Kaiser patients are able to leave hospital earlier

Trusts in eight areas of England have adopted practices developed by Kaiser Permanente, a not-for-profit private health provider based in California.

They are trying to treat more patients in the community, allowing them to leave hospital much earlier.

However, the move has come under fire from some members of the Labour Party and trade unions.

They are concerned that the policy will undermine the NHS and have criticised the decision to look to the US for ways to improve hospitals.

Kaiser Permanente is the world's biggest private health insurer, providing health insurance to over eight million Americans.

There are problems with Kaiser Permanente's pilot schemes

Karen Jennings, UNISON

As a result, Kaiser uses around one third of the number of bed days as the NHS for leading causes of admission such as asthma, bronchitis and strokes among people over 65.

Government approval

Health Secretary John Reid, who is currently in the US, has given the pilots his seal of approval.

He will tell an international gathering of health ministers in Washington on Thursday that he is encouraged by the early results from the pilots.

On Friday, he will visit a Kaiser medical centre in the city to see at first hand how it treats patients.

However, Mr Reid rejected criticism of the policy.

Primary care trusts running pilots Torbay St Albans Taunton Deane Northampton East Sussex Eastern Birmingham Blackpool Lincolnshire South West

"On the other hand, people like Kaiser, a not-for-profit organisation working in the United States, do operate in a fashion that we can learn from in terms of improving the efficiency of our national health service."

He insisted that the decision to adopt some US style hospital practices did not represent a threat to the NHS.

"We are totally committed to the NHS providing high quality care free at the point of need," he said.

"Nevertheless, it doesn't mean that we cannot learn lessons from insurance based systems."

Professor Chris Ham, director of the Department of Health's strategy unit, also backed the Kaiser model.

"The main lesson from Kaiser is its ability to minimise the use of acute hospital beds through an integrated approach to service delivery.

"At the heart of this approach is a strong focus on the management of people with chronic diseases and the breaking down of barriers between secondary and primary care.

"Compared with the NHS, more care is delivered in a community setting, and this includes the use of intermediate care, home care and self care by patients.

Policy under fire

Former health secretary Frank Dobson is among those who have criticised the move.

The biggest health union Unison has also expressed concerns.

Karen Jennings, its head of health, said: "I think most people will be horrified to learn that John Reid is looking to America for lessons on how to run the NHS.

"This is a country where millions of the poorest people struggle to get any healthcare at all and where a chronic illness can bankrupt a family."

Shadow health secretary Liam Fox said: "After all of New Labour's criticisms of the US healthcare system, and while the Conservatives have been looking at alternatives in Europe and Australia, the news that John Reid is examining a US-style insurance based system yet again demonstrates New Labour's cynical spin and hypocrisy."

But Mike Hall, chairman of the Association of British Insurers private medical insurance committee, welcomed the move.

"The fact that the health secretary recognises that insurance-based systems, like the Kaiser Permanente model in the US, can offer new ways of improving patient care is definitely a step in the right direction."