Health spending continues to rise faster than economic growth according to the latest figures from the Organisation for Economic Co-operation and Development, the rich countries’ club. Can it go on?

Ironically, those most affected by the recession saw the biggest increases in 2009. In Ireland it rose from 7.7% to 9.5% and in the UK from 8.4% to 9.8% as the economy shrunk.

Health spending per capita increased on average across OECD countries by 3.8% in 2008 and 3.5% in 2009. Public spending on health grew even faster, at an average rate of 4.8% in 2008 and 4.1% in 2009. Private spending also continued to increase in most countries, but at a slower pace (1.9% in 2008 and 2.7% in 2009).

The OECD reckons that it should stabilise or fall slightly in 2011 as economies grow faster and countries rein in budgets. John Appleby, chief economist at the King’s Fund, reckons that in the UK it will hit 10% of GDP in 2010.

The USA remains far ahead of the pack, spending a mammoth 17.4% of GDP in 2009 or more than five percentage points clear of the next two - France and the Netherlands. That equates to $7,940 per capita - only two other countries, Switzerland and Norway, spent more than $5,000 per head on healthcare.

In practice, academics say Finland in the early 1990s is the only country to ever drop healthcare spending as a percentage of GDP.  That followed the collapse of the USSR which led to a 13% fall in Finnish GDP.  Finland managed to shrink expenditure without cutting output by paying doctors less. That is a measure adopted by Romania which imposed a 25% cut, Greece and Spain (5%) this time round.

Our view is that politicians in Europe do not have the balls to reorganise healthcare properly as this involves taking on powerful vested professional interests and around 10% of the workforce.

Change does happen but only slowly. EU bed numbers per thousand people have dropped from 7.3 in 1995 to 5.7 in 2008. That might sound impressive, but it isn’t given the massive increase in ambulatory surgery and the impact on residential psychiatric care from the introduction of anti-depressants.

Often the closed wards are simply shut and left. Dr Mike Shillingford at property management group MedicX quotes a recent EC Harris survey which found that the English NHS is sitting on more empty ward floor space than the entire footprint of supermarket chains Waitrose and Sainsbury combined - a total of 2.1 million square metres or over 2 square kilometres.