Noticeable variations in health outcomes, spending, staffing and quality exist around the UK, according to a report published today by the National Audit Office (NAO).
Healthcare across the UK: A comparison of the NHS in England, Scotland, Wales and Northern Ireland analysed the key trends and differences in the NHS between the four countries in the UK.
Since 1999, responsibility for health services has been devolved to the administrations in Scotland, Wales and Northern Ireland.
The NAO analysis found that GPs in England have an average taxable income of £109,400 compared with just £89,500 in Scotland. GPs in Wales receive an average income of £93,500 and in Northern Ireland it is £91,400.
The NAO said some of the variations in pay could be due to the higher funding received by practices with, for instance: larger patient registers (Scotland has the fewest patients per GP); higher external cost pressures arising from local employment conditions; and contracts for providing additional services.
Scotland has the most GPs per person – 80 per 100,000 people in 2009 compared with 70 in England and 65 per 100,000 in both Wales and Northern Ireland – while Scotland also has the most medical hospital staff and nursing, midwifery and health visiting staff per person.
The report says that there is a lack of routinely collected comparable data on the number of patients seen by GPs, but from a 2009 survey, GPs in Wales were estimated to see more patients per week (137) on average than their counterparts in the other nations, with GPs in Scotland seeing the fewest (112).
By analyzing data from the Quality and Outcomes Framework to assess aspects of the quality of primary care provided in four disease areas – coronary heart disease, stroke, hypertension, and diabetes – the report’s authors found that GP practices in Scotland and Northern Ireland generally scored better in 2010-11 than those in England and Wales.
A significant difference was found between the counties on life expectancy, which is lowest in Scotland (75.9 years for men and 80.4 for women) and highest in England (78.6 for men and 82.6 for women).
Spending on health services per person varies and in 2010-11, England spent the least on health per person (£1,900), compared with £2,106 in Northern Ireland, £2,017 in Wales and £2,072 in Scotland.
The authors said that because easily comparable data on the efficiency and quality of healthcare were not so clear, they would not say which of the four countries provided best value for money.
Amyas Morse, head of the National Audit Office, said: “We publish this report at a time when the NHS across the UK is under increasing pressure to use resources more efficiently. Funding is tighter while the demand for healthcare continues to grow as a result of an ageing population and advances in drugs and technology.
“We consider that there would be value in the health departments in the four nations carrying out further work to investigate the variations in performance and identify how they can learn from each other to achieve better value for money for taxpayers and better care for patients.”