How much does the NHS cost?

How much does the NHS cost?

It is actually very hard to say, as it is surprisingly difficult to define the NHS.

For example, does it include all the 4 nations, as they have different NHSs. Does it include healthcare for the armed services? Does it include arms length bodies like NICE, HEE, CQC and UKHSA? What about public health (UKHSA)? It is not clear. 

Either way, the NHS is not cheap, and the NHS is not free.

Total UK central government funding for health in the UK in 2022/23 (including spending by central government departments and devolved administrations) is about £180 billion. This is about 10% of total GDP (Gross Domestic Product), i.e. about 10% of your taxes. This is in line with other developed countries.

So, let’s expand on how much does the NHE cost?

The NHS budget and how it has changed | The King's Fund

This compares to about 35% on ‘welfare’ (including benefits and pensions), 4% on justice (police, courts, and prisons), 2% of GDP spent on defence.

NHS England runs the NHS in England for the DHSC. It receives the largest amount (£113 billion), as it has the biggest population. £108 billion of this budget was allocated to the 42 Integrated Care Systems (which took over from CCGs in April 2022).

Specialised commissioning

NHS England retains around a quarter of the budget for other responsibilities including about £30 billion in 2022/23, mainly for Specialised Commissioning; which is a national and regional method of funding the treatment of rare and expensive diseases. Examples include dialysis/transplantation, and cardiothoracic surgery.

Pre COVID-19 pandemic, Specialised Commissioning (part of ‘direct commissioning’ in the pie chart below) was one of the fastest growing elements of the NHS budget – increasing by an average of over 7% per year. This is a concern as it means in the future, there will be less funds for ‘ordinary’ healthcare like GPs, local hospitals and mental health.

Pie chart - 2022/23 NHS England Central Admin and Programme Funding (£3,158m)NHS England funding allocation 2022/23

Other funding

The rest funds other things like prisons, armed services, and itself. It also funds ‘arms lengths bodies’ (linked to the NHS) like United Kingdom Health Security Agency (UKHSA; public health), Health Education England (HEE), National Institute of Health and Special Care Excellence (NICE) and Care Quality Commission (CQC). These are national institutions that advise government and the NHS but are not formally part of it. This is because it is felt they need a degree of independence so they can say what they like.

The largest arms lengths bodies, in terms of cost, are UKHSA, and Health Education England – receiving £4.0 and £4.4 billion respectively.

What is the cost of the NHS per person in the UK?

In 2022/23, it is £2700 per person per year (£180 billion divided by 67 million population).

Summary

We have explained how much does the NHS cost. We hope it is clearer now.

Other resources

This is a good article from the BMA, especially comparing current funding to previous years.
This video explains more about the money flow.

https://www.youtube.com/watch?v=CFLKlE-UaBo

Last Reviewed on 15 March 2024

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