Press release: NHS Confederation criticises conclusions of study comparing UK's NHS and US Kaiser health system
17 Jan 2002
The NHS Confederation has criticised the findings of a study published today by the BMJ1 comparing the UK's NHS and California's Kaiser Permanente health system. The study conducted by the University of California denounced the NHS as worse value than the US system Kaiser Permanente, but failed to take into account the full staff costs of the Kaiser system and its impact on the wider US health system. However, the Confederation identified telling lessons about the importance of clinicians engaging in management and the difference between efficiency and cheapness.
Nigel Edwards, acting chief executive of the Confederation and visiting professor at the London School of Hygiene & Tropical Medicine 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 study points out the effect of competition on improving Kaiser's performance - this is a truly academic point given the huge shortage of staff in the NHS which would not sustain competition of this sort.
The research also fails to consider the real costs of competition to the Californian health care system, while it may drive higher quality this is at a substantial cost to the rest of the system," continued Edwards.
On the lessons he highlighted: "The Kaiser experience shows that contrary to popular belief in this country investing in professionals makes more sense than preserving out of date hospitals and crucially that if you want good results you need to invest a great deal in management. Doctors in the Kaiser system are subject to much more management of their clinical work than those in the NHS and the results come through in this research. There has been strong resistance to extending management to cover clinical practice in this country and we are still at the early stage. The benefits of high quality clinical leadership and management that Kaiser enjoy are starting to come through in the NHS but to really get the benefits large increases in numbers of staff will be required."
Finally, the study illustrates the confusion between efficiency and cheapness that has beset the NHS.
Ends
Notes for editors
- The NHS Confederation is the voice of NHS management. Our members include the majority of NHS trusts, primary care trusts and health authorities in England; trusts, health authorities and local health groups in Wales; trusts and NHS boards in Scotland; and health and social services trusts and boards in Northern Ireland.
- (1) BMJ www.bmj.com
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