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Tuesday, 18 January, 2000, 17:20 GMT
The health gap - Britain and Europe

The government has promised billions more for the health service

The Prime Minister has pledged to drag the UK up the European league when it comes to healthcare - but is it a realistic aim?

One of the accusations made by eminent doctor Professor Robert Winston in his controversial attack on Labour's health policy was that health spend in the UK was less than that in Poland.

The European league: health spending as a % of GDP
Germany - 10.71
France - 9.61
Sweden - 8.63
Greece - 8.60
Netherlands - 8.54
Austria - 8.25
Denmark - 8.00
Portugal - 7.88
Belgium - 7.61
Italy - 7.59
Spain - 7.40
UK - 6.81
Ireland - 6.33
In fact the UK shades it on this score, but the point only served to illustrate an apparent gulf between our health systems and those in other more developed European countries.

On average, according to previous figures, the percentage of Gross Domestic Product spent on health in Europe is 8%. In the UK it is reckoned to be 6.8%.

And the average only tells half the story -countries generally considered to be economic matches for the UK, such as Germany, and France, spend 10.7% and 9.7% respectively.

Tony Blair promised in an interview to match the average within five years - a promise which, under the current set-up, carries a bill of 11.4bn extra into the annual budget by 2005.

That is an increase of more than 20%, and threatens either tax rises, or cuts in other ministries, regardless of the continuing success of the economy.

Statistical flaws

In addition, fresh analysis by health charity the Kings Fund suggest that the average is even higher than previous thought - meaning many more billions would have to be spent to reach it.

The Conservatives want more private healthcare
However, many people argue that it is unfair to compare percentage of GDP spent on healthcare, as health systems vary widely from country to country.

A higher reliance on private insurance or patient charges can have a marked impact on the percentage of GDP spent on healthcare.

And the Kings Fund believes that Germany and France may not be getting full value for money for the extra billions they spend.

It points to the example of the US - in which a massive 14% of GDP is spent on health, claiming it certainly does not see a health system which is "twice as good" as that in the UK.

So the Kings Fund says that the government should not be obsessed by reaching the magic 8% mark, as the statistic is fatally skewed by differences in systems.

A spokesman said: "We think that the health system in this country are quite efficient compared to some other countries in Europe.

"There is an argument to say that it has gone slightly too lean, but the more you put money into the private sector, the more inefficient your health care system becomes.

"This is because you can't plan resource allocation according to need."

Higher death rates

There is little doubt that the UK lags behind many other European countries in terms of death rates from cancer and heart disease.

The deficit is the focus of ambitious public health targets set by the government last year.

The government has also acknowledged that substantial investment is needed in equipment such as scanners to improve survival rates.

But there is an argument that pumping too much money into healthcare could be counter-productive.

If too much money has to be taken from other budgets, such as welfare, then the health of certain sections of society could be adversely affected - wrecking any chance of reaching the targets.

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See also:
18 Jan 00 |  Health
Health gap 'even bigger than thought'
17 Jan 00 |  Health
Q & A: Extra money for the NHS

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