Abstract
Abstract
This analysis of the United Kingdom health system reviews recent
developments in organization and governance, health financing, health
care provision, health reforms and health system performance. It provides
an overview of how the national health services operate in the four nations that
make up the United Kingdom, as responsibility for organizing health financing
and services was devolved from 1997.
With devolution, the health systems in the United Kingdom have diverged in
the details of how services are organized and paid for, but all have maintained
national health services which provide universal access to a comprehensive
package of services that are mostly free at the point of use. These health
services are predominantly financed from general taxation and 83.5% of total
health expenditure in the United Kingdom came from public sources in 2013.
Life expectancy has increased steadily across the United Kingdom, but
health inequalities have proved stubbornly resistant to improvement, and the gap
between the most deprived and the most privileged continues to widen, rather
than close. The United Kingdom faces challenges going forward, including how
to cope with the needs of an ageing population, how to manage populations with
poor health behaviours and associated chronic conditions, how to meet patient
expectations of access to the latest available medicines and technologies, and
how to adapt a system that has limited resources to expand its workforce and
infrastructural capacity so it can rise to these challenges.