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| - Last month in Parliament Conservative peer Baroness Noakes claimed that the NHS “gobbles up” 40% of the UK’s public expenditure. That’s not right.
Speaking during a House of Lords debate on public sector productivity, Lady Noakes emphasised that “overall public sector productivity will be a problem if the NHS is not fixed” because “the NHS gobbles up about 40% of public expenditure”.
This claim seems similar to those Full Fact has seen several times over the years, and we’ve asked Lady Noakes for more information on what she was referring to.
Honesty in public debate matters
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Understanding public spending
When we have looked into previous claims that 40% of public spending goes towards the NHS, the percentage relates specifically to budgeted expenditure, rather than public expenditure more broadly, as Lady Noakes’ claim suggested.
Public finances are generally separated into two main categories: departmental budgeted spend for use in things like running a hospital (known as departmental expenditure limits, or DEL); and annually managed expenditure (AME), which is used on things that can’t be easily predicted or budgeted for, like welfare or pensions.
We can split each of those further into day–to-day spending (or resource spending) and capital spending on one-off investments and projects.
Data from the Treasury shows that in 2024/25, total planned spending for the Department of Health and Social Care in cash terms is:
- departmental budgeted day-to-day spend: £187.6 billion
- departmental budgeted capital spend: £12.7 billion
- AME day-to-day spend: £25.3 billion
- AME capital spend: £943 million.
That totals around £227 billion, which is about 18% of all public spending (£1,226 billion), rather than 40%. Around £177 billion of that £227 billion is budgeted spending on NHS England.
When we have seen claims about 40% before, the calculations generally seem to exclude capital spending, and annually managed expenditure, which itself accounts for almost half of all public spending—as set out above.
Leaving those aside and just looking at day-to-day departmental budgeted spend (£187.6 billion) out of total departmental expenditure limits (£489 billion) gives us 38%.
Politicians should take care to be accurate when talking about public finances, or public services, so that people are not misled.
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