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Harvard Health Expert Knighted

Appointment recognizes efforts to reform British National Health Service

By Daniel J. T. Schuker, Crimson Staff Writer

Most Harvard professors can boast a seemingly endless array of academic accolades, but Donald M. Berwick ’68, a professor at the Harvard School of Public Health (SPH) and Harvard Medical School (HMS), last week received an award shared by only a few Americans—an appointment as an honorary Knight Commander of the Most Excellent Order of the British Empire.

Queen Elizabeth II bestowed the honor on Berwick, a leading authority on health care quality and improvement, for his efforts to help reform Britain’s National Health Service (NHS) since the mid-1990s.

As an honorary knight, Berwick will join such Americans as Bill Gates, Class of 1977; Steven Spielberg; Alan Greenspan; Rudy Giuliani; Wesley Clark; and Norman Schwarzkopf.

And while the honorary appointment might not garner Berwick VIP treatment in the U.S., it catapults him to one of the most distinguished echelons of British society.

“It is extraordinarily rare,” said Terri Evans, a spokeswoman for the British Consulate-General in Boston. “That level of distinction is really reserved for exceptional achievement.”

Berwick is the first American from New England in at least 15 years to be made an honorary knight, according to Evans. At most, two or three Americans across the nation receive the honor each year.

Berwick played an important role in helping Prime Minister Tony Blair’s Labour Party develop a plan to improve the NHS—especially through its “Modernisation Plan” for the U.K.’s health care system.

“There was a great deal of overlap between their work and the work we’d done,” said Berwick, who was the only non-British member of the Modernisation Plan’s board. “They adapted a number of techniques that my colleagues and I had developed in the U.S.”

Berwick said he had also worked to help plot the future path of Britain’s health care system.

Under the Labour Party’s reforms, health care waiting times were drastically reduced, cancer treatment became more efficient, and care for heart-attack patients was improved, Berwick explained, citing independent assessments by private health care foundations.

Thomson Professor of Government James E. Alt, who studies British politics, said that the British government had “some success” in its recent health care reforms, particularly in its push to reduce hospital waiting lists. But he also acknowledged—as did the reports Berwick cited—that Britain’s health care system has several hurdles that it must still overcome.

“Compared to the severe problems the NHS faces in improving the quality of service and accountability of doctors,” Alt wrote in an e-mail, “there is still a long way to go.”

Sir Brian Jarman, a former president of the British Medical Association, echoed Alt’s observation.

“Waiting times for hospital entry are virtually unchanged since 1997, [and] we still have fewer doctors and hospital beds per head…than comparable Western countries,” Jarman wrote in an e-mail.

HMS and SPH Professor Howard H. Hiatt—who co-teaches General Education 187, “The Quality of Health Care in America,” with Berwick and has worked closely with him in other endeavors—said he could speak “only in superlatives” about his colleague.

“He’s focused on quality of care, which has been greatly neglected in much of the medical community,” Hiatt said. “That extends all the way from how you lower death rates in an emergency room to how you lower waiting times in a doctor’s office.”

Berwick said he was “just thrilled” when he heard the news.

“I did not expect it,” he added. “I know that the work that they’re talking about is really the work of dozens of colleagues of mine.”

Besides his professorships at SPH and HMS, Berwick is also president and chief executive officer of the Institute for Healthcare Improvement, a Cambridge-based nonprofit organization that aims to improve the quality of health care systems around the globe.

With degrees from three of Harvard’s schools, Berwick is well acquainted with the University. He graduated summa cum laude from the College, earned his medical degree from HMS in 1972, and received a masters in public policy from Harvard’s Kennedy School of Government that same year.

According to a press release by the British Consulate-General, Berwick will receive the honor in a ceremony later this year.

Berwick’s knighthood—which does not require any additional responsibilities and does not offer any pay—is “honorary” because he is an American citizen. Only British citizens are appointed knights that can call themselves “sir.”

Knight Commander is the second rank of the Most Excellent Order of the British Empire, which was established in 1917.

Jarman, who was knighted in 1998, said that the honor did not have a major effect on his daily life.

“It’s very nice for my family,” he wrote. “[It] also helps when writing letters of complaint.”

—Staff writer Daniel J. T. Schuker can be reached at

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