Health insurance in the United Kingdom

Healthcare in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments, together with smaller private sector and voluntary provision. As a result of each country having different policies and priorities, a variety of differences now exist between these systems.

Despite there being separate health services for each country, the performance of the NHS across the UK can be measured for the purpose of making international comparisons. In a 2014 report ranking developed-country healthcare systems, the United Kingdom was ranked the best healthcare system in the world overall and in the following categories: Quality of Care Access to Care, Efficiency, and Equity.The UK's palliative care has also been ranked as the best in the world. On the other hand, in 2005-09 cancer survival rates lagged ten years behind the rest of Europe, although survival rates continue to increase.

In 2015, the UK was 14th (out of 35) in the annual Euro health consumer index. It was criticised for its poor accessibility and "an autocratic top-down management culture".The index has in turn been criticized by academics, however.

Common features

Each NHS system uses General Practitioners to provide primary healthcare and to make referrals to further services as necessary. Hospitals then provide more specialist services, including care for patients with psychiatric illnesses, as well as direct access to Accident and Emergency (A&E) departments. Community pharmacies are privately owned but have contracts with the relevant health service to supply prescription drugs.

The public healthcare system also provides free (at the point of service) ambulance services for emergencies, when patients need the specialist transport only available from ambulance crews or when patients are not fit to travel home by public transport. These services are generally supplemented when necessary by the voluntary ambulance services (British Red Cross, St Andrews Ambulance Association and St John Ambulance). In addition, patient transport services by air are provided by the Scottish Ambulance Service in Scotland and elsewhere by county or regional air ambulance trusts (sometimes operated jointly with local police helicopter services) throughout England and Wales.^[15] In specific emergencies, emergency air transport is also provided by naval, military and air force aircraft of whatever type might be appropriate or available on each occasion, and dentists can only charge NHS patients at the set rates for each country. Patients opting to be treated privately do not receive any NHS funding for the treatment. About half of the income of dentists in England comes from work sub-contracted from the NHS, however not all dentists choose to do NHS work.

Assessment of the UK as a whole

The OECD publication Health at a Glance 2015 enabled comparisons of the UK as a whole with other countries. It was reported that the UK had an “outstandingly poor” record of preventing ill health and that hospitals in the UK were now so short-staffed (needing 75,000 more doctors and nurses to match standards in similar countries) and under equipped that people were dying because of a chronic lack of investment since 2010. The UK survival rates were 21st out of 23 countries for cervical cancer, 20th out of 23 countries on breast and bowel cancer and 19th out of 31 countries for stroke.

Healthcare in England

Most healthcare in England is provided by the National Health Service (NHS), England's publicly funded healthcare system, which accounts for most of the Department of Health's budget (£110 billion in 2013-14 

In April 2013, under the terms of the Health and Social Care Act 2012, a reorganisation of the NHS took place regarding the administration of the NHS. Primary care trusts  and strategic health authorities ) were abolished, and replaced by clinical commissioning groups ). Cogs now commission most of the hospital and community NHS services in the local areas for which they are responsible. Commissioning involves deciding what services a population is likely to need, and ensuring that there is provision of these services. The Cogs are overseen by NHS England, formally known as the NHS Commissioning Board (NHS CB) which was established on 1 October 2012 as an executive non-departmental public body. NHS England also has the responsibility for commissioning primary care services - General Practitioners, opticians and NHS dentistry, as well as some specialised hospital services. Services commissioned include general practice physician services (most of whom are private businesses working under contract to the NHS), community nursing, local clinics and mental health services.

Provider trusts are NHS bodies delivering health care service. They are involved in agreeing major capital and other health care spending projects in their region.NHS trustsare care deliverers which spend money allocated to them by CCG's. Secondary care (sometimes termed acute health care) can be either elective care or emergency care and providers may be in the public or private sector.