Assessing the Relative Health Care Spending Needs of the UK's Devolved Territories: A Scottish Perspective

Abstract

This paper applies Scotland's health allocation formula to Primary Care Trusts (PCTs) in England, Health Boards in Wales, and Health and Social Care Trusts in Northern Ireland in order to assess the relative health care expenditure needs of the countries. According to the Scottish formula, England's per capita health care expenditure need is around 10% lower than Scotland's, while Wales' per capita expenditure need is around 2% lower than Scotland's, and Northern Ireland's is around 7% lower than Scotland's. Scotland's relative expenditure need over England is largely a function of higher rates of mortality and long-term illness, rather than its relative sparsity. Northern Ireland's relatively lower need is largely due to it having a relatively young population. We also compare the results of Scotland's allocation formula with the equivalent English formula and find that the two approaches differ in their view of what constitutes an equitable distribution of resources between PCTs.