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Sean Boyle, Senior Research Fellow at LSE, reflects on what the English health reforms mean for the NHS and outlines the key findings from the European Observatory of Health Systems and Policies' health profile for England.
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The English health system
Author:
Seán Boyle
LSE
Location:
The King’s Fund
23 March 2011
Outline
• The structure of the report
• Some thoughts on the health system–Improvements in access–More spent and more staff–Why has productivity not improved?–Some quality improvement–Health improvement
The report (1)
• Geographic, economic and political context
• Health status• Organisational structure • Financing• Regulation and planning• Physical and human resources • Provision of services
The report (2)
• Public health • Primary care• Secondary and tertiary care • Emergency care• Pharmaceutical care• Intermediate care and rehabilitation • Long-term care• Services for informal or unpaid carers• Palliative care• Mental health• Dental care• Complementary and alternative medicine
The report (3)
• Principal health care reforms
• Assessment of health system–Access–Equity–Efficiency–Quality–Health improvement
Access (numbers waiting)
Access (median waiting times)
Access (referral to treatment within 18 weeks)
Increase in staff 1996 – 2009
Average annual change in staff numbers (1996 – 2009)
Change in mean earnings (2000 – 2009)
Comparison of changes in mean earnings (2000 and 2009)
Meanearnings
2000
Mean earnings
2009
Total %change
Between2000
and 2009
mean annual
% change
Consultants 71,900 120,900 68% 5.9%
Doctors in training & equivalent 35,000 51,800 48% 4.5%
Managers 35,700 47,900 34% 4.3%
Nurses and midwives 22,600 30,700 36% 3.5%
Maintenance and works 19,600 27,300 39% 3.8%
Admin & clerical 14,000 22,100 58% 5.2%
Healthcare assistants 12,400 18,700 51% 6.0%
Public sector 17,000 25,300 49% 4.5%
Private sector 19,800 27,500 39% 3.7%
Productivity (1)
Productivity (2)
Improvements in quality (deaths per 100,000 hospital spells)
0
5,000
10,000
15,000
20,000
25,000
30,000
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Stroke
Hip fracture
Improvements in quality (change in death rate)
Mortality amenable to health care (absolute levels)
Mortality amenable to health care – % change between 1997/98 and 2002/03
-30
-25
-20
-15
-10
-5
0
5
10
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y
Fra
nce
Can
ada
Gre
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Japa
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Spa
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Den
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Mortality amenable to health care (absolute levels)
Mortality amenable to health care – % change between 1997/98 and 2007
Gay, J. G. et al. (2011), “Mortality Amenable to Health Care in 31 OECD Countries: Estimates andMethodological Issues”, OECD Health Working Papers, No. 55, OECD Publishing
What is the reason Ireland does so well?
What is the reason Ireland does so well?
