Perfect Medical System Seeks Global Best Practices: Insights from Mark Britnell's 'In Search of the Perfect Health System'

“The world is a book, and those who do not travel read only one page.” — Augustine

In fairy tales, a prince demanding perfection would traverse every corner of the world to find the most beautiful woman as his bride. Today, there is indeed an extraordinary individual who travels the globe in pursuit of a dream—only his quest is to identify the world’s most perfect healthcare system.

This courageous practitioner is Mr. Mark Britnell. He currently serves as Chairman and Partner of KPMG’s Global Centre of Excellence for Health, a role he has held for six years. Over the past six years, Mr. Britnell has tirelessly visited and studied healthcare systems in 60 countries, delivered more than 200 guest lectures worldwide, and authored a series of research papers.

Mr. Mark previously served as a senior NHS official, was a member of the NHS Management Board for three consecutive years, and was appointed as the UK Secretary of State for Health. He also became the youngest hospital director in the UK’s public hospital system, a record that remains unbroken to this day. Meanwhile, Mr. Mark is actively involved in charity and public welfare initiatives, serving as a trustee and board member of the UK Pancreatic Cancer Charity Foundation.

In accordance with the Sustainable Development Goals proposed by the United Nations, all 192 countries worldwide are tasked with achieving universal health coverage by 2030. This is indeed an ambitious goal and a monumental undertaking for all of humanity. Can this aspiration truly be realized? Believing that practice yields true knowledge, Mr. Mark conducted in-depth field research across more than 60 countries, ultimately distilling his insights and reflections into a book titled《In search of the Perfect Health System》。

Mr. Mark is not only a healthcare administrator but also an ordinary patient. Having been unfortunately diagnosed with prostate cancer six years ago, he examines healthcare systems in various countries from a patient’s perspective in this book, evaluates major healthcare reform measures implemented across nations, and analyzes and distills the most valuable successful elements worthy of emulation.

The new book, *In Search of the Perfect Health System*, provides an overview of the healthcare systems in 29 countries, covering interconnections among national systems, lessons learned, key initiatives, and best practices. It comprehensively addresses critical challenges facing global healthcare today, such as population aging, health informatics, and sustainable development.

As a rare new book with significant practical implications and reference value, it was highly commendable that Mr. Mark Britnell traveled all the way to China to recommend this valuable guide to his industry peers in the country. On December 6, KPMG Advisory (China) Co., Ltd. officially held a launch event for the book In Search of the Perfect Health System.



At the press conference, Mr. Mark Britnell concisely presented the key highlights of his new book, providing succinct summaries of 12 countries selected from a pool of 29:

United KingdomIt was the first country to establish a universal healthcare system in 1948, following World War II. Against the backdrop of post-war society, where there was a strong public demand for rebuilding the nation, the National Health Service (NHS) was established. Without exception, it provides equitable medical services to every legal resident, regardless of age, physical condition, race, faith, social status, or even ability to pay. Currently, the UK’s per capita personal healthcare expenditure is very low, accounting for only about 2% of total healthcare spending. Therefore, to this day, the NHS remains regarded as one of the proudest achievements of modern British society.

Israel: In terms of global healthcare standards, its system is excellent. The primary care system is particularly robust, operated by domestic Health Maintenance Organizations (HMOs), and so strong that it dominates the entire national healthcare system. This differs significantly from China. For instance, although Israel’s healthcare industry accounts for only 7.3% of its gross domestic product (GDP), it has achieved an average life expectancy of 83 years.

Brazil: The Brazilian flag bears the motto “Order and Progress,” a principle that also holds true in the healthcare sector. As a dynamic developing country, Brazil has made widely recognized achievements in healthcare. In 1988, Brazil established the Unified Health System (SUS), one of the largest public health systems in the world. Currently, Brazil’s community health services are relatively well-developed, similar to China’s situation; both countries face shortages of healthcare professionals. Therefore, Brazil places great emphasis on training sufficient primary care personnel at the community level. Community health services will play a significant role in reducing national mortality and disease incidence rates.

Australia: In 1991, its healthcare system was among the best in the world and continues to be ranked as the fourth-best healthcare system by the Commonwealth Fund. Its most prominent feature is the diversity of the system, with both private and public sectors establishing funds and delivering medical services within the national legal framework. Additionally, Australia began reforming its mental health system in 1990 to ensure that patients with mental illnesses receive adequate care.

AfricaHealthcare in Africa is undergoing transformation. Although infectious diseases and access to clean water and sanitation remain the continent’s most pressing challenges, a 6% economic growth over the past decade has lifted millions out of poverty and into the middle class, thereby driving greater demand for healthcare services. African governments are implementing a 14-year comprehensive National Health Insurance (NHI) system to cover 48 million people. Furthermore, to address the critical shortage of healthcare workers—who constitute only 5% of the global workforce yet serve 25% of the world’s patients—Africa has begun training large numbers of patients in self-health management and disease self-control, effectively reducing mortality rates and disease incidence.

United States: The United States boasts the most prominent pharmaceutical R&D capabilities in the world, with its research and development strength surpassing that of all European countries combined. This is evident from its investment in the healthcare sector, where total funding exceeds the combined budgets of the 27 European Union member states. Moreover, the U.S. has more Nobel laureates in fields such as medical devices and new drug development than all other countries combined.

India: In India, one can observe the coexistence of contradictory medical systems, where the best and worst extremes of healthcare services thrive side by side on this remarkable land. India has combined American-style intensive management with Japanese lean management techniques, shattering the myth that only wealthy nations can afford quality healthcare. With an innovative healthcare system, India has standardized clinical practices to guide medical professionals—including doctors and nurses—in adhering to standardized protocols, while also advancing health informatics. As a result, surgical costs are 25% lower than in Western countries; for procedures such as cataract surgery, some outcomes even surpass those achieved by U.S. hospitals.

Singapore: Singapore claims to have the world’s best healthcare system, with the highest life expectancy globally at 82.3 years. The infant mortality rate is only 2.7 per 1,000 live births. Since its independence, the country has consistently allocated 4.6% of its GDP to healthcare. The most distinctive feature of Singapore’s healthcare system is its advanced information and communications technology (ICT), which enables 40% of patients in the country to possess and freely access their electronic medical records.

France: The entire healthcare system fully embodies the nature of an egalitarian and fair collective entity. France allocates 11.7% of its GDP to its healthcare system, the highest proportion in Europe. It can be said that France has established a nearly perfect multi-payer hybrid healthcare service system, characterized by social insurance, patient choice, professional autonomy among specialists, and central regulations. Among healthcare providers, 40% are public institutions, 30% are private, and 30% are hospitals operated by charitable organizations; both public and private entities jointly deliver high-quality medical services.

Switzerland: For the 8 million residents of Switzerland, they are indeed fortunate. The Organisation for Economic Co-operation and Development (OECD) and the World Economic Forum have ranked Switzerland as the happiest, healthiest, and most highly educated country on our planet. According to the latest research report issued by the Commonwealth Fund in the United States, Switzerland’s healthcare system ranks second, only behind the United Kingdom. With an average life expectancy of 82.7 years, it trails only Japan, whose citizens enjoy the longest lifespans. This very small yet exceedingly wealthy nation allocates 10%–12% of its GDP to healthcare services. It boasts highly competitive standards in education, healthcare capabilities, and employer-employee relations, fostering an overall harmonious society.

Japan: Japan is known as a land of longevity, with an average life expectancy of 83.3 years. Its well-developed elderly care services and healthcare system are widely recognized around the world. Another issue brought about by longevity and declining birth rates is the intensification of population aging. In 2013, China ranked third in healthcare service investment, following the United States and itself. Due to the severe challenge of population aging, Japan’s elderly care services are very thorough and comprehensive, making them worthy of study.



Summary of the Advantages of Healthcare Systems in Different Countries: Mr. Mark has consolidated them into the following proposals. While it is unrealistic to implement all these solutions within a single country, they can serve as reference pathways for nations to draw upon.

1. Leverage the combined strength of the private sector and government to prevent disease and enhance healthcare services;
2. Implement tiered diagnosis and treatment for patients, with type-specific curative approaches;
3. Expand the scale of the primary healthcare system;
4. Centralized and localized delivery of clinical medical services;
5. Enhance scientific research capabilities to address clinical challenges;
6. Reform and improvement of the compensation and benefits system for medical personnel, with the introduction of effective incentive mechanisms;
7. Integrate hospitals into the healthcare system;
8. Provide welfare homes for the elderly and improve the elderly care system;
9. Provide mental health services for mental disorders on a community basis;
10. Caring for Patients Starts in the Community: Family and Community Involvement in Care Ensures That the Elderly Have Support and Can Leave This World with Greater Dignity.

At the event, KPMG also invited top executives from the healthcare industry and senior leaders from pharmaceutical institutions—including officials from the National Health and Family Planning Commission, the Medical Director of United Family Healthcare, representatives from the China Medical Board, and leaders from Sinopharm Group—to provide insightful brief commentaries on this book.

On-site Book Review:

1. Mr. Mark has extensive experience, having served as a physician under management, an administrator of healthcare institutions, and an official in government regulatory bodies. Having been involved in every segment of the healthcare service system, he possesses a highly comprehensive perspective. The greatest challenge our country faces when formulating healthcare policies is whether these policies can be designed from the perspective of those being regulated and whether they are implementable; this is the key issue.

The construction of healthcare systems is more akin to an art than a science. Science distinguishes between right and wrong, whereas art does not; it recognizes only good and better. Since the development of national healthcare systems is influenced by a multitude of factors—including history, politics, economics, and culture—our evaluation of medical systems should be approached from an artistic perspective.

2. This book introduces the strengths and weaknesses of 29 countries. Since World War II, the United Kingdom has been the first country to achieve universal health coverage, establishing a healthcare system underpinned by legal safeguards. China should learn two key lessons from the UK: first, enact a Health Law that clearly defines the functions of the government, the responsibilities and obligations of citizens, and the role of medical institutions;

Second, laws governing medical quality and patient safety should be strengthened, with provisions specifying requirements for healthcare service providers, mandating qualification reviews for personnel, and establishing regulatory frameworks. Additionally, it is recommended that the book supplement its content with the strengths of China’s healthcare system. China’s hospital service delivery, preventive care, and maternal and child health systems are among the most comprehensive in the world. The author is encouraged to include relevant material on these topics, as China offers valuable lessons for the global community. It is hoped that Mark will help disseminate China’s healthcare experiences to the world.

3. From this book, we learn that there is no necessary correlation between a country’s healthcare system and its national economy; rather, the strength of the government’s resolve and determination in policymaking is a critical factor influencing the comprehensiveness and effectiveness of the healthcare system.

4. The United Kingdom boasts a near-perfect universal healthcare system, which is directly linked to the fact that most of its top-tier talents are engaged in healthcare services. This is not the case in China. It is hoped that China’s outstanding talents will also concentrate in the healthcare sector, thereby contributing to the well-being of its citizens.

Returning to the beginning, the fairy tale ends with the prince failing to find his ideal goddess. Upon finally accepting reality, he willingly marries a princess who is equally beautiful but has a mole on the sole of her foot. Similarly, Mr. Mark’s global journey confirms that there is no absolutely perfect healthcare system in the world. The best we can do is to select the most effective solutions from various countries and implement changes to approximate our envisioned ideal.