18/01/2002
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
By Nicole Martin