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Feature Data Briefing

What does the UK spend on health and social care?

BMJ 2019; 365 doi: (Published 09 April 2019) Cite this as: BMJ 2019;365:l1619
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What does the UK spend on health and social care?

  1. John Appleby, director of research and chief economist
  1. Nuffield Trust, London, UK
  1. john.appleby{at}

Care is the second biggest sector of the UK economy, and new accounting practices tell us more about the £208bn is spent, finds John Appleby

The Organisation for Economic Co-operation and Development’s 2011 system of health accounts, revised in 2017, is a Herculean effort to try to impose some international order on the way member countries report their spending on health and care.1 Although it is impossible to obtain completely comparable data across countries, given differences in funding systems and organisation, the new accounts now drill down to reveal more information about what countries spend their money on.

The UK’s spending on health and social care (a grand total of nearly £208bn—including £5.3bn of capital spending) comes from two main sources, public (£157.6bn) and private (£44.9bn), and eventually flows through to various types of care: inpatient care, home based care, prevention, and medical goods, for example (fig 1).

Fig 1
Fig 1

Public and private spending on health and social care in the UK in 2016

These sorts of spending data alone cannot answer the sort of policy questions countries may grapple with: for example, are we spending too much or too little on secondary care versus preventive services? But as trends start to emerge from these new datasets, countries should be more able to supply data at more detailed levels of spending. And, importantly, as spending is linked to health outcomes, health and care services will be better able to assess the effectiveness of spending, given the allocative decisions they make.


  • Competing interests: I have read and understood BMJ’s policy on declaration of interests and have no relevant interests to declare.

  • Provenance and peer review: Commissioned; not externally peer reviewed.


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