Intended for healthcare professionals

Education And Debate

“Getting UK health care expenditure up to the European Union mean”—what does that mean?

BMJ 2000; 320 doi: (Published 04 March 2000) Cite this as: BMJ 2000;320:640
  1. Adrian Towse (, director,
  2. Jon Sussex, associate director
  1. Office of Health Economics, 12 Whitehall, London SW1A 2DY
  1. Correspondence to: A Towse

    Tony Blair's statement that the United Kingdom should increase the share of gross domestic product (GDP) that it spends on health care to the average of the European Union (EU)1 raises several questions. Firstly, will the proposed increases in NHS spending of 5% in real terms (after accounting for inflation) each year to 2006 raise the UK figure from the 6.7% of GDP spent in 1998 to the 8% that the prime minister identified as the EU average? Secondly, is 8% the current EU average, and will it still be in 2006, seeing that the average is a moving target dependent on health spending and economic growth in the 15 countries of the EU? Thirdly, is this a sensible target to aim for?2

    Summary points

    The prime minister intends NHS spending to rise in real terms (after adjusting for inflation) by 5% a year to achieve 8% of gross domestic product (GDP) being spent on health care by 2006

    Achieving this target would require 5.8% real growth in NHS spending every year, assuming that private healthcare spending rises in line with

    The 8% target understates the average proportion of GDP that is spent on health care in the European Union (EU) outside the United Kingdom, which is 9.1%: hence a real annual increase of 7.7-8.7% in NHS resources is required to match EU levels

    Nursing home care is not included in the UK figures for health expenditure but is included in the figures of some EU countries

    Although international comparisons are fraught with difficulty, it is reasonable to set a spending target in terms of share of GDP achieved in the rest of the EU


    Spending plans for the NHS for the three budget years from 1999-2000 to 2001-2 were announced in the comprehensive spending review.3 A revised estimate …

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