Health spending gap between Scotland and England narrows over last 20 years

Increases in health spending in Scotland has been significantly smaller than in England in the twenty years since devolution, research from the Institute for Fiscal Studies (IFS) has found.

In 1999-2000, spending on health per person was 22 per cent higher in Scotland than in England. That gap had narrowed to three per cent in 2019-20.

But the report said the squeeze in relative spending had not led to a decline in service performance over the last decade.

It also found larger growth in spending on adult social care in Scotland, which is now 43 per cent higher than in England.

Ben Zaranko, IFS economist, said: “Over the past two decades, under both Labour and SNP-led administrations, the NHS has been prioritised to a lesser extent than in England.

“As a result, Scottish health spending per person is now just 3% higher than in England, versus 22% at the start of the devolution.

“Instead, Scottish governments have placed relatively more priority on other services.”

The report, published as part of a series of policy papers funded by the Scottish Policy Foundation, also found higher spending in Scotland on education, but this had not resulted in Scottish pupils outperforming their English counterparts.

Spending per pupil aged three to 19 was over £7,000 in 2019-20 in Scotland, while in England the figure was under £6,000.

According to international assessments, the achievement of Scottish pupils has fallen in the last 15 years while in England it has remained relatively stable. In addition, the number of 18-year-olds going on to higher education has grown more slowly in Scotland despite free tuition.

The IFS also said spending on early years was “particularly high” compared to England, despite having a “more stringent” provision for two-year-olds.

It suggested the reason could be due to more of a focus on education development rather than childcare, as well as greater use of local authority managed nurseries.

Christine Farquharson, a senior economist at IFS, said: “Scotland spends substantially more than England on education, and that gap has been growing over time. But on a range of indicators, it’s not always clear that this spending delivers better outcomes.”

She added: “However, the Scottish Government has done more than England did to increase early years funding ahead of bringing in full-time free childcare this summer; still, it will be crucial to evaluate properly the impact that this policy has on children, their families and the childcare sector as a whole.”