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Gold, incentives and meh

'Flawed evidence backs US-style care'

Government accused of relying on unsupported findings for flagship health policy – by Joe Lepper and Emma Wilkinson

Ministers are using 'flawed' evidence to support their crusade to bring American health care systems to the NHS, academics claim.

The attack came in a study that criticises research cited by the Department of Health as evidence for using US pro-vider Kaiser Permanente.

The research 'Getting more for their dollar', published in 2002, found Kaiser Permanente provided better-quality care and used fewer acute

beds at a lower cost than the NHS.

Health Secretary John Reid hailed the findings and the department set up eight pilot schemes using Kaiser's active case management strategy for chronic disease management.

The Government has also paid for dozens of NHS staff to visit the organisation's base in California.

But a study in this month's British Journal of General Practice has argued the original research is 'unsupported by the evidence'.

Author Professor Allyson Pollock, chair of health policy and health services research at University College London, said it failed to take into account Kaiser's younger, healthier client base in the US, was based on 'wrongly inflated NHS costs' and used questionable data for NHS bed days.

Professor Pollock told Pulse there were doubts over the evidence for all of the US systems being promoted by the Government, not just Kaiser. GPs criticised ministers last month for announcing a nationwide rollout of the Evercare programme without enough evidence of its success.

She said: 'It looks like the Government is being selective when it comes to looking at evidence.'

GPC negotiator Dr Andrew Dearden said the Government was 'trying to find evidence' to support its policy rather than looking at how the system could be improved.

Dr Robert Morley, a GP in Birmingham who visited Kaiser as part of a department trip, said the NHS could learn from its integrated approach.

He added: 'What impressed me was that it was an integrated service led by doctors, not managers.'

A department spokesman said it had made its own analysis of Kaiser's work.

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