NHS set to employ one in eight people by 2060

The NHS could be employing one person in eight by 2060 and spending almost a fifth of the UK's wealth on healthcare, according to a report by The King's Fund.

Professor John Appleby said spending on the NHS was now 2.5 times greater than in the 1960s
Professor John Appleby said spending on the NHS was now 2.5 times greater than in the 1960s

The think tank’s projection follows the trajectory of NHS spending over the past 50 years, which has resulted in the service currently employing one in 18 of the population.

Author Professor John Appleby, chief economist at The King's Fund, said public spending on the NHS was now 2.5 times greater than it was in the 1960s – amounting to 8.2% of GDP and equivalent to seven times more in real terms.

But he said it was up to future governments, and public debate, to decide whether NHS spending continued to rise at the same levels over the next 50 years.

‘Healthcare spending in the UK is a matter of government policy and, therefore, choice. There is no reason that spending will consume such large proportions of GDP in the future or that it should,' he said.

‘However, this raises the question of how much of the country’s national resources will and, more importantly, should be devoted to healthcare.’

Professor Appleby’s report, Spending on Health and Social Care Over the Next 50 Years, analyses the factors that influence the demand for services over the long term, and how these could be affected by decisions on levels of taxation, government borrowing and public spending priorities.

He suggests that although the UK population will rise by 31% from 62.3m in 2010 to 81.5m in 2060, and the proportion of people older than 60 years will increase from 23% in 2010 to 31%, demographic changes will not be the most significant factors.

He said: ‘The scale of this pressure will not be as important as either changes in national income or technology.’


Professor John Appleby speaking about the report (Video: King's Fund)

Professor Appleby argues that increases in GDP will mean that providing healthcare at this level will still be possible, if that is what society wants.

‘If projections hold true, over the next 50 years, national GDP will treble in real terms and, given the evidence on the choices we tend to make about what we spend extra money on, we are likely to choose healthcare.’

In terms of technology costs, 40% of the average annual real growth in health spending in the UK between 1970 and 2002 could be attributed to this factor, according to the Organisation for Economic Co-operation and Development (OECD).

This value, says Professor Abbleby, would double the spending on healthcare over 50 years.

He concludes: ‘The scale of spending increases over 50 years may not be as large as to threaten to be unsustainable in fiscal terms, but all the same suggest that choices will need to be made about whether and how to meet those increases.

‘All of this implies that there are important political and social choices to be made, not only about the aggregate of spending from the public purse, but also the types and volumes of services that should be provided and how they should be funded. If GDP growth continues to be sluggish over a prolonged period, then these choices will become much more difficult.’

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