Section 4 Family Health Services

Family Health Services

Table 4.1        Cost of Family Health Services (FHS) at 2002 prices, UK, 1949 – 2002

Figure 4.1       Family Health Services (FHS) expenditure as a percentage of gross NHS cost, UK, 1949 - 2002

Table 4.2        Family Health Services (FHS) expenditure distribution by service, UK, 1949 - 2002

Figure 4.2       Primary health care as a percentage of total health expenditure in selected OECD countries,
circa 2002

Box 1               Real decadal growth (per cent) of FHS expenditure, UK

Figure 4.3       Real growth in expenditure on Family Health Services (FHS) and hospital services, UK,
1949 - 2002

Table 4.3        Real cost of Family Health Services (FHS) per capita, UK, 1949 – 2002

Box 2               FHS gross expenditure per capita at 2001 prices, UK

Box 3               Annual average real growth (per cent) in per capita FHS expenditure

Table 4.4        Family Health Services (FHS) gross expenditure (revenue and capital) per capita and per
household, UK, 1975/76 - 2002/03

Box 4               Real decadal growth (per cent) in FHS expenditure by service, UK

General Medical Services

Figure 4.4       Cost of General Medical Services (GMS) at 2002 prices, UK, 1949 – 2002

Box 5               Real decadal growth (per cent) of GMS expenditure, UK

Table 4.5        Cost of General Medical Services (GMS) per capita and per household, UK, 1975/76 - 2002/03

Box 6               Staff (whole-time equivalents) employed in GP practices, England

Table 4.6        Number of general medical practitioners (GPs) by country, UK, 1991 – 2003

Table 4.6(a)   Number of general medical practitioners (GPs) per 100,000 population, by country, UK, 1991 -
2003

Table 4.7        NHS medical workforce (GPs, hospital and community medical staff), UK, 1951 - 2002

Figure 4.5       Number of GPs per 1,000 population in selected OECD countries, circa 2002

Table 4.8        Number of unrestricted GPs, UK, 1951 – 2003

Box 7               Decadal change (per cent) in numbers of unrestricted principals, UK

Table 4.9        Number and index (1952=100) of GPs by type in England and Wales, 1952 - 2003

Table 4.10      Number of unrestricted GPs by country, UK, 1991 - 2003

Table 4.10(a) Average list size of unrestricted GPs by country, UK, 1991 – 2003

Table 4.11      Resident population per unrestricted principal, UK, 1951 - 2003

Figure 4.6       Average list size of unrestricted GP principals by country, UK, 1964 - 2003

Table 4.12      People aged 65 and over per unrestricted GP by country, UK, 1991 - 2003

Table 4.12(a) People aged 75 and over per unrestricted GP by country, UK, 1991 - 2003

Table 4.13      Number of patients per unrestricted GP by patient age group, UK, 1951 - 2003

Table 4.14      Number of unrestricted principals, assistants and trainees by age and sex, England, 1985 -
2003

Table 4.15      Number of trainee GPs by country, UK, 1991 - 2003

Table 4.15(a) Number of unrestricted principals per trainee by country, UK, 1991 - 2003

Figure 4.7       Index (1959=100) of number of unrestricted GPs by size of practice, England and Wales,
1959 - 2003

Table 4.16      Distribution of unrestricted GP principals by size of practice, UK, 1975 - 2003

Table 4.17(a) Number of unrestricted GP principals by size of practice, England and Wales, 1975 - 2003

Table 4.17(b) Number of unrestricted GP principals by size of practice, Scotland, 1975 - 2003

Table 4.17(c) Number of unrestricted GP principals by size of practice, Northern Ireland, 1975 - 2003

Table 4.18      Number and percentage of GPs practising in deprived areas and numbers of patients from
deprived areas on their lists, by country, Great Britain, 1997 – 2003

Box 8               Average cost of a GP consultation, Great Britain

Table 4.19      Estimated number and index (1975=100) of NHS GP consultations by age group, UK, 1975 -
2002

Table 4.20      Estimated number and index (1975=100) of NHS consultations per unrestricted principal, UK,
1975 – 2002

Box 9               Per cent of NHS GP consultations taking place in surgery, Great Britain

 Table 4.21     Number of dispensing doctors by country, UK, 1991 - 2003

Table 4.21(a) Number of NHS prescription items dispensed by dispensing doctors by country, UK, 1991 -
2003

General Pharmaceutical Services

Box 10             Proportion of patients consulting a NHS GP who obtained a prescription, Great Britain

Table 4.22      Total number of NHS prescriptions dispensed, by country, UK, 1991/92 – 2002/03

Table 4.22(a) Number of NHS prescriptions dispensed per capita, by country, UK, 1991/92 – 2002/03

Table 4.23      Number of chemists and appliance contractors and number per 100,000 population by
country, UK, 1991 - 2003

Figure 4.8       Practising pharmacists per 1,000 population in selected OECD countries, circa 2002

Table 4.24      Number and index (1991=100) of prescription items dispensed per chemist by country, UK,
1991 - 2003

Table 4.25      Number of NHS prescriptions (Rxs) dispensed by chemists and appliance contractors, UK,
1948 – 2003

Box 11             Change (per cent) in number of prescriptions dispensed, UK

Figure 4.9       Prescription items dispensed per capita in selected OECD countries, circa 1998

Table 4.26      Number of prescription items dispensed, and per capita, by age group, England, 1978 - 2003

Figure 4.10     Prescription items dispensed per capita among older people, England, 1978 - 2003

Table 4.27      Number of NHS prescriptions dispensed by chemists and appliance contractors, and per
capita, by country, UK, 1991 - 2003

Figure 4.11     NHS prescription charges and items dispensed by chemists and appliance contractors, UK,
1949 – 2003

Box 12             Charges and non-exempt prescriptions, UK

Figure 4.12     Basic rate of prescription charges at constant prices and as a percentage of total prescription
costs, UK, 1978 - 2002

Figure 4.13     Revenue from prescription charges and as a percentage of General Pharmaceutical Services
(GPS) cost, UK, 1952 – 2002

Box 13             Prescription charge exemption categories

Figure 4.14     Proportion of NHS prescriptions exempt from the prescription charge, England, 1984 - 2003

Table 4.28      Total cost of NHS prescriptions (Rxs) dispensed by chemists and appliance contractors, UK,
1948 – 2003

Box 14             Decadal Change (percentage) in the real total cost of pharmaceutical services, UK

Figure 4.15     Gross cost of General Pharmaceutical Services (GPS), UK, 1952 - 2002

Table 4.29      Total and per capita cost of NHS prescriptions dispensed at 2003 prices, by country, UK,
1991 - 2003

Figure 4.16     Pharmaceutical expenditure as per cent of GDP in selected OECD countries, circa 2002

Figure 4.17     Pharmaceutical expenditure per capita in selected OECD countries, circa 2002

Box 15             Chemists' income as a % of the gross cost of pharmaceutical services, UK

Table 4.30      Net ingredient cost (NIC) of NHS prescriptions (Rxs) dispensed by chemists and appliance
contractors, 1949 – 2003

Box 16             Decadal change (percentage) in real NIC, UK

Table 4.31      Net ingredient cost (NIC) of prescriptions per capita and per household, UK, 1975 - 2003

Table 4.32      Net ingredient cost of NHS prescriptions dispensed and cost per capita at 2003 prices by
country, UK, 1991 - 2003

Table 4.33      Net ingredient cost per prescription dispensed and real cost index (1991=100) by country, UK,
1991 - 2003

Table 4.34      Net ingredient cost of prescriptions and cost per capita by age group, England, 1978 - 2003

Figure 4.18     Net ingredient cost (NIC) per older person, England, 1978 - 2003

Table 4.35      Percentage of total number and net ingredient cost (NIC) of prescriptions by therapeutic group,
UK, 1995 - 2002

Table 4.36      Percentage of total number and net ingredient cost (NIC) of prescriptions by therapeutic group,
England, 1995 - 2003

Table 4.37      Percentage of total number and net ingredient cost (NIC) of prescriptions by therapeutic group,
Wales, 1995 - 2003

Table 4.38      Percentage of total number and net ingredient cost (NIC) of prescriptions by therapeutic group,
Scotland, 1995 - 2002

Table 4.39      Percentage of total number and net ingredient cost (NIC) of prescriptions by therapeutic group,
Northern Ireland, 1995 - 2002

Table 4.40      Number and net ingredient cost (NIC) of prescriptions by therapeutic group, UK, 1995 - 2002

Table 4.41      Number and net ingredient cost (NIC) of prescriptions by therapeutic group, England, 1995 -
2003

Table 4.42      Number and net ingredient cost (NIC) of prescriptions by therapeutic group, Wales, 1995 - 2003

Table 4.43      Number and net ingredient cost (NIC) of prescriptions by therapeutic group, Scotland, 1995 -
2002

Table 4.44      Number and net ingredient cost (NIC) of prescriptions by therapeutic group, Northern Ireland,
1995- 2002

Box 17             Share of the top eight broad therapeutic groups, England 2002

Figure 4.19     Prescription items per capita, dispensed by chemists, by major therapeutic group, UK, 1995 -
2002

Figure 4.20     Net ingredient cost (NIC) per capita, by major therapeutic group, UK, 1995 - 2002

Table 4.45      Age and sex distribution of adults taking various categories of prescribed medicines, England,
1995

Table 4.46      Net ingredient cost (NIC) per prescription item at 2002 prices by therapeutic group, UK,
1995 - 2002

Table 4.47      Net ingredient cost (NIC) per prescription item at 2002 prices by therapeutic group, England,
1995 - 2003

Table 4.48      Net ingredient cost (NIC) per prescription item at 2002 prices by therapeutic group, Wales,
1995 - 2003

Table 4.49      Net ingredient cost (NIC) per prescription item at 2002 prices by therapeutic group, Scotland,
1995 - 2002

Table 4.50      Net ingredient cost (NIC) per prescription item at 2002 prices by therapeutic group, Northern
Ireland, 1995 - 2002

Figure 4.21     Market share of branded and generic prescription items dispensed by chemists, England,
1949 - 2003

Figure 4.22     Relationship between generic prescribing and generic dispensing, England, 2003

Box 18             Cost comparison of generic and branded prescriptions  dispensed in England

Table 4.51      Hospital bed days and estimated annual hospital savings, England, 1957 - 2002/03

Table 4.52      Estimated inpatient treatment costs to NHS hospitals of various diseases, UK, 1990/91 -
2001/02

Table4.52(a)  Costs of various diseases as a percentage of total NHS hospital expenditure, UK, 1990/91 -
2001/02

Table 4.53      Estimated net ingredient cost (NIC) of prescriptions by disease group, UK, 1990/91 - 2001/02

Table 4.54      Estimated cost of GP consultations by disease group, UK, 1990/91 - 2001/02

Table 4.55      Estimated prescription dispensing costs by disease group, UK, 1990/91 - 2001/02

Table 4.56      Estimated total cost of disease treatment to the NHS, UK, 1990/91 - 2001/02

Table 4.57      Estimated total real cost of disease treatment to UK NHS, at 2001 prices, 1990/91 - 2001/02

Table 4.58      Estimated total NHS expenditure on pharmaceuticals at manufacturers' prices, UK, 1969 -
2003

Figure 4.23     Estimated total NHS expenditure on medicines (at manufacturers' prices) and per cent of gross
NHS cost, UK, 1969 - 2003

General Dental Services

Box 19             Decadal percentage change in real GDS expenditure, UK

Figure 4.24     Gross cost of General Dental Services (GDS) and per cent of gross NHS cost, UK, 1949 - 2002

Table 4.59      General Dental Services (GDS) gross expenditure per capita and per household, UK, 1975/76 -
2002/03

Box 20             Decadal real percentage growth of dental charges, UK

Figure 4.25     Patient dental charges and as a percentage of the gross cost of General Dental Services (GDS),
UK, 1951 - 2002

Figure 4.26     Courses of dental treatment and per 1,000 people, UK, 1951 - 2002

Table 4.60      Number of NHS dental practitioners, UK, 1951 - 2002

Figure 4.27     Number of practising dentists per 1,000 population in OECD countries, circa 2002

Box 21             Percentage of adults with no natural teeth, Great Britain

General Ophthalmic Services

Figure 4.28     Gross cost of General Ophthalmic Services (GOS) and per cent of gross NHS cost, UK, 1949 -
2002

Table 4.61      General Ophthalmic Services (GOS) expenditure per capita and per household, UK, 1975/76 -
2002/03

Box 22             Prevalence (percentage) of spectacles/contact lenses, 1994, Great Britain

Figure 4.29     Numbers of NHS sight tests and pairs of glasses supplied per 1,000 population, UK, 1965 -
2002

Table 4.62      Number of opticians and per 100,000 population, UK, 1949 - 2002/03