United Kingdom

  • Over the last 4 decades, the United Kingdom is widely considered to have one of the foremost health systems in the world – with its wonderful balance of clinical expertise, use of technology and compassionate care for its members
  • The United Kingdom spends 9.3 % of its GDP on healthcare. 84 % of the health care expenditure in 2012 came from the government, while 16 % was from private sources. Healthcare represented 16 % of all government expenditure.
  • Healthcare is mainly provided by the National Health Service (NHS). The NHS covers all permanent residents of the United Kingdom and is funded for from general taxation. Private health care, largely funded by private insurance, is used by less than 8% of the population. The NHS is the world's largest health service and the world's fourth-largest employer
  • The NHS is divided into two parts covering primary care and secondary care. Trusts are given the task of health care delivery. There are 2 main kinds of trusts
    • Commissioning trusts are responsible for healthcare capital and spending projects in a region. They examine local needs and negotiate with providers (both NHS bodies and private).
    • Provider trusts are NHS bodies the deliver the health care service. Funds are allocated to them by commissioning trusts based on population size and health parameters – and they are held accountable for health outcomes in the catchment they serve
  • In recent times, the NHS has sought to garner unused private sector capacity to augment their own – on occasion, the NHS even commissions the private sector to establish and run new facilities on a sub contracted basis.
  • The most important purchases are services including General Practice (GP) physician services. Most GPs are private businesses under exclusive contract to the NHS. Other services are community nursing, local clinics and mental health service. The majority of health is in a primary setting – recognising the need for preventive care and early detection through its network of primary care practices that are meshed into the community
  • GPs advice patients needing specialist care and help them make their choice of contracted hospitals. In urgent cases, GPs by-pass the normal booking and arrange emergency admission. The median wait time for a consultant led first appointment in English hospitals is a little over 3 weeks
  • As in the case of Singapore, the NHS has also struggled in recent years to fund the ever-growing medical needs of an aging population. They have tried to balance the books through a number of productivity and efficiency measures – that has led to criticism that the system is now bureaucratic, unfair to the medical community and often lacks the compassion that has been its hallmark over the last 4 decades