Looking Westwards

A view, shared by many, is that competition, of one form or another, will improve outcomes and quality within the NHS. Moreover, when one thinks of competition in health care, one may think of the United States, which might, by extension, make one think of Kaiser Permanente. Like the NHS, Kaiser Permanente is essentially a health maintenance organisation (HMO) in that it combines its purchaser and provider arms into a single organisation; indeed, it is one of the largest integrated health service networks in the US. Therefore, following a somewhat circuitous route, we might ask ourselves the question: can the NHS learn anything from Kaiser Permanente? Given the frequent transatlantic visits involving NHS, Department of Health and Kaiser Permanente staff, it seems clear that many people believe that the answer to the above question is affirmative.