ABSTRACT
Each of the professions represented in this book is faced with the challenge of educating professionals to work in the health and social care sector of a modern economically developed society – a highly complex task conducted in an ever-changing economic, social and political climate. In the UK, the annual spend on health care was £109 billion in 2006, some 8.3 per cent of gross domestic product (GDP); 1 actual expenditure on health care has been rising steadily since 2002. In 2006–07, £20.1 billion was spent by local authorities 2 on social care. Although the spend on social care has increased by 70 per cent in real terms since 1997, the total amount spent on social as opposed to health care is significantly less. Whether these levels of expenditure are sufficient, in total or in this particular ratio, to meet needs is a moot point, and indeed a political question. It is widely accepted that there is increasing demand for a range of services as our technological capabilities advance, some of which are very expensive to deliver; there is also a growing expectation that high-quality services can be provided as more ‘consumerist’ ageing cohorts in the population are less willing to accept levels of service provided to previous generations (the prime example being the ‘baby-boomer generation’ who are now entering the ranks of the retired). These tensions, singularly and cumulatively, increase the pressure on the government to provide more funding for health and social care provision and on the various professions included in this book to meet perceived levels of increasing need. There is no easy and straightforward approach to the determination, that commands universal acceptance, of what would be a reasonable level of funding on health and social care. However, a good indicator is the comparative amount spent by other similar countries. In this respect, the UK spent less than 8 per cent of GDP on health expenditure in 2001; 3 in the EU15 only Spain, Finland, Ireland and Luxembourg spent a smaller proportion of GDP. Irrespective of the absolute or comparative levels of expenditure there are a series of pressures that have a tendency to increase demand for health and social care. For example, in the EU15 in 2003, some 4 per cent of the population were over 80, traditionally heavy users of health and social care, and by 2018 this figure will have risen by 50 per cent (European Commission, 2003).
