The NHS has been judged the best, safest and most affordable healthcare system out of 11 countries analysed and ranked by experts from the influential Commonwealth Fund health thinktank.
It is the second time in a row that the study, which is undertaken every three years, has found the UK to have the highest-rated health system.
The NHS has held on to the top spot despite the longest budget squeeze in its 69-year history, serious understaffing and the disruption caused by a radical restructuring of the service in England in 2013.
Its ranking is even more notable because the thinktank found the UK to put the fourth smallest amount of GDP into healthcare among the 11 nations. While the US spends 16.6% of its national income on health, the UK comes near the bottom, investing just 9.9%. Only New Zealand (9.4%), Norway (9.3%) and Australia (9%) put in less.
The UK emerged with the best healthcare system overall, just ahead of Australia, with the Netherlands a little further behind. A group of experts assessed them against 11 criteria designed to measure the effectiveness of different health systems.
“The UK stands out as a top performer in most categories except for healthcare outcomes, where it ranks with the US near the bottom,” according to the Mirror, Mirror 2017 report from the US-based Commonwealth Fund.
“In contrast to the US, over the last decade the UK saw a larger decline in mortality amenable to healthcare than the other countries studied,” the report says. Experts view that as a key measure, because it captures how well a health system is doing at preventing, detecting and treating illness.
Jeremy Hunt, the UK’s health secretary, lauded the NHS’s top ranking. “These outstanding results are a testament to the dedication of NHS staff, who despite pressure on the frontline are delivering safer, more compassionate care than ever,” he said.
“Ranked the best healthcare system of 11 wealthy countries, the NHS has again showed why it is the single thing that makes us most proud to be British.”
Supporters of the NHS are likely to use the Commonwealth Fund’s findings to rebut claims that the NHS is wasteful and inefficient. Theresa May has told the chief executive of NHS England, Simon Stevens, to ensure that the service uses its £120bn annual budget more efficiently.
The US was again judged to be the worst system, despite investing far more money than all the other countries. It spends 5.2 percentage points more of its GDP on health than France, which invests the second largest amount (11.4%).
The UK came first in four of the 11 categories. It was judged to deliver the safest care, be the best at “care processes”, provide the most affordable care and offer the most equity.
However, the gap between the UK and the next best-placed countries is narrowing. Those four categories are only half of the eight in which the UK came top in 2014, when the fund last undertook its in-depth multi-country research. The UK also came second for providing preventative and well-coordinated care.
But the NHS came 10th on healthcare outcomes, a category that measures how successful treatment has been – a significant weakness that was also identified in 2014. The experts concluded that the UK does very poorly in relative terms on five-year survival rates for breast and bowel cancer, and deaths among people admitted to hospital after a stroke, for example.
An NHS England spokesperson said: “This international research is a welcome reminder of the fundamental strengths of the NHS, and a call to arms in support of the NHS Forward View practical plan to improve cancer, mental health and other outcomes of care.”
Richard Murray, the director of policy at the London-based King’s Fund thinktank, said: “The UK’s ranking is welcome and reflects the strong fundamentals of the NHS. Universal access to health services, a founding principle of the NHS, is rightly recognised by the Commonwealth Fund ranking.
“Other international comparisons that are largely based on measuring the health of the population of the country do not always rank the UK as highly. The Commonwealth Fund also recognises these poorer health outcomes, and this is particularly stark given the cuts to public health spending that were announced recently.”