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International comparisons expose the UK’s poor performance on health

BMJ 2023; 382 doi: (Published 14 July 2023) Cite this as: BMJ 2023;382:p1613
  1. Irene Papanicolas, professor of health services, policy, and practice
  1. Brown School of Public Health, Providence, Rhode Island, USA
  1. irene_papanicolas{at}

Report identifies striking lack of progress relative to peer countries

“You get what you pay for” most aptly summarises the UK’s position in recent international comparisons published by the King’s Fund.1 Compared with the health systems of 19 high income countries, the UK spends just below average per capita on health and is “neither a leader nor a laggard” in overall performance, but “more of a laggard than a leader on health outcomes.” As the authors note, these findings are not so different from a series of comparisons published around the time of the 70th birthday of the NHS, five years ago.23 This indicates a lack of progress at best, but given that international data often come with a lag, the full effects of the pandemic on the health system are also not fully reflected.

There are two areas where the UK is a laggard, and health outcomes is the most concerning. The UK performs worse not only in aggregated measures of population health such as life expectancy and mortality from avoidable causes but also in hospital deaths within …

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