NHS: Expenditure

House of Lords written question – answered on 16th July 2009.

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Photo of Lord Warner Lord Warner Labour

To ask Her Majesty's Government what was the expenditure on the National Health Service in each financial year from 1988—89 to 2007—08 at 1996—97 prices; how many completed hospital consultant episodes there were in each of those years; and what were the percentage NHS productivity changes in each of those years as calculated by the Office for National Statistics (or its predecessors).

Photo of Lord Darzi of Denham Lord Darzi of Denham Parliamentary Under-Secretary, Department of Health, Parliamentary Under-Secretary (Department of Health)

Where possible, the requested data are given in tables 1, 2 and 3. Care should be taken in comparing data across time periods. As noted in footnotes, definitional changes make direct comparisons of data problematic.

Table 1: National Health Service (NHS) Expenditure England (1988-89 to 2007-08)
Year Net NHS Expenditure (4) £ billion Net NHS Expenditure (in 1996-97 Prices)£ billion
Cash(1)
1988-89 Outturn 18.420 25.878
1989-90 Outturn 19.855 26.039
1990-91 Outturn 22.326 27.141
1991-92 Outturn 25.353 29.098
1992-93 Outturn 27.968 31.139
1993-94 Outturn 28.942 31.364
1994-95 Outturn 30.590 32.639
1995-96 Outturn 31.985 33.168
1996-97 Outturn 32.997 32.997
1997-98 Outturn 34.664 33.777
1998-99 Outturn 36.608 34.929
1999-00 Outturn 39.881 37.318
Resource Budgeting Stage 1(2)
1999-00 Outturn 40.201 37.617
2000-01 Outturn 43.932 40.576
2001-02 Outturn 49.021 44.289
2002-03 Outturn 54.042 47.301
Resource Budgeting Stage 2(3)(5)
2003-04 Outturn 64.173 54.612
2004-05 Outturn 69.051 57.207
2005-06 Outturn 75.822 61.556
2006-07 Outturn 80.561 63.661
2007-08 Outturn 89.261 68.624

Notes:

1. Expenditure pre 1999-2000 is on a cash basis.

2. Expenditure figures from 1999-2000 to 2002-03 are on a Stage 1 Resource Budgeting basis.

3. Expenditure figures from 2003-04 to 2010-11 are on a Stage 2 Resource Budgeting basis.

4. Figures are not consistent over the period (1988-89 to 2007-08), therefore it is difficult to make comparisons across different periods.

5. Figures from 2003-04 include a technical adjustment for trust depreciation.

6. Expenditure excludes NHS Annually Managed Expenditure (AME)

7. Gross Domestic Product (GDP) deflator 23 April 2009.

8. Total Expenditure is calculated as the sum of revenue and capital expenditure net of non-trust depreciation and impairments. This is in line with HM Treasury Guidance.

Table 2: Count of Finished Consultant Episodes in each Data Year from 1989-90 to 2007-08 (Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector)
Data Year Finished Consultant Episodes
1989-90 8,416,673
1990-91 8,898,744
1991-92 9,091,323
1992-93 9,614,508
1993-94 10,097,884
1994-95 10,313,379
1995-96 10,923,489
1996-97 11,072,003
1997-98 11,532,895
1998-99 11,983,893
1999-2000 12,196,270
2000-01 12,264,676
2001-02 12,337,724
2002-03 12,712,153
2003-04 13, 295,166
2004-05 13,706,450
2005-06 14,423,506
2006-07 14,784,581
2007-08 15,359,062

Source:

Hospital Episode Statistics (HES), The NHS Information Centre for health and social care.

Notes:

1. Inpatients are defined as patients who are admitted to hospital and occupy a bed, including both admissions where an overnight stay is planned and day cases.

2. Assessing growth through time: HES figures are available from 1989-90 onwards. The quality and coverage of the data have improved over time. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. Some of the increase in figures for later years (particularly 2006-07 onwards) may be due to the improvement in the coverage of independent sector activity. Changes in NHS practice also need to be borne in mind when analysing time series. For example, a number of procedures may now be undertaken in outpatient settings and may no longer be accounted for in the HES data. This may account for any reductions in activity over time.

3. Data quality: Hospital Episode Statistics (HES) are compiled from data sent by more than 300 NHS trusts and primary care trusts (PCTs) in England. Data are also received from a number of independent sector organisations for activity commissioned by the English NHS. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain.

4. A finished consultant episode (FCE) is defined as a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which they end. Please note that the figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.

Table 3: United Kingdom Health Care Productivity (Index 1995 = 100)
Year Index % Change
1995 100.0
1996 99.9 -0.1
1997 99.3 -0.6
1998 98.3 -1.0
1999 98.3 0.0
2000 97.2 -1.1
2001 98.4 1.2
2002 95.5 -2.9
2003 94.0 -1.6
2004 93.8 -0.2
2005 93.2 -0.6
2006 93.9 0.7
2007 95.0 1.2

Source:

Office for National Statistics (ONS).

Notes:

1. Source 1995 to 1997: Article ONS Public Service Productivity January 2008

2. Source 1997 to 2007: Article ONS Total Public Service Output and Productivity June 2009

3. No published figures are available for the years prior to 1995. In analyses prior to this period

ONS assume output = input

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