BigGovHealth Improve and Strengthen Health Care for all Americans

Case Study: United Kingdom

Denial of Care

In the United Kingdom’s Health Care System, patients are denied access to medicines that could save their lives

• The five-year patient survival rate for breast cancer caught early in England is just 78 percent, compared to 98 percent in the United States.¹
• 80,000 patients with mild Alzheimer’s symptoms do not receive treatment because the National Health Service (NHS) only approved drugs for those “moderately” affected by the disease.²
• British citizens wait up to five years for new hearing aids³

Not only does patient care suffer, but the United Kingdom’s health services are filled with inequalities

• Medicines are available in some parts of the United Kingdom for patients, but not available in other areas
• Waiting lists for treatment also vary wildly from region to region. ⁴
• In fact, some regions in the United Kingdom spend $280 per capita on cancer care, while other regions just spend $90. ⁵

Patients in the United Kingdom’s health care system are not satisfied and the health care system is wasting money

• Thousands of NHS patients are failing to receive appropriate care due to waste, inefficiency and postcode prescribing, according to Sir Liam Donaldson, the chief medical officer for England.⁶
• Overall, patients are not satisfied with the United Kingdom’s NHS as Patient satisfaction ratings with NHS services failed to show any clear improvements between 2005-06 and 2006-07according to the Department of Health.⁷

In fact, a United State’s health care organization, Kaiser Permanente in California, outperforms the United Kingdom’s NHS

• A study comparing the costs and performance of the private company California’s Kaiser Permanente and the United Kingdom’s NHS found:
  • Kaiser’s performance in key areas, including key preventive practices and access to care, is significantly better
  • Per capita costs in Kaiser and the NHS are within 10 percent of each other, with Kaiser only costing $187 more than NHS.
  • Kaiser uses only one-third as many hospital days as the NHS. ⁸
• Overall, the study found that Kaiser’s members experience more comprehensive and convenient primary care services and much more rapid access to specialist services and hospital admissions. ⁹

Costs to Patient Care

Physicians cannot provide the best care for patients in the United Kingdom’s and they are speaking out against their government-controlled systems

• According to the Organization for Economic Co-operation and Development (OECD), the number of practicing physicians per 1,000 residents increased in the United Kingdom from 1.9 in 1999 to 2.3 in 2005. However, the United Kingdom is still well below the OECD average of 3 physicians per 1,000 citizens and ranks 24th out of 27 nations. ¹⁰
• Doctors in the United Kingdom are beginning to express concern and dismay about the NHS. A group of 500 doctors in the United Kingdom have joined together to create “Doctors for Reform.” This group calls for NHS reform, stating on their Web site, “We once believed that the NHS was the finest health care system in the world. Today few health care professionals would make such a claim.” ¹¹
• Dr. Jonathan Fielden, chairman of the Central Consultants and Specialists Committee, said that medical professionals in the United Kingdom are “angry because of this government’s mishandling of the health service.” He went on to say that the profession has “lost all confidence that the government can solve the problems it has created.” ¹²
• Dr. Ahmet Fuat, a long-time Darlington general practitioner, launched an outspoken attack on NHS, saying the NHS was no longer free at the point of use and is letting down vulnerable cancer patients. He also said restrictions on new cancer drugs widely prescribed in Europe and in the United States showed that the NHS was no longer meeting the needs of patients. “It saddens me that the NHS is withholding care from patients.”¹³
• Dr. John Crippen (alias), a British doctor who has worked for more than 20 years in the NHS, has developed his own blog to “[watch] and [weep] as the Health Service, slowly but inexorably, is destroyed.”¹⁴ His writing has appeared in the United Kingdom’s Guardian, one of the country’s largest newspapers.

1. ¹ “National Health Care Can Kill” By Michael Reagan, Ledger Independent (KY) (April 5, 2007).
2. ² Ibid.
3. ³ “Five-year wait for new hearing aid” Yorkshire Post (September 18, 2007).”
4. ⁴ “Paying Patients Test British Health Care System” By Sarah Lyall, The New York Times (February 21, 2008).
5. ⁵ Ibid.
6. ⁶ “Patients ‘failed’ by NHS inefficiency” The Guardian, http://www.guardian.co.uk/society/2006/jul/21/health (July 2006).
7. ⁷ “Patient satisfaction levels remain in a critical condition” http://www.timesonline.co.uk/tol/life_and_style/health/article3803656.ece (April 2008).
8. ⁸ “Getting More for Their Dollar: a Comparison of the NHS with California’s Kaiser Permanente,” By Richard G. A. Feachem, Neelam K. Sekhri, Karen L. White, British Medical Journal (January 19, 2001).
9. ⁹ Ibid.
10. ¹⁰ “Europe has the answer to NHS woes” By David Green, http://www.telegraph.co.uk/opinion/main.jhtml?xml=/opinion/2006/10/05/do0502.xml (May 2006)
11. ¹¹ “Doctor’s for Reform” http://www.doctorsforreform.com
12. ¹² Speech by Dr Jonathan Fielden, Chairman of the Central Consultants and Specialists Committee, at the Consultants Conference, British Medical Association (June 6, 2007)
13. ¹³ “Doctor hits out at NHS drugs policy” By Barry Nelson The Northern Echo (May 25, 2007)
14. ¹⁴ See example at http://www.blogger.com/profile/06683912157707013827.