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Growing risk UK public will need to self-fund healthcare, King’s Fund suggests

Growing risk UK public will need to self-fund healthcare, King’s Fund suggests
By Jess Hacker
26 June 2023

People in the UK with less disposable income may be forced to choose between self-funding their healthcare or enduring longer waits for treatment, The King’s Fund has said.

On the whole, the UK population has ‘relatively good protection’ from the potentially catastrophic costs of ill health, it said.

But, the think tank warned, there is ‘growing concern’ that significant waiting lists for hospital care are ‘leading to a situation whereby people are having to choose between self-funding their care or enduring longer waits for NHS treatment’.

In a major report comparing the NHS’ performance against its international peers (26 June), The King’s Fund highlighted that the UK health system ‘offers a relatively high degree of financial protection’ for people who need to use its services.

‘But this safety net is worryingly threadbare in some areas. Financial protection wanes significantly for some services, such as dental care (and adult social care), where people may face the choice of either high financial costs to access care or the substantial health consequences of forgoing the care they need,’ it said.

Researchers pointed to the fact that people on lower incomes in the UK are more likely to report missing medical and dental appointments and to have ‘difficulty paying medical bills’.

This was similar across Europe with unmet needs for dental care ranking higher than for other types of medical care, with people on lower incomes particularly affected by poor access to services.

Overall, The King’s Fund found that the NHS is performing ‘substantially less well’ than its 19 international peers assessed and is lagging more than it is leading, a major new report has found.

It indicated that it performs worse on many measures, including those health outcomes that can be ‘heavily affected’ by the actions of a health system – such as cancer survival – and on life expectancy, which is significantly affected by factors beyond the NHS’ direct control.

It found that:

  • The UK had among the lowest levels of life expectancy for men and women, sitting at 36th place in 2020, just above countries that include the Maldives, Chile and Costa Rica
  • The UK has 2.5 hospital beds per 1,000 people, placing it second last given the average is 3.2
  • The UK spends only 1.9% of its health spending on administration, the lowest out of all six countries measured.

Siva Anandaciva, chief analyst at The King’s Fund, said: ‘Some may speculate that adopting an alternative funding model for the NHS would resolve these challenges. But we found little evidence that any one country’s model of health funding and delivery is inherently better than another.

‘Equally, this is not an excuse to accept the current state of the UK health service. Working to improve our existing health system while providing it with the adequate resources, political support and long-term planning it desperately needs would give the NHS the best chance of delivering the timely, high-quality care and outcomes it is capable of.’

Responding to the report, Miriam Deakin, director of policy and strategy at NHS Providers, said: ‘It’s very worrying that after a decade of underinvestment, severe staff shortages and insufficient capacity to meet increasing demand that our overstretched NHS isn’t top of the international league table when it comes to certain performance indicators and outcomes.

‘This telling report shows us why. Less is spent on healthcare per person here than in many other countries and we have fewer doctors and nurses per head than most similar nations.’

She added: ‘These findings back our call for more investment to improve NHS performance, capital funding to upgrade buildings and the publication of the government’s long-awaited NHS workforce plan to boost staff numbers.’

A Health Foundation report also published today suggested that the NHS is ‘in effect rationing care’ by admitting fewer patients.

Former chancellor George Osborne also said he ‘completely rejects’ the claim that austerity policies weakened the UK’s health and social care capacity.

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