Britain is on course to surpass the United States and could have the best health system in the world, an American health strategist said on Thursday.

Dr Donald Berwick, of the non-profit Institute for Healthcare Improvement (IHI) in the United States, said both countries face similar problems in bettering the health services they provide, but Britain is more likely to succeed.

“The biggest reason is simple,” Berwick said in an editorial in the journal Quality and Safety in Health Care. “The UK has people in charge of its health care - people with the clear duty and much of the authority to take on the challenge of changing the system as a whole.”

But in the United States the health system is leaderless and chaotic, he added.

Britain’s state-funded National Health Service (NHS) has been dogged by medical scandals, long waiting lists for routine surgery and a shortage of trained medical staff.

Berwick admits there are problems and major improvements are needed. But he said since 1997 total UK expenditure on health rose to from 6.5 percent of gross domestic product (GDP) closer to the European Union average of about 8.5 percent. In the United States it is about 15 percent.

“Three tough issues lie between the good successes that are almost in hand and the great ones that could be,” he added.

Berwick said the NHS was still too fragmented and improvements in care were needed at the community levels. British patients are far too passive and doctors are too controlling. Better education and training of health professionals is also needed to foster change.

“I do predict success for the UK in its efforts to build what can become the best healthcare system in the world - nothing less,” he added.