Facts and figures on the NHS at 70

Facts and figures on the NHS at 70

1. We spend a lot more on healthcare UK health spending as a % of GDP The UK health budget in cash terms ( bn) UK health spending per head ( ) 1949-50 2016-17 1949-50 2016-17 1949-50 2016-17 3.5 7.3 0.4 144 9 2187 Sources: 1949-50 data from Office of Health Economics; 2016-17 data from HM Treasury 2

2. There are more staff Full time nurses 1949 () Full time hospital doctors 1949 () Full time GPs 1961 () () 60,997 285,093 11,735 109,960 20,865 39,843 Source: Nuffield Trust analysis of NHS Digital data 3

3. which means fewer people per staff member People per nurse 1949 People per hospital doctor 1949 People per GP 1961 641 174 3328 473 2091 1397 Sources: Nuffield Trust analysis of NHS Digital data; population data from ONS 4

4. The biggest killers have changed over time Deaths from heart disease (% of all deaths) and 28.8 15.7 Deaths from stroke (% of all deaths) and 11.2 6.2 Deaths from cancer (% of all deaths) and 16.8 27.8 Source: Nuffield Trust analysis of 20 th Century Mortality Files and 21 st Century Mortality Files, Office for National Statistics 5

4. The biggest killers have changed over time Deaths from tuberculosis (% of all deaths) and 4.7 0.0 Deaths from diabetes (% of all deaths) and 0.8 1.1 Deaths from senility and dementia (% of all deaths) and 2.6 10.5 Source: Nuffield Trust analysis of 20 th Century Mortality Files and 21 st Century Mortality Files, Office for National Statistics 6

5. People live 13 years longer than in Life expectancy in and Wales, -2016 2016 65.9 79.5 70.3 83.1 90 80 70 60 50 40 30 20 10 0 1955 1962 1969 1976 1983 1990 1997 2004 2011 Males Females Source: Office for National Statistics, 2016 based and Wales period life expectancies, to 2016 7

6. Deaths of babies have reduced hugely Infant mortality (under 1 year) per 1000 live births 2016 and 34.5 3.8 Neonatal mortality (under 1 month) per 1000 live births 2016 and 19.8 2.7 Stillbirths per 1000 live births 2016 and 23.2 4.4 Source: Office for National Statistics, Vital statistics: population and health reference tables November 8

6. We re prescribing more drugs than ever before Number of prescriptions 1949 UK 2016 UK Prescription charges per item 2018 2018 Scotland, Wales & NI 225 million 1.3 billion 0 8.80 (exemptions for certain groups) 0 Source: 1949 data from Office of Health Economics; 2016 data from NHS Digital, Welsh Government, IDS Scotland, NI Government 9

7. Eye care and dentistry NHS glasses provided (UK) /49 2016 Proportion of population with no teeth 1968 2009 5.25 million 5.17 million* *vouchers 37% 6% Source: /49 data from National Archives; 2016 data from NHS Digital, ISD Scotland, StatsWales and HSC NI Source: Adult Dental Health Survey for, Wales and NI, 2009 10

How good is the NHS? Compared to 18 similar countries, the NHS gets a mixed scorecard Strengths Weaknesses It provides unusually good financial protection from the consequences of ill health The NHS does worse than the average in the treatment of 8 out of the 12 most common causes of death It is relatively efficient with lower than average admin costs and a high rate of generic prescribing It performs well in managing patients with some long-term conditions like diabetes and kidney diseases It has consistently higher rates of death for babies at birth and within a month It has lower levels of staff in all categories except midwives, and the lowest levels of CT and MRI scanners Source: Dayan M, Gardner T, Kelly E and Ward D (2018) How good is the NHS? Nuffield Trust. 11

Key events from history The beginning July 1946: The NHS Act is published July 5 th : The NHS comes into being April 1951: Charges introduced for glasses and dentistry Picture credits: Wikimedia Commons, Department of Health, IWM ((MOW) L 55651)

Key events from history Reviews and reforms December 1956: The Guillebaud Commission, asked by the Treasury to look into rising NHS costs, finds the system is sustainable October 1983: The Griffiths Report calls for the introduction of professional managers in the NHS June 1990: The NHS and Community Care Act introduces competition and the internal market, creating NHS Trusts Picture credits: Public Health Image Library, #8990, CDC/Barbara Jenkins, NIOSH, Wikimedia Commons, istockphoto #7184699.

Key events from history Reviews and reforms 1999: Powers over the Scottish and Welsh health services are devolved July 2000: The NHS Plan kicks off an era of big spending increases and a drive to cut waiting times April 2004: NHS Foundation Trusts introduced in, designed to be more autonomous Picture credits: World Economic Forum, Wikimedia Commons, Department of Health, Nuffield Trust

Key events from history Reviews and reforms March 2012: Andrew Lansley s Health and Social Care Act creates NHS and the current system of Clinical Commissioning Groups 2014: NHS publish the Five Year Forward View, outlining options for how local health communities can create new ways of organising and delivering patient care 2018: The Government pledges an additional 20bn for the NHS in over 5 years Picture credits: Nuffield Trust, No 10 Downing Street

If you would like to speak to one of our experts, please contact our press office on 020 7462 0555 or by emailing press.office@nuffieldtrust.org.uk or one of our press team below: Leonora Merry: 020 7462 0555/ 07920 043 709 / leonora.merry@nuffieldtrust.org.uk Kirsty Ridyard: 020 7462 0552/ 07780 475571 / kirsty.ridyard@nuffieldtrust.org.uk Mark Dayan: 020 7462 0538/ 07920 043844 / mark.dayan@nuffieldtrust.org.uk Fiona Johnson: 07825 510527 / fiona.johnson@nuffieldtrust.org.uk