The document provides an overview of the English health system, including its structure, financing, provision of services, reforms, and performance on key metrics like access, efficiency, quality, and health outcomes. It discusses improvements in access over time through increased spending and staffing levels. While more resources were invested, productivity did not improve correspondingly. Some progress was made on quality improvements as mortality rates in hospitals declined. Health outcomes also improved as mortality rates for causes considered amenable to healthcare interventions decreased between 1997/98 and 2007.

1. The English health system Author: Seán Boyle LSE Location: The King’s Fund 23 March 2011

6. Access (numbers waiting)

7. Access (median waiting times)

8. Access ( referral to treatment within 18 weeks)

9. Increase in staff 1996 – 2009

10. Average annual change in staff numbers (1996 – 2009)

11. Change in mean earnings (2000 – 2009)

12. Comparison of changes in mean earnings (2000 and 2009) Mean earnings 2000 Mean earnings 2009 Total % change Between 2000 and 2009 mean annual % change Consultants 71,900 120,900 68% 5.9% Doctors in training & equivalent 35,000 51,800 48% 4.5% Managers 35,700 47,900 34% 4.3% Nurses and midwives 22,600 30,700 36% 3.5% Maintenance and works 19,600 27,300 39% 3.8% Admin & clerical 14,000 22,100 58% 5.2% Healthcare assistants 12,400 18,700 51% 6.0% Public sector 17,000 25,300 49% 4.5% Private sector 19,800 27,500 39% 3.7%

13. Productivity (1)

14. Productivity (2)

15. Improvements in quality (deaths per 100,000 hospital spells)

16. Improvements in quality (change in death rate)

17. Mortality amenable to health care (absolute levels)

18. Mortality amenable to health care – % change between 1997/98 and 2002/03

19. Mortality amenable to health care (absolute levels)

20. Mortality amenable to health care – % change between 1997/98 and 2007 Gay, J. G. et al. (2011), “Mortality Amenable to Health Care in 31 OECD Countries: Estimates and Methodological Issues”, OECD Health Working Papers , No. 55, OECD Publishing

21. What is the reason Ireland does so well?

22. What is the reason Ireland does so well?