More MS news articles for Jan 2002

NHS is left trailing by the Americans

By Nicole Martin

THE Government's belief that the NHS is more efficient than most other health care systems in the world is challenged today by an independent study.

Comparison with a similar non-profit health organisation in California found that NHS patients received inferior care, including longer waiting lists and fewer specialists, than Americans being treated for a similar price.

The authors of the study, published in the British Medical Journal, said the findings challenged the view that Britain's poor medical record was the result of years of underfunding.

They compared the costs and performance of the NHS with those of Kaiser Permanente, which caters for 6.1 million people in California and eight million across America.

After adjusting for age and socio-economic differences, they found that the health costs per capita, per year, were similar - £1,269 for the NHS and £1,404 for Kaiser.

But American patients received more for their money than NHS patients including longer GP consultations and better access to expensive treatments.

Kaiser had twice the number of obstetricians and gynaecologists per 100,000 of the population - 8.3 compared with 4.1.

It also had three times the number of cardiologists - 2.4 compared with 0.8, and almost twice the number of oncologists - 1.7 compared with 0.9 in the NHS.

The result was that waiting lists for the Californian patients were shorter. In America, not a single patient had to wait more than five months for surgery after seeing a consultant, compared with a third of NHS patients.

Ninety per cent of the American patients were admitted to hospital within 13 weeks, compared with only 41 per cent in Britain.

GP consultations in California lasted for between 10 and 20 minutes, compared with only nine minutes in the NHS.

American patients also had more access to expensive procedures such as angioplasty, which is used to treat people with blocked blood vessels.

The authors said this showed that Kaiser was not more effective than the NHS because it denied its patients costly care.

Richard Feacham, professor of international health at the University of California, who co-wrote the study, said: "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.

"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."

He said the key to Kaiser's success was that patients spent a significantly shorter time in hospital.

Only 270 days were spent in hospital per 1,000 of the population in America, compared with 1,000 in the NHS.

The NHS could save 40 million hospital days or £10 billion a year if its patients spent the same time in hospital as those in America, Prof Feacham said.

In the NHS Plan published in 2000, the Government said: "The NHS gets more and fairer health care for every pound invested than most other health care systems."

Dr Richard Smith, editor of the British Medical Journal, conceded that the study "exploded" the myth that the NHS was "remarkably efficient".

But he added: "In America, roughly 40 million people are either uninsured or under-insured. The idea that a whole, huge chunk of the population would be cut out from health care is unthinkable in Britain."

A spokesman for the Department of Health 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."

© Copyright of Telegraph Group Limited 2001