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Thursday, 17 January, 2002, 14:06 GMT
NHS 'worse value than US provider'
Busy hospital ward
US patients had better access to consultants
NHS patients are getting poorer care than millions of people being treated for a similar price in the US, according to a study.

It rejected the government's claim the British health service is efficient and gets more from its money than similar organisations abroad.

The University of California team said patients treated by a non-profit health service in the state had access to significantly more specialists than those in Britain, spent only a third as much time in hospital and had more time with doctors

If a Kaiser patient moved to the NHS they would be horrified

Professor Richard Feachem

They said the US organisation, Kaiser Permanente, offered the NHS valuable lessons on how to provide cost-effective care, integrate services and use information technology to ensure efficiency.

The report also highlighted the importance of competition in the US, claiming patients receive high quality care because health firms know they can go elsewhere if they are unhappy.

A spokesman for the British Department of Health said the findings showed there was still a long way to go with the modernisation of the NHS.


Kaiser, which serves more than six million people in California and eight million across the US, had waiting times to see a consultant a third the length of those in the NHS.

The organisation had twice the concentration of obstetricians and gynaecologists and three times the concentration of cardiologists.

Where hospital care was needed nine out of ten Kaiser patients were admitted within three months, compared to four out of ten NHS patients.

Kaiser vs the NHS
80% of Kaiser patients see specialist in two weeks
80% seen in NHS in under 13 weeks
Kaiser gives up to 20 minutes with doctors
NHS patients get nine minutes
Hospital treatment within 13 weeks for 90% of Kaiser patients
Hospital treatment within 13 weeks for 41% of NHS patients
Kaiser cost per capita of 1360
NHS cost per capita of 1230
Professor Richard Feachem, one of the authors of the report, told BBC News Online British people should be asking questions about the standard of care they receive.

He said: "It is certainly true that the experience of the Kaiser patients in terms of access to care, the quality of it, and the friendliness and responsiveness of nurses is very much better than in the NHS.

"If an NHS patient moved to Kaiser they would be delighted with the experience, and if a Kaiser patient moved to the NHS they would be horrified."

Professor Feachem said the key to Kaiser's success was that patients spent a comparatively short time in hospital, freeing it to target resources elsewhere.

He added: "Kaiser is not creating efficiency by denying care. To the contrary, it's doing considerably more expensive procedures than the NHS."

Different patients

Responding to the findings a spokesman for the Department of Health said the study showed the NHS was 10% cheaper overall and that a comparison between two systems catering for very different patients was difficult.

Applying the same approach to other European countries would almost certainly reveal that Kaiser was more efficient than any of them too

Department of Health
But he added: "The performance achieved by Kaiser underlines that we still have much further to go in terms of modernising the NHS."

The Department of Health also said the areas where Kaiser was outperforming the NHS had already been identified and were included in the NHS Plan.

The spokesman said: "These findings do not undermine the long held view that the NHS is highly efficient compared with the great majority of health care systems.

"At most they suggest that a small part (one thirtieth) of the US population is covered by a health system that may be more efficient than the NHS.

"Applying the same approach to other European countries would almost certainly reveal that Kaiser was more efficient than any of them too."


The research team chose Kaiser because of its similarities with the NHS, in terms of age, organisation, services provided and 'blue collar' origins.

After taking account of age and socio-economic differences between Britain and California they found the health care costs per person were similar to within 10%.

Nigel Edwards, acting chief executive of the NHS Confederation, said the study failed to take into account the full staff costs of the Kaiser system and its impact on the wider US health system.

He said: "It is very strange that the huge difference in staff salaries between the NHS and Kaiser can be written off.

"The authors don't seem to consider that being paid twice as much might significantly change ones attitude and approach."

The full study will be published in the British Medical Journal.

See also:

15 Jan 02 | Health
Anger at major NHS overhaul
10 Jan 02 | Health
Waiting times are 'NHS key'
26 Aug 01 | Health
NHS patients to be sent abroad
10 Jan 02 | England
Channel hop for knee surgery
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