chapter  4
27 Pages

Expenditure and resource allocation policies in the NHS

However,theysoughttoimproveefficiencythroughinducing economybyalmostnilgrowth,strongmanagementandavariety ofcost-cuttingmeasures.Asaconsequence,the1980swere doggedbychargesofbothprofligacy(fromthegovernment) andparsimony(fromthoseprovidingcareandfromopposition parties).Evidencecanbefoundtosupportbothpositions.However,arecentstudybytheOECDcomparingsevencountries concludedthatalthoughtheUKspentlessofitsGDPthanmost othercountries,andlessthanwouldbeexpectedinacountry withtheUK'sstandardofliving'itneverthelesshadabetter healthrecordthanmightbeexpectedfromitsrelativelylow levelsofspendingandactivity'(OECD1992:119).Itranked secondforperinatalmortalityandthirdformalelifeexpectation. Document29(page345)providesfurthercomparativefigures. ThischapteraimstoconsiderthepressuresonNHSexpenditure, makecomparisonsbetweentheNHSandotherhealthsystems, andexaminethepatternsofexpenditureandactivityovertime andlookathowdifferentgovernmentshaveapproachedissues ofinternalallocationsandvalueformoney.