how should we pay for health care in future?
DESCRIPTION
The King’s Fund, in collaboration with Ipsos MORI, held two deliberative events with members of the public, one in London on 20 October 2012, and one in Leeds on 10 November 2012, to discuss how we will pay for health care in future. Anna Dixon used the following slides during these events to introduce the current state of the NHS, current perceptions of the NHS, and some of the issues that we might face in funding the health and social care system in the future. These slides do not represent The King's Fund's views on how the NHS should be funded in the future, but were used as a prompt for group discussions on the challenges the NHS faces and how it is funded.TRANSCRIPT
How should we pay for health care in future?Deliberative event, LondonOctober 2012
The case for change
The National Health Service in England is…
UniversalIt is there for everyone
AccessibleAccess based on need, not ability to pay
High qualityCare that is safe, effective and personalised
› This equates to about £1,500 per person.
› In 2010/11 we spent £87.61 billion on the NHS.
As a society we spend a lot of money on health care
› In 1948 the NHS had a budget of about £9 billion.
› Today this is ten times more.
The NHS is facing significantpressures that are driving spend.
The population is growing
› Over the next 20 years the population is
predicted to grow by 8 million.
› Over the next 20 years those aged
65-84 will by 41 per cent
and those 85+ will by 118 per cent.
The population is ageing
› In the next 20 years, there will be a doubling in the number of people
with some diseases.
Cancer
Arthritis
Diabetes
Dementia
People will increasingly suffer from multiple chronic disease
› By 2018 the number of people with 3+ long-term conditions is expected
to rise from 1.9 million to 2.9 million.
There will be new technologies and drugs so we can treat more diseases and more people
Over the 20 years we expect:
› Novel therapies
› New vaccines
› New drugs to combatobesity & diabetes.
As a result of these pressures we could be spending a lot more on health care in future
> In 1962 we spent 3.4% of GDP
> In 2011 we spent 8% of GDP
> By 2032 we would be spending
11% of GDP.
Public and private health expenditure as a percentage of GDP
£1 in every £5 of
government spending to
day
is on th
e NHS.
-5
5
15
25
35
45
55
Oct-04
Nov-04
Dec-04
Jan-05F
eb-05M
ar-05A
pr-05M
ay-05Jun-05Jul-05A
ug-05S
ep-05O
ct-05N
ov-05D
ec-05Jan-06F
eb-06M
ar-06A
pr-06M
ay-06Jun-06Jul-06A
ug-06S
ep-06O
ct-06N
ov-06D
ec-06Jan-07F
eb-07M
ar-A
pr-07M
ay-07Jun-07Jul-07A
ug-07S
ep-07O
ct-07N
ov-07D
ec-07Jan-08F
eb-08M
ar-08A
priM
ay-08Jun-08Jul-08A
ug-08S
ep-08O
ct-08N
ov-08D
ec-08Jan-09F
eb-09M
ar-09A
pr-09M
ay-09Jun-09D
ec-09M
ar-10
% Lack of resources/ investment
54%
What do you see as the biggest problems facing the NHS? What else?
Biggest concern is the lack of resources
Long waitinglists/times 15%
Bureaucracy/top heavy management 25%
Not enough doctors /nurses/understaffed
24%
Overstretched/ageing population 11%
* Please note that results from March 2007
onwards are not directly comparable to previous
data as the question was placed on different
studiesBase: English adults aged 16+ (c.1,000 per wave)
Source: Ipsos MORI/DH Perceptions of the NHS Tracker
Overworked staff 13%
Please tell me whether on the whole you agree or disagree with each of the following statements:
% agree
The NHS provides good value for money to taxpayers
The NHS will face a severe funding problem in the future
Will the NHS face a severe funding problem in the future?
The NHS is doing everything it can to reduce waste and inefficiency
It is possible to increase quality of care for patients while reducing NHS
costs
Base: Adults aged 16+ in England (c. 1000 per wave)
Source: Ipsos MORI/DH Perceptions of the NHS Tracker
What do you think we should do about these pressures?
Today the NHS is
AccessibleAccess is based on need, not ability to pay.
prescriptionsdental careeye carehealth travel (certain travel vaccines)wigs and fabric services.
Those who are below 16, full-time students or over 60 are covered for most of these. There are schemes for low-income households.
But we already have to pay some charges in the NHS…
In future should we have to pay for some types of services?
Today the NHS is
AccessibleAccess is based on need, not ability to pay.
Today the NHS is
UniversalIt is there for everyone.
In England there are few charges and people on low incomes are usually exempt from paying.People with health insurance can use the NHS if they wish.Care for older people who need help at home is currently means tested in England, which means that people who own their own houses or who have good pensions have to pay for themselves.In some countries, richer people have to buy health insurance or must pay for their own care.
Currently everyone can get care on the NHS regardless of how wealthy they are...
In future should some people have to pay for their health care?
Today the NHS is
UniversalIt is there for everyone.
Today care in the NHS is
High qualityThe NHS provides care that is safe, effective and personalised.
Some people in England choose to pay for:
Speed – so they can be seen more quickly.
Hotel facilities – so they can stay in a private room.
Clinical upgrades – so they can be treated with the latest drug or technologies.
The NHS tries to provide the same standards of care to everyone
In future should the NHS only pay for a basic standard of health care?
Today care in the NHS is
High qualityThe NHS provides care that is safe, effective and personalised.