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UK pays more for less in healthcare

Review doctors’ and nurses’ pay in bid for greater efficiency, suggests OECD

Caroline White

Tuesday, 30 November 2010

The UK countries are among those with most to gain from more efficient healthcare, reveals an analysis of cash-strapped health economies in OECD member states.

The report highlights doctors’ and nurses’ pay as one of the target areas of action.

The Organisation for Economic Cooperation and Development report, which is based on data gathered from 29 OECD countries, says that greater efficiency is the only option if countries are to maintain the strides made in improved health outcomes while dealing with the knotty problem of rising costs and demand against a backdrop of squeezed public finances.

It shows that health spending has grown by more than 70% per head in real terms since the early1990s, prompting life expectancy to increase by one year every four years and rises in survival rates from serious disease.

Australia, Japan, Korea, Switzerland and Iceland get the best health outcomes for money spent, says the report. Denmark, Greece, Hungary, the Slovak Republic and the United States have the widest margin for improving health outcomes without increasing spending.

Exploiting efficiency gains would allow countries to continue improving the quality of care while containing costs, claims the report, singling out savings of more than 3% of GDP by 2017 for the UK, Greece, and Ireland if best practice were to be adopted.

If all countries were to become as efficient as the best performers, life expectancy at birth could be raised by more than two years on average across the OECD area, without any additional funds, says the report. On the other hand, a 10% increase in health care spending would only increase life expectancy by three to four months, if the extent of inefficiencies is allowed to continue, it says.

The UK gets mixed scores on the efficiency of its acute care, quality of outpatient and preventive care, compared with other countries with similar healthcare systems, including Hungary, Ireland, Italy, New Zealand, Norway and Poland.

It has fewer acute care beds and less hi-tech equipment, and fewer consultations per head of the population than other counties. Despite its high degree of priority setting, it is very inconsistent in the way in which responsibilities for meeting them are assigned, the report notes.

Clinical health outcomes are also mixed. The UK has one of the lowest avoidable admission rates for congestive heart failure, but among the highest rates for asthma and COPD, and its vaccination rates for measles are among the lowest of the 29 OECD countries.

And despite an average per capita spend on healthcare, the UK pays some of the highest salaries to doctors of all the OECD countries and employs fewer of them per head of the population.

“Adjusting the relative income level of health practitioners may be warranted. These are particularly high in the UK,” says the report.

“Health care is now one of the largest government spending items, representing on average 15% of government spending across the OECD, and costs are still rising,” comments OECD Secretary-General Angel Gurria. “The economic and financial crisis has weighed heavily on public finances, reinforcing the need to improve health care efficiency.”

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