The “perfect” health system

20 Oct
Joan MV Pons
Joan MV Pons

Mark Britnell is an international expert in health systems having held several senior positions in the NHS and currently provides consulting services for several countries. With this wealth of experience, Britnell wrote a book in 2015 with the inspiring title of, In search of the perfect health care system (1). In it, Britnell examines the dilemmas facing governments, the global challenges such as demographic, epidemiological, technological and economic transitions, as well as the more specific cases facing each country.

A significant portion of the book, more than half, is dedicated to examining individual countries grouped by continent: the Asian region including Australia (with large countries from Japan, China and India, to small densely populated enclaves such as Singapore and Hong Kong) Africa and the Middle East (just three very different examples such as Qatar, Israel and South Africa), Europe (from Portugal to Russia via the Nordic countries, Germany, Italy, France and the English) and the Americas (from the north; Canada, USA and Mexico and the south, such as Brazil). Too bad that the section on the Iberian Peninsula only speaks of our western neighbours (the eastern side but a general walk through).

There is no questioning that Britnells’ knowledge has been acquired first hand, given his worldwide expertise in conferences and consultancy. As the author mentions, he is often asked which country has the best health care system? Since the WHO report, Health systems: Improving performance (2), published in 2000, several country rankings have been published according to the assessment of their health systems using a variety of methodologies and outcomes. The table below serves as an example.


Nowadays, rankings proliferate as can be seen in universities and research institutions/centres. The indicators may be different, but it seems that one may always end up finding the most favourable ranking for them. Catalan public universities are a good example, given that centre advertises their position – besides that of excellence in comparison to other universities which are not necessarily British –  in the ranking system which makes it stand out to a greater degree that other Catalan universities.

Britnell, getting back to our point, after so many rankings, lectures and consulting, make a proposal on what the best health system might be by taking the best areas from the different countries. If the world could have a perfect health system, it would have to possess the following characteristics:

–    Universal healthcare values (UK)
–    Primary health care (Israel)
–    Community services (Brazil)
–    Mental health and welfare (Australia)
–    Promoting health (Scandinavian countries)
–    Empowerment of patients and communities (certain African nations)
–    Research and development (USA)
–    Innovation and new ways of doing things (India)
–    IT and Communication technologies (Singapore)
–    The capacity of choice (France)
–    Funding (Switzerland)
–    Care for the elderly (Japan)


(1) Britnell M. In Search of the Perfect Health System. London (United Kingdom): Palgrave Macmillan Education; 2015.

(2) The World Health Report 2000. Health systems: improving performance. Geneva (Switzerland): World Health Organization (WHO); 2000.

(3) Where do you get the most for your health care dollar?. Bloomberg Visual Data; 2014.

(4) Davis K, Stremikis K, Squires D, Schoen C. 2014 Update. Mirror, mirror on the wall. How the performance of the U.S. Health Care System Compares Internationally. New York, NY (US): The Commonwealth Fund; 2014.

(5) Health outcomes and cost: A 166-country comparison. Intelligence Unit. The Economist; 2014.

Post written by Joan MV Pons.

Ideally, professionals could prescribe app’s and websites with trustworthy and quality content

15 Oct

mireia sansMireia Sans (MS in the text), family physician and director of the Unitat de Gestió Hospitalet Nord of Institut Català de la Salut, in an interview made by Anna García-Altés (AGA in the text), discusses the advantages of the new technologies for the health care world and advocates the importance of digital identity.

AGA: What it is meant by digital identity?

MS: It is the set of information that exposes us on the Internet, whether we’re talking about personal data, images, records, news, reviews… All this provides our description to digital level. It’s important to not try to invent a false identity but rather to emphasize the virtues-values​​-knowledge-skills you have and wish to publicize.

AGA: Is it necessary for health professionals to have a well presented digital identity? What are the benefits?

MS: Yes, it’s fundamental. Working on this identity is the first step towards a successful and proactive management of our digital reputation, which reflects what we do, what we teach and say about ourselves and also what others say about us. Continue reading

Social networks and health, an opportunity that still has far to go

8 Oct

Josep Vidal AlaballJosep Vidal Alaball, Family Doctor. EAP Artés (ICS)

Whatever the field, social networks open a range of opportunities. Their features has been changing many people’s lives for many years, starting with the closest relationships to organizations, companies and brands around us and yes, even the medical staff.

In the health field, I’m not quite sure whether the social networks should be used to improve the relationship and interaction with patients, as this aspect should be dealt with in everyday consultations. What is certain is that social networks can be used to enable patients to consult doctors or reinforce aspects that sometimes can not be completely covered during a medical consultation. A good example is the use of inhalers. Sometimes, it can be easier for a professional to recommend patients a video showing how people with respiratory diseases use it, instead of briefly and superficially teaching the correct technique during the consultation. Continue reading