In 1965 the National Health Service cost the nation over £1300 million of which the Hospital Service absorbed almost £800 million. Where such very large sums of money are involved, almost all of which are spent out of public funds, it is obviously important that the expenditure should yield the greatest possible value. This paper reviews trends in hospital spending and describes measures being taken to examine efficiency in the Hospital Service as well as the problems inherent in such efficiency studies.

A full account of the trends in hospital expenditure has been given elsewhere but a brief summary of hospital costs and how they have developed since the inception of the National Health Service is necessary in order to put the need for efficiency into perspective.