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Low health spending left UK ‘vulnerable’ to Covid


By Jess Hacker
10 November 2021

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The UK spent significantly less on health per person in 2019 compared to other Western European countries, a new report has shown, which in turn left the country vulnerable to the Covid-19 pandemic.

The report, published by the Organisation for Economic Co-operation and Development (OECD), indicates that the UK spent around US$4,500 (£3,331.69) per capita in the year before the pandemic.

This compared to:

  • $5,274 (£3912.39) in France
  • $6,518 (£4835.22) in Germany
  • $7,138 (£5295.15) in the Netherlands
  • $10,948 (£8121.50) in the US.

However, the onset of the pandemic led to a ‘sharp increase’ in health spending, it found, with the average health spending to GDP ratio in the UK jumping from 10.2% in 2019 to 12.8% in 2020.

The authors noted there is a ‘clear positive association’ between health spending per capita and life expectancy, even when considering avoidable mortality.

It acknowledged, however, that the US stands as an outlier, with a ‘worse’ rate of avoidable death despite having spent more than the OECD average.

UK life expectancy and mental health worsening

The report also found that life expectancy in the UK reduced by one year during the pandemic, after stalling over the last decade.

One of the principal causes for the drop in life expectancy is rising levels of obesity and diabetes, it said.

However, more broadly, economic recessions and related austerity measures – such as those that followed the 2008 crisis – have been linked to deteriorating mental health and an increase in the number of deaths by suicide.

It warned that life expectancy should not be taken for granted, with better protection needed to prevent it from falling, particularly among older and at-risk groups.

Similarly, it found that prevalence of depression in the UK more than doubled during the pandemic, rising to 19% in 2020 and climbing to 21% in 2021.

Prevalence of anxiety or symptoms of anxiety rose from just over 20% to 50% as of 2020.

NHS entered pandemic in ‘vulnerable’ position

Responding to the report, Dr Jennifer Dixon, chief executive for the Health Foundation, said the UK entered the pandemic ‘in a vulnerable position’, both in terms of systemic weaknesses in the health care system and ‘poor’ underlying population health.

Commenting on the UK’s ‘significantly’ lower health spending per capita, she said: ‘Underinvestment in the NHS over many years has resulted in fewer doctors, nurses, beds and scanners relative to our European neighbours.’

This reduced the health and social care system’s resilience when facing the pandemic, and will also impact how quickly the services can recover.

Currently, the UK’s backlog for care stands at 5.7 million people.

‘Prior to the pandemic, the UK had experienced stalling life expectancy over the last decade. Covid-19 has highlighted the extent of poor underlying health in the UK, which contributed to the higher excess deaths we have seen during the pandemic compared to the rest of Europe,’ Dr Dixon said.

‘The Government must now ensure that it puts the nation’s health at the heart of the pandemic recovery. It has promised to level up the country but levelling up health must be central to its plans.’

Veena Raleigh, senior fellow at The King’s Fund said: ‘However, while the impact of the pandemic is still playing out, so far the UK compares poorly with other advanced nations. Excess deaths in the United Kingdom from January 2020 to June 2021 were higher than in most West European and high-income countries, behind only Spain, Portugal, Italy and the United States.’

She added: ‘Although health spending rose sharply in response to the pandemic, historically spending in the UK on health care services, staffing and infrastructure has been lower than in many comparable countries. As a result, the NHS is further on the back foot than most advanced health systems in coping with the pandemic’s legacy, which includes an exhausted workforce, a large and growing backlog of care and widening health inequalities.’

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