International healthcare systems are unsustainable, says new research

The findings of an international research project by Nottingham Business School have suggested that the way in which many healthcare systems across the world are financed, including the NHS, is unsustainable in modern times.

Only 9% of respondents indicated that their country's existing approach to financing health services is definitely sustainable in the long term.

Sustainable healthcare systems: An international study

The findings of an international research project have suggested that the way in which many healthcare systems across the world are financed, including the NHS, is unsustainable in modern times.

Research carried out for the Association of Chartered Certified Accountants (ACCA) by Professor Malcolm Prowle and Dr Don Harradine from Nottingham Business School, Nottingham Trent University, examined the healthcare systems in 11 countries across several continents - taking in developed, middle income and developing nations.

They assessed how well existing systems are coping with various challenges, in particular austerity, how sustainable they are in the long term and the sorts of changes being proposed. As well as reviewing relevant documents, the researchers interviewed informed people from the selected countries and asked them to complete a questionnaire.

The research clearly showed that austerity has had a big impact on the finances of healthcare systems across the globe, with countries being effected in different ways, from the rise in unemployment and reduced income impacting on demand for healthcare, to a reduction in financial aid to developing nations.

Only 9% of respondents indicated that their existing approach to financing health services in their country is definitely sustainable in the longer term, while 64% stated that it is unlikely - or impossible - for it to be sustainable, bringing into doubt most financing systems across the globe.

Professor Malcolm Prowle, professor of Business Performance at Nottingham Business School, said: “While many governments think that administrative reorganisation is the way forward, many healthcare commentators would argue that this does not deal with the root of the problem, and a complete overhaul of funding is actually what’s needed. It must be recognised that existing healthcare funding mechanisms were often developed a long time ago and are no longer appropriate in the modern world.

“When it comes to answers, not surprisingly given the impact of financial and economic austerity, a large majority of those we spoke to did not see the solution to their financial woes as being additional government revenues.

“Our research did suggest that some health insurance models could work satisfactorily – where cost is linked to either income or health risk – but there is also the option of increasing general taxation or introducing a specific earmarked taxation where the proceeds of the tax are used for the funding of healthcare.

“However, many of those we questioned agreed that the introduction of charges to service users was a likely change to the financing methods of healthcare systems. Across the globe a large variety of different charges are already levied on service users for a variety of reasons, for example car parking charges and charges for drug prescriptions, however, the levying of co-charges for the receipt of direct healthcare services is a more controversial issue and there are concerns for the impact on those unable to afford it and the administrative tasks of collecting the revenue.

“Nearly all of the issues we studied relate to the NHS and while there does not seem to be one right answer, the time has come to look seriously at how the NHS is funded. It is obvious that changes to healthcare is a very political and publicly sensitive issue and it is unlikely that any of the major political parties will want to risk outlining major reforms in their manifestos for the upcoming general election.

“Much of the political debate among the three main parties is around who can spend the most tax payers money on health care but, as this report shows and many commentators have said, this is not the right answer. We need to go back to the beginning and look at how we fund the NHS in the current environment. ”

Professor Malcolm Prowle and Dr Don Harradine are co-directors of the Health and Social Care Finance Research Unit at Nottingham Business School, which was set up to research and comment on a wide range of issues concerning the financial aspects of these services.

We need to go back to the beginning and look at how we fund the NHS in the current environment.

Professor Malcolm Prowle

  • Notes for editors

    Press enquiries please contact Helen Breese, Media Relations Manager, on telephone +44 (0)115 848 8751, or via email.

    The full report Sustainable healthcare systems: an international study can be found on the ACCA website

International healthcare systems are unsustainable, says new research

Published on 5 February 2015
  • Category: Press office; Research; Nottingham Business School

Still need help?

+44 (0)115 941 8418