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Performance of UK National Health Service compared with other high income countries: observational study

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6326 (Published 27 November 2019) Cite this as: BMJ 2019;367:l6326

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Re: Performance of UK National Health Service compared with other high income countries: observational study

Dear Editor

Reading into this issue further, I realise that a couple of my statistics are wrong: Since 1998 UK health spending (not NHS spending) has increased from about 6% GNP to over 9%, and 22% (not 27%) of UK healthcare spending is "private".

My point that we don't know where this extra money is spent remains. I doubt it has been spent on more staff or hospital beds. Who can explain?

Competing interests: No competing interests

10 December 2019
Keith Dudleston
Retired Psychiatrist
Devon, England

Re: Performance of UK National Health Service compared with other high income countries: observational study

Dear Editor

"The data presented in this paper are purely descriptive, and the interpretation of the results is sensitive to the selection of comparator countries." - True. A different selection might have produced a very different conclusion.

Please also note: "Data for the UK represent the NHS and not the privately financed healthcare sector." Using the OECD definition of healthcare, we see that about 27% of UK healthcare is "private". BMJ 2019;365:l1619]

What we should understand is that since 1998 NHS spending has increased from about 6% GNP to about 9%. A considerable increase. Yet we still have fewer doctors (2.8), nurses (7.8), hospital beds (2.5), than most OECD countries. (Rates are /1000 population)

Many staff are demoralised and burnt out because of their high workload, and many hospitals are in crisis.

Your researchers should explain how this disaster has been allowed to happen.

Competing interests: No competing interests

09 December 2019
Dudleston Keith
Retired Consultant Psychiatrist
Devon, England
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