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14-07-2011 | General practice | Article

Health spend ‘could be afforded’


BMJ 2011; 343: d4321

A leading health economist has challenged the government's line that health spending will become unaffordable in England if the NHS is not reformed.

Much of the debate over the Health and Social Care Bill has centred on the need to make efficiency savings, with the government arguing that the health spend will become unaffordable in 20 years' time if it continues to rise at current rates.

This argument appears to have some sympathy within the medical profession; a recent snapshot poll on univadis found just over half (57%) of respondents agreed that the NHS is no longer affordable.

Yet a debate on rationing at the BMA's last Local Medical Committees annual conference reflected an alternative view, with GP representatives rejecting a specific part of a motion stating that the NHS is in its current form is "unaffordable".

Now, in a data briefing in this week's BMJ, King's Fund chief economist Professor John Appleby addresses Health Secretary Andrew Lansley's recent claim that a projected doubling of real-terms spending on health, to £230 billion by 2030, is unaffordable.

If the UK economy grows by 2.5% per year as forecast, £230 billion will represent 10.9% of England's gross domestic product (GDP), Professor Appleby reasons.

"This is certainly more than is currently spent - 2.4% of GDP more - but is it 'unaffordable'?", he asks.

Adding private spending would mean the total health spend would be 12.4% of GDP in 2030, Appleby notes. Other European Union countries currently already devote more than 10% of GDP on healthcare.

"Spending on health will be a matter of choice, not affordability," Appleby continues. "The real question to ask about health spending is what we think we might get in return as a result of forgoing the benefits of spending increasing amounts of our wealth on other things."

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Caroline Price