Demographic and Financial Aspects of the National Health Service in Scotland

Abstract

SynopsisThe first section of the paper describes the National Health Service in Scotland with particular reference to its administrative system, its operational system and the capital and revenue expenditure of a specific year allocated to the various types of health service.Allocation of finance to health services in the United Kingdom is determined on a United Kingdom Basis. Some international and UK comparative figures are given. The paper proceeds to describe how the allocation made to the National Health Service in Scotland is subdivided. Capital and revenue are separately referred to, including the problems of assessing the investment merits of capital and revenue expenditures. A brief description is included of the Scottish Health Authorities Revenue Equalisation report (commonly known as S.H.A.R.E.) with specific reference to the use made of Standard Mortality Ratios as a measure of morbidity. A section is included on Multiple Deprivation referring to the correlation between multiple deprivation and mortality.The demographic aspects of the National Health Service in Scotland are enumerated and subdivided into the three main population age-groups. The birth-rate projections are discussed.Various measurements of the health of a population are selected and some international comparisons are given. The difficulty of measuring morbidity is highlighted.The various statistical activity measures available in the Scottish National Health Service are described. A description is given of the uses made of this information, together with health service professionals' views and demographic factors, for health service planning for the future in relation to the service as a whole, to its various specific activities and to its manpower.A selection is given of the various scientific or theoretical bases suggested for allocating priorities in the future planning, and the practical method adopted in the Scottish Health Authorities Priorities for the Eighties (S.H.A.P.E.) is briefly described.The paper concludes with comments by the author on certain controversial aspects of the problems.