New HiT Report on England

The new Health System in Transition (HiT) report on England provides a detailed analysis of the changes made to the health care system in England between 1997 and 2010. The report’s author assesses the impact that these changes have had in terms of access, equity, efficiency, quality and health outcomes. Between 1997 and 2008 health expenditure in cash terms more than doubled from £55.1 billion to £125.4 billion. Expenditure on health care per capita increased from £231 in 1980 to £1,852 in 2008. This spending was accompanied by a continuous and comprehensive programme of transformation of the National Health Service (NHS). Expansion of the NHS workforce has been a key focus of government policy since 2000. Thus, there are now over 50,000 more doctors, including 10,000 more GPs, and almost 100,000 more nurses and midwives. Moreover, waiting lists have halved and people wait less time for treatment. However, NHS productivity did not increase over this period, mainly due to the absorption of resources by more staff, pay rises, increased capital costs and increases in costs associated with improvements in care through, for example, the implementation of National Service Frameworks and NICE recommendations. Reducing health inequalities was another key target, but despite various policies introduced to meet that target, the position has worsened, even though the health of the population overall has improved.