The NHS is, once again, a central plank of pre-election debate and given the public’s views on the future of the NHS , waiting times and staffing numbers are being rightly scrutinised. Less attention, however, is being paid to the hidden health agenda of out-of-pocket spending. Along with Anita Charlesworth from the Health Foundation think tank, we’ve been looking at the reasons why this has been increasing recently .
Out-of-pocket spending is not covered by private medical insurance or the NHS. It is dominated by people paying out for their long-term care but also includes diagnostic tests, inpatient care (such as cataracts) and outpatient care (such as physiotherapy), and medical goods, including over-the-counter pharmaceuticals. Dentistry is also an increasingly important area of spending.
A growing proportion of UK health spending has been classified as out-of-pocket. In 2021, it accounted for 12.7% of UK health spending, but this has varied over time.
In 1997, for example, it comprised of 18% of UK health spending, falling to a low of 11% in 2006 before growing again to 16% in 2019. During COVID-19 this percentage fell again but it is now increasing, reaching 13.9% in 2022 .
Out-of-pocket spending is now equivalent to 1.4% of the UK’s GDP. By international comparisons, the UK ranks just below the EU14 and quite far below the EU27 average.
In the UK, the current scale of self-funding reflects a combination of five factors: 1. NHS crisis . Waiting lists and times hav.
