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Funding and performance of healthcare systems in the four countries of the UK before and after devolution

Connolly, Sheelah, Bevan, Gwyn and Mays, Nicholas (2011) Funding and performance of healthcare systems in the four countries of the UK before and after devolution. . The Nuffield Trust, London, UK. ISBN 9781905030408

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Abstract

Political devolution means there are now four National Health Services in the United Kingdom. The health services of England, Scotland, Wales and Northern Ireland are all funded by the UK taxpayer, but have developed different systems of governance and different methods of providing health care. Funding and performance of healthcare systems in the four countries of the UK before and after devolution examines the impact of devolution in the four countries by studying a number of key performance indicators such as expenditure, staffing levels and waiting times, at three key points – 1996/7, 2002/3 and 2006/7. This is the first time such an analysis has been conducted. Broadly, the report finds striking differences in performance with some UK countries spending more on health care and employing greater numbers of health staff but performing worse in key areas. This report provides a comprehensive comparative study of NHS performance across the four health services of the UK. The analysis confirms that, historically, Scotland, Wales and Northern Ireland have had higher levels of funding per capita for NHS care than England. The research suggests the NHS in England spends less on health care and has fewer doctors, nurses and managers per head of population than the health services in the devolved countries, but that it is making better use of the resources it has in terms of delivering higher levels of activity, crude productivity of its staff, and lower waiting times. Some of these differences and trends may be because of historic differences in funding levels, which are not directly related to policy differences following devolution. But some will reflect the different policies pursued by each of the four nations since 1999, in particular the use in England of targets, strong performance management, public reporting of performance by regulators, and financial incentives.

Item Type: Monograph (Report)
Official URL: http://www.nuffieldtrust.org.uk/
Additional Information: © 2010, 2011 The Nuffield Trust
Divisions: Management
Subjects: H Social Sciences > HJ Public Finance
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
J Political Science > JN Political institutions (Europe) > JN101 Great Britain
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Sets: Departments > Management
Date Deposited: 21 Nov 2014 10:01
Last Modified: 27 Jun 2020 23:14
Projects: Quality of care, UK & international comparisons
Funders: The Nuffield Trust, Health Research Board, Dublin (Health Services Fellowship)
URI: http://eprints.lse.ac.uk/id/eprint/60209

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