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3. FinancingHealth services are mainly funded through general taxation, with theremainder coming from private medical insurance and out-of-pocketpayments. In the early 2000s the United Kingdom governmentcommitted to increasing health care spending as a share of GDP to a levelthat corresponded with the average of the EU members at that time. Healthexpenditure as a share of GDP grew from 6.9% in 2000 to 9.4% in 2010, whichwas similar to the EU average, but below the average for the EU-15 countries.The implementation of austerity measures in 2010 following the financial crisisof 2007–2008 has meant a cut in total health expenditure in real terms in 2010and 2011; in 2013 health spending accounted for 9.1% of GDP.Once administrations in Scotland, Wales and Northern Ireland and theDepartment of Health have their health care allocation, they distribute to theircommissioners (in England and Northern Ireland) or providers (in Scotlandand Wales), and to public health organizations, according to their own formulas,which all include some form of weighted capitation.Most services are provided free of charge at the point of use, but thereare some that can involve cost-sharing (like dental care and pharmaceuticals)or direct payments (like most social care). Only England has prescriptiondrug charges.Purchasing of health services varies between Scotland, Wales and NorthernIreland. In Northern Ireland the Health and Social Care Board negotiatescontracts with Health and Social Care trusts. Wales uses a capitation-basedfunding method, and local health boards manage the funds they use in deliveringservices. Boards and community health partnerships manage their own fundsin Scotland and use a capitation-based allocation system. NHS Employers was 42 Health systems in transition United Kingdomset up in 2004 and negotiates pay and conditions for NHS employees on aUnited Kingdom-wide basis, with some variations made in Scotland, Walesand Northern Ireland.
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