Introduction

This chapter will aim to answer the question ‘What kind of health system is the NHS, on how does it compare to others?’. It aims to do this through an examination of a range of different health statistics from the OECD, G7 and Commonwealth Fund and by locating the NHS in relation to a recent typology of health systems. The strategy is to consider the NHS in 2019 (the last year pre-COVID-19), and compare statistics for total spend, funding sources, capacity (doctors, nurses, beds, scanners) and health outcomes at that date as a means of exploring changes during the pandemic and to try and see its effects. These three elements cannot capture all the dimensions of health systems (and measures of care will also be introduced), but they do cover many of the most distinctive dimensions of differences between such systems. Having explored changes during the pandemic in terms of the UK in relation to other countries in the OECD, it then performs further comparisons with the G7 group of nations and the 11 countries included in the Commonwealth Fund’s most recent reports, and which it argues reflect better comparisons as they are made up of advanced industrial nations which the UK would more often regard as its peers, and so are likely to be facing more similar challenges in relation to healthcare than countries that less obviously fit into that category.

The chapter then performs two further comparisons – with the situation in 2000 (broadly 20 years ago, and at the beginning of the period in which the NHS Plan was meant to expand resources for the health service) and 2009 (the end of the funding expansion under the NHS Plan, and after which there was a change in government) to consider whether the position of the NHS in comparative context has improved or worsened since. This date was chosen to get some sense of how the NHS has changed over the last 20 years under governments of different political parties, but also with a pragmatic eye in that good comparative data often becomes much harder to come by prior to that date.