending in billion Spending as % of GDP Funding gap 34 billion 56 billion 8 billion

25 TME as % GDP Health spending as % GDP Health spending has risen without an increase in the overall size of the state Total spending and health spending as % of GDP 50% 10% 45% 40% TME (LHA) 9% 8% 35% 7% 30% 6% 25% 20% Health (RHA) 5% 4% 15% 3% 10% 2% 5% 1% 0% 0%

26 % Total Managed Expenditure We ve previously paid for increased government spending on health by cutting spending on other things Health Defence

27 This looks implausible for the future Even since many elements of public spending have suffered real cuts Health Social security (pensioners) Social security (working-age and children) Overseas aid Transport Net debt interest Long-term care Defence Education Housing and community amenities Public order and safety billion ( prices)

28 Relative to most other G7 and EU-15 countries our tax burden is relatively low FIN DNK FRA BEL SWE GRC AUT ITA DEU NLD LUX PRT UK (modernised) UK (status quo) CAN UK (current) ESP JPN USA IRL % of GDP