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NHS: Expenditure

Volume 712: debated on Thursday 16 July 2009

Question

Asked by

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). [HL4961]

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