The Health Foundation: International comparisons of capital in health care: why is the UK falling behind?
Joshua Kraindler & Ben Gershlick
This analysis suggests that the UK is investing significantly less in health care capital as a share of GDP compared with most other similar European countries. As a result, the total value of capital in health care in the UK has fallen.
Key Points:
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The UK spends significantly less on health care capital – which includes buildings, machinery, equipment and IT – as a share of GDP than most other comparable countries.
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As a result of low capital spending, from 2000 to 2017 the total value of health care capital in the UK has fallen by 3% in real terms. Over this period, most other countries have seen significant increases in the value of their health care capital driven by higher spending.
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In the UK, the value of capital per health worker – which provides an estimate of the resources available to staff to deliver care to patients – has fallen by 35% since 2000. Many other countries have seen significant and consistent rises in capital per worker over this period. Of the countries analysed, the UK has the second lowest value of health care capital per health care worker (at just over half the average).
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The value of machinery and equipment per health care worker in the UK is the lowest of all countries analysed and continues to fall – countries such as Austria and Denmark have more than five times the value per worker.
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The data raise questions about why the UK is lagging so far behind other countries and concerns about what the implications might be for staff and patients. This reinforces our view that there is a clear need for a long-term capital settlement for the NHS in England – including a substantial funding increase – to address problems such as ageing estates and infrastructure, and to invest in new medical technology in the future.
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Despite government announcements of new funding, we estimate an extra £2.5bn would be required in 2019/20 to bring capital spending in England up to the average of comparable countries.