1. Developments in UK Health Accounts OECD Meeting of Experts in National Health Accounts 27-28 October 2003 Gavin Wallis Health Accounts Team Office for National Statistics

2. Outline Introduction Total UK Health Expenditure UK Health Accounts Results Next Steps Conclusions Questions / Discussion

3. Introduction to UK Health Accounts Stimulating debate Previous releases Next releases Project Board Key users identified

4. Use of National Accounts Major deviations dealt with: (i) Nursing Care not funded by NHS (ii) Research and Development (iii) education and training Charities, religious organisations, prisons, armed forces Total UK Health Expenditure sources

5. Total UK Health Expenditure issues Private finance most problematic Conformity with SHA: (i) Household production of health care services (ii) Occupational health care Further deviations: using National Accounts

6. UK Health Accounts sources Health administrations (i) Main source activity costs (ii) Budgetary information (iii) Double counting? Household expenditure based on National Accounts Nursing care Public / private split

7. UK Health Accounts issues Reasonable first estimate Some "top-down" methods Exclusion of Household production & Occupational health care NPISH, prisons, armed forces not fully cross-classified Financial year basis No time series Health related functions?

8. Results: UK Health Accounts 1999/2000

9. Total current expenditure on health by function, UK, 1999/2000 HC.1-2. Cure/rehabilitation HC.3. LT nursing HC.4. Ancillary services HC.5. Goods (and related services) to outpatients HC.6. Prevention & public HC.7. Administration

10. Total current expenditure on health by provider, UK, 1999/2000 HP.1 Hospitals HP.2 Nursing facilities HP.3 Ambulatory facilities HP.4 Retailers of goods HP.5 Providers of public health HP.6 Administration HP.9 Rest of the world (imports)

11. Next Steps Household production of health services Further investigation into sources and methods Primary data sources (“bottom-up”) Function and provider for NPISH, prisons, armed forces? Calendar year basis Time series

12. Conclusions Reasonable first estimate Some documented deviations from SHA Improvements in pipeline Growing user demand Publication on 16 December 2003

13. Questions / Discussion