Brian Currie and Helen Puttick

Published on 20 Jan 2010

A damning report today says Scotland has the worst-performing health service in the UK despite being better funded than England, Wales and Northern Ireland.

It finds that while Scotland has the highest levels of poor health, the country has more hospital doctors, GPs, and nurses per head of population, but productivity is the worst and inpatient admissions are the lowest.

Today’s report by the Nuffield Trust is the first to compare Scotland’s health record since devolution with regions of England, as well as the four nations as a whole. Even areas with a similar socio-economic profile to Scotland appear to do more with less money.

In 2006, Scotland spent 6% more than the north-east of England but treated fewer patients in hospital, according to the report, which says staff in the north-east had “far higher levels of crude productivity”.

The authors question whether, instead of addressing entrenched health problems, the extra money spent in Scotland allows health service staff to do less work.

The study, using figures from 2006/07, tracked performance against expenditure, staffing levels, outpatient appointments, inpatient admissions and day cases, waiting times and staff productivity.

It found that less money was spent in England, it had fewer doctors, ­nurses and managers per head of population than the devolved countries but was making better use of resources.

Trust director Dr Jennifer Dixon said: “A key question for the NHS in all four countries, especially in the current economic climate, must be whether or not value for money is being obtained.”

The report said that health services across the UK had enjoyed “massive increases in funding” since devolution but Scotland “appears to perform less well than anywhere else on almost every measure examined”.

Read the rest of this Scottish healthcare article here

The Main findings from the Nuffield Trust are below

The main findings are:

• Historically Scotland, Wales and Northern Ireland have had higher levels of funding per capita for NHS care than England. However, the research suggests the NHS in England spends less and has fewer doctors, nurses and managers per head of population than the health services in the devolved countries, but that it is making better use of the resources it has in terms of delivering higher levels of activity, crude productivity of its staff and lower waiting times.
• Scotland has the highest levels of poor health, the highest rates of expenditure, the highest rates of hospital doctors, GPs and nurses per capita, and yet it has the lowest rates of crude productivity of its staff and the lowest rates of inpatient admissions per head of population in 2006/7.
• In 2006, Wales had the lowest rate of day cases but the highest rate of outpatient attendances, while Northern Ireland had the lowest rate of outpatient attendances but the highest rate of inpatient admissions and day cases.
• The performance of Wales and Northern Ireland in key measures of waiting has been poor compared with England (Scotland’s waiting times could not be compared with those of England, Wales and Northern Ireland at the three time points because they were measured in a different way). By 2006, virtually no patients in England waited more than three months for an outpatient appointment, whereas in Wales and Northern Ireland 44 per cent and 61 per cent of patients did. By 2006, virtually all patients in England who needed inpatient or day case treatment were seen within six months, while in Wales and Northern Ireland 79 per cent and 84 per cent of patients waited longer than this.

Read the full report from the Nuffield Trust