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Country profiles of health system responses to the crisis | United Kingdom
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Wales
• Pressures to reduce the cost of central administration and policy
have continued as part of a government-wide policy, with significant
constraints on central budgets and workforce. Figures which relate to
health and social care are not yet available.
Provider infrastructure and capital investment
England
• Capital spending has fallen in real terms from £5.2 billion in 2009–2010 to
£3.8 billion in 2011–2012, and is planned to be £4.3 billion in 2014–2015.
• The government announced plans to release public land to build up to
100 000 new homes (2011). As part of this initiative, the Department of
Health encouraged NHS bodies to sell off unused land and buildings. In
2012 almost 600 hectares of NHS land and buildings were designated as
likely for future disposal.
Northern Ireland
• The capital expenditure for the Department of Health, Social Services
and Public Safety proposed in the first budget (2008–2011) was
£202.8 million on average per annum; that for the second (2011–2015)
was £212.8 million. Gross capital expenditure by the Health and Social
Care Board has fallen from £4.2 million in 2009–2010 to £2.7 million
in 2011–2012.
• The government launched a policy that puts greater emphasis on primary
and social care and less on hospital provision, with the aim of ensuring
sustainability and realizing value for money (2011).
• Closure of health board residential homes was proposed (2013). This was met
with great resistance.
Scotland
• In 2011–2012, the capital budget was reduced by 15% and is forecast
to fall by around 50% between 2011 and 2015. This is expected to be
more than offset by substantial revenue-financed investment involving
private finance, which should allow the programme of modernization
to continue, thereby releasing future revenue savings (including tackling
backlog maintenance estimated at over £1 billion in 2011). Five of
ten current large NHS projects (over £50 million) are being funded
through the non-profit distributing model of public–private partnership
financing. Some NHS boards have also transferred funding from revenue
(£7.8 million) to capital budgets in 2011–2012 to fund capital spending
and the maintenance backlog.