Originally created 03/08/06

Britain looks to U.S. on care, expert says



Getting a centrally controlled, government-run health care system to be more "patient-led" and consumer friendly is not an easy task, and England might look to the United States for clues, an expert on English health care told an Augusta State University audience Tuesday.

The rise of a "consumer" movement among British patients has not been without its problems, said Michael Bury, professor emeritus of sociology at the University of London. For instance, a few months ago the New England Journal of Medicine ran a study that showed the drug Herceptin was effective in earlier breast cancers (the drug is approved for late-stage disease) in some patients, Mr. Bury said.

"There was a huge campaign developed by patients in the Midlands in England to demand Herceptin," he said. "But there was a problem: Herceptin isn't licensed in Britain. They were demanding an unlicensed drug for their condition."

Nevertheless, the National Health Service gave in, even though the drug is very expensive and no new money was given to the local health authority to pay for it, Mr. Bury said.

"The British health system, at least in the rhetoric of the government's policy, is to be much more patient-oriented," he said. "Saying you want patient preferences to have a bigger role is different from actually dealing with the consequences."

It is an example of how the tax-funded British system is looking to the United States for ideas and even trying out some of its own, such as putting clinics in supermarkets. Now, for example, the general practitioner must provide a patient with a choice of five hospitals.

"My guess is a lot of patients will say to their (physician), 'Which one would you choose, doctor?'" Mr. Bury said.

Learning to work patients into the system as advisers, on family councils and getting them actively involved in the decision-making process has been pioneered at Medical College of Georgia. Other health care facilities are catching on, said Patricia Sodomka, director of the Center for Patient and Family Centered Care at MCG.

"In terms of where the U.S. is, there is definitely movement in this direction. By no means would I say that it was in the majority of health care facilities," she said.

There are pros and cons to each system and getting everyone health care would be a plus on the British side, said Augusta State student Shalonda McCullus.

"It would ensure that anyone would have equal access to health care," she said. "I don't know that it is better than the U.S. in terms of treatment."

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.

The Money Paradox



According to British health expert Michael Bury, England spends about 7 percent of its gross domestic product on health care while the U.S. spends about 14 percent. Yet the English have a higher life expectancy and lower infant mortality than Americans.