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Trends in the structure, productivity, effectiveness and unit costs of the hospital and community health services workforce in England: 1979–1991
Author(s) -
Cutler Peter
Publication year - 1993
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.4730020109
Subject(s) - workforce , productivity , unit (ring theory) , index (typography) , agency (philosophy) , wage , wage growth , demographic economics , business , labour economics , falling (accident) , medicine , economics , environmental health , economic growth , psychology , philosophy , mathematics education , epistemology , world wide web , computer science
In this paper it is shown that there have been significant structural changes in the composition of the Hospital and Community Health Services (HCHS) workforce over the 1980s. The number of doctors, nurses and other medical professionals has grown at the expense of support staff such as ancillaries and maintenance workers. The number of agency and contract staff has risen rapidly, partly offsetting the loss of directly‐employed support staff. Changes in the workforce have been compared with changes in activity, as measured by the cost‐weighted activity index. According to this measure labour productivity has grown by a compound rate of 1.9% annually. Adjusting the labour force index for the wage bill of each group reveals productivity growth of 1.5%. The effectiveness of treatment, as proxied by the decline in avoidable perinatal mortality, has grown by 3.4% annually. Unit labour costs have fallen over the period at an average annual rate of 0.3%. The trend conceals wide fluctuations, with labour costs falling slowly during the first half of the decade, and rising strongly during the second half. Medical professionals benefited disproportionately from wage increases in comparison with other HCHS groups during the mid to late 1980s.