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

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% 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.