Intended for healthcare professionals


Doctor-population ratio grows in UK but is still short of that in France and Germany

BMJ 2008; 336 doi: (Published 14 February 2008) Cite this as: BMJ 2008;336:353
  1. Susan Mayor
  1. 1London

    The number of doctors in the United Kingdom grew more quickly than in other European countries in the first five years of this century, but the ratio of doctors to the population still remains lower than in many of them.

    The ratio rose from two doctors per 1000 people in 2000-1 to 2.4 in 2005-6, but it was still only two thirds the ratio in France, Germany, or Italy.

    The figures, published by the Office of Health Economics, also show that the total number of inpatients and patients treated as day cases in NHS hospitals in the UK grew by more than 15% in the same five years. The number was 17.1 million in 2005-6, 15% higher than in 2000-1.

    These figures were measured as finished consultant episodes or discharges (periods of care spent under one consultant in one NHS trust) in England and as hospital discharges and deaths in Wales, Scotland, and Northern Ireland. More than four fifths (81%) of hospital inpatient admissions in Great Britain were for acute medicine or surgery.

    The ratio of finished consultant episodes, hospital discharges, and deaths per hospital bed continued to rise each year, reaching 76 per bed in 2005-6, a figure 10 times that of 50 years earlier.

    The number of available beds in acute NHS hospitals has changed little for more than a decade and remains low by international standards at 2.2 beds per 1000 people in Great Britain.

    The higher number of patients treated per hospital bed was accounted for by a continuing decrease in the average length of hospital stay in all specialties apart from mental illness and learning disabilities. The average stay was 4.4 days in 2005-6.

    The total number of outpatient attendances at NHS hospitals grew to more than 81 million in 2005-6, an increase of 20% over the past 10 years. Most of this increase was due to growth in the number of new outpatient cases (first attendances), which rose by 35% over the five years.

    The number of NHS hospital and community health staff rose by 23% from 2000-1 to 2005-6, to more than 1.2 million, the highest ever number. The greatest increase was in non-medical, non-nursing, professional, and technical areas, followed by administrative and clerical staff.

    Mortality data show that circulatory diseases remain the most common cause of death in the UK, accounting for almost 36% of all deaths in 2005. The UK has higher death rates from coronary heart disease and breast cancer than most EU countries, and Scotland also has relatively high mortality from lung cancer and stroke.

    For the first time the birth rate among women in their early 30s had overtaken that among women in their late 20s. The number of live births in 2006 was 748 591, increasing from an all time low in 2002. Figures for 2005-6 show that 24% of deliveries in England and Wales were by caesarean section, and almost one in seven were by emergency caesarean.

    Emma Hawe, head of statistics at the Office of Health Economics, said that the increase in the percentage of caesarean sections did not seem to be due to mothers’ choice. Possible reasons for the increase may include more older women giving birth, as the likelihood of needing a caesarean delivery increases with age, and an increase in the risk of fetal distress, which may be associated with a higher prevalence of obesity in women, she said.


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