NHS productivity has fallen, according to figures from the Office for National Statistics.
Between 1995 and 2008 there was a 3.3% fall in the amount of NHS activity for every pound spent.
This meant an average annual fall in productivity of 0.3%.
Inputs measured were the volume of goods and services, including clinical supplies, and spend on staff including nurses, doctors and support workers. Healthcare inputs grew by 75%, averaging 4.4% growth a year, the ONS data showed.
But healthcare output grew by just 69% overall, averaging 4.1% growth a year.
From 1995 to 2001, productivity was broadly stable as output and inputs grew at a similar pace, the ONS said.
But from 2001 to 2008 productivity declined as inputs grew more quickly than outputs every year except 2005 and 2006.
Productivity in 2008 is estimated to have fallen by 0.7%, compared with a fall of 0.3% in 2007.
Health Minister Mike O'Brien said: "In 1997, the NHS was severely understaffed and underfunded. We have had to address this understaffing and that has affected productivity."