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Kaiser Permanente
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Kaiser Permanente
Type
Consortium of for-profit and not-for-profit entities.
Industry
Healthcare
Founded
July 21, 1945; 72 years ago (1945-07-21)
Founder
Henry J. Kaiser
Sidney R. Garfield
Headquarters
Ordway Building
Oakland, California, U.S.
Key people
Bernard J Tyson,
Health Plan and Hospitals CEO
Geoffrey Sewell, M.D.,
Federation Executive Director
see section below
Revenue
$64.6 billion USD (2016)[1]
Net income
$1.9 billion USD (2016)[1]
Number of employees
208,975 employees (2017)
21,275 physicians (2017)[2]
Website
kp.org
Kaiser Permanente (/ˈkaɪzər pɜːrməˈnɛnteɪ/; KP) is an integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser Permanente is made up of three distinct but interdependent groups of entities: the Kaiser Foundation Health Plan, Inc. (KFHP) and its regional operating subsidiaries; Kaiser Foundation Hospitals; and the regional Permanente Medical Groups. As of 2017, Kaiser Permanente operates in eight states (Hawaii, Washington, Oregon, California, Colorado, Maryland, Virginia, Georgia) and the District of Columbia, and is the largest managed care organization in the United States.
As of October 2017, Kaiser Permanente had 11.7 million health plan members, 208,975 employees, 21,275 physicians, 54,072 nurses, 39 medical centers, and 720 medical facilities.[2] As of December 31, 2016, the non-profit Kaiser Foundation Health Plan and Kaiser Foundation Hospitals entities reported a combined $1.9 billion in net income on $64.6 billion in operating revenues.[1] Each Permanente Medical Group operates as a separate for-profit partnership or professional corporation in its individual territory, and while none publicly reports its financial results, each is primarily funded by reimbursements from its respective regional Kaiser Foundation Health Plan entity. KFHP is one of the largest not-for-profit organizations in the United States.
KP's quality of care has been highly rated and attributed to a strong emphasis on preventive care, its doctors being salaried rather than paid on a fee-for-service basis, and an attempt to minimize the time patients spend in high-cost hospitals by carefully planning their stay. However, Kaiser has had disputes with its employees' unions, repeatedly faced civil and criminal charges for falsification of records and patient dumping, faced action by regulators over the quality of care it provided, especially to patients with mental health issues, and has faced criticism from activists and action from regulators over the size of its cash reserves.
Contents
[hide]
1 Structure and governance
1.1 Governance
1.2 National structure
1.3 Regional entities
2 History
2.1 Early years
2.2 World War II
2.3 Postwar growth
2.4 Managed care era
2.5 Regional evolution
2.6 KP HealthConnect
2.7 International reputation
3 Quality of care
3.1 Historical issues
4 Research and publishing
5 Controversies
5.1 Mandatory arbitration
5.2 Labor unions
5.3 Cash reserves
6 See also
7 References
8 External links
Structure and governance[edit]
Kaiser Permanente provides care throughout eight regions in the United States. Two or three (four, in the case of California) distinct but interdependent legal entities form the Kaiser system within each region. This structure was adopted by Kaiser Permanente physicians and leaders in 1955.
Governance[edit]
Each entity of Kaiser Permanente has its own management and governance structure, although all of the structures are interdependent and cooperative to a great extent. There are multiple affiliated non-profits registered with the U.S. Internal Revenue Service. According to Form 990 governance questions, Kaiser Foundation Hospitals and Kaiser Foundation Health Plan do not have members with the power to appoint or elect board members, meaning that the board itself nominates and appoints new members.[3]
Chairman and CEO George Halvorson retired in December 2013, after serving since 2002.[4]
On November 5, 2012, the board of directors announced that Bernard J. Tyson, Kaiser's president and chief operating officer for the last two years, would replace Halvorson[5] — the first time an African American was appointed to that position.[6]
National structure[edit]
The two types of organizations which make up each regional entity are:
Kaiser Foundation Health Plans (KFHP) work with employers, employees, and individual members to offer prepaid health plans and insurance. The health plans are not-for-profit and provide infrastructure for and invest in Kaiser Foundation Hospitals and provide a tax-exempt shelter for the for-profit medical groups.
Permanente Medical Groups are physician-owned organizations, which provide and arrange for medical care for Kaiser Foundation Health Plan members in each respective region. The medical groups are for-profit partnerships or professional corporations and receive nearly all of their funding from Kaiser Foundation Health Plans. The first medical group, The Permanente Medical Group, formed in 1948 in Northern California. Kaiser doctors become Permanente stockholders after three years at the company.[7]
In addition, Kaiser Foundation Hospitals operates medical centers in California, Oregon, Washington and Hawaii, and outpatient facilities in the remaining Kaiser Permanente regions. The hospital foundations are not-for-profit and rely on the Kaiser Foundation Health Plans for funding. They also provide infrastructure and facilities that benefit the for-profit medical groups.
Regional entities[edit]
Kaiser Permanente is administered through eight regions, including one parent and six subordinate health plan entities, one hospital entity, and nine separate, affiliated medical groups:
[show]Various legal entities serve the areas of the US where Kaiser operates: California (the largest two), Colorado, Georgia, Hawaii, mid-Atlantic, Pacific Northwest, and Washington.
Northern California, 3,351,449 members[8]
Kaiser Foundation Health Plan, Inc. (KFHP)
Kaiser Foundation Hospitals (KFH)
The Permanente Medical Group, Inc. (TPMG)
Southern California, 3,499,035 members
Kaiser Foundation Health Plan, Inc. (KFHP)
Kaiser Foundation Hospitals (KFH)
Southern California Permanente Medical Group (SCPMG)
Colorado, 531,908 members
Kaiser Foundation Health Plan of Colorado (KFHPCO)
Colorado Permanente Medical Group, P.C. (CPMG)
Georgia, 222,074 members
Kaiser Foundation Health Plan of Georgia, Inc. (KFHPGA)
The Southeast Permanente Medical Group, Inc. (TSPMG)
Hawaii, 226,900 members
Kaiser Foundation Health Plan, Inc. (KFHP)
Kaiser Foundation Hospitals (KFH)
Hawaii Permanente Medical Group, Inc. (HPMG)
Mid-Atlantic (vicinity of Washington, D.C., including Maryland and Virginia), 581,000 members
Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. (KFHPMA)
Mid-Atlantic Permanente Medical Group, P.C. (MAPMG)
Northwest (Northwest Oregon and Southwest Washington), 480,386 members
Kaiser Foundation Health Plan of the Northwest (KFHPNW)
Kaiser Foundation Hospitals (KFH)
Northwest Permanente, P.C. Physicians and Surgeons (NWP)
Washington (except Southwest Washington), 681,386 members
Kaiser Foundation Health Plan of Washington
Washington Permanente Medical Group
In addition to the regional entities, in 1996, the then-twelve Permanente Medical Groups created The Permanente Federation, a separate entity, which focuses on standardizing patient care and performance under one name and system of policies. Around the same time, The Permanente Company was also chartered as a vehicle to provide investment opportunities for the for-profit Permanente Medical Groups.[9] One of the ventures of the Permanente Company is Kaiser Permanente Ventures, a venture capital firm that invests in emerging medical technologies.[10]
Kaiser Permanente's headquarters (the Ordway Building in downtown Oakland)
One of Kaiser's six other office buildings in Oakland
History[edit]
Kaiser Sunset Hospital complex in Los Angeles, California
Early years[edit]
The history of Kaiser Permanente dates to 1933 and a tiny hospital in the town of Desert Center, California. At that time, Henry J. Kaiser and several other large construction contractors had formed an insurance consortium called Industrial Indemnity to meet their workers' compensation obligations. Dr. Sidney Garfield had just finished his residency at Los Angeles County-USC Medical Center at a time when jobs were scarce; fortunately, he was able to secure a contract with Industrial Indemnity to care for 5,000 construction workers building the Colorado River Aqueduct in the Mojave Desert. Soon enough, Garfield's new hospital was in a precarious financial state (with mounting debt and the staff of three going unpaid), due in part to Garfield's desire to treat all patients regardless of ability to pay, as well as his insistence on equipping the hospital adequately so that critically injured patients could be stabilized for the long journey to full-service hospitals in Los Angeles.[11]:19–26
However, Garfield won over two Industrial Indemnity executives, Harold Hatch and Alonzo B. Ordway. It was Hatch who proposed to Garfield the specific solution that would lead to the creation of Kaiser Permanente: Industrial Indemnity would prepay 17.5% of premiums, or $1.50 per worker per month, to cover work-related injuries, while the workers would each contribute five cents per day to cover non-work-related injuries. Later, Garfield also credited Ordway with coming up with the general idea of prepayment for industrial healthcare. Garfield also later explained that he did not know much at the time about other similar health plans except for the Ross-Loos Medical Group.[12]
Hatch's solution enabled Garfield to bring his budget back into the positive, and to experiment with providing a broader range of services to the workers besides pure emergency care. By the time work on the aqueduct concluded and the project was wrapped up, Garfield had paid off all his debts, was supervising ten physicians at three hospitals, and controlled a financial reserve of $150,000.[13]
Garfield returned to Los Angeles for further study at County-USC with the intent of entering private practice. However, in March 1938, Consolidated Industries (a consortium led by the Kaiser Company) initiated work on a contract for the upper half of the Grand Coulee Dam in Washington state, and took over responsibility for the thousands of workers who had worked for a different construction consortium on the first half of the dam. Edgar Kaiser, Henry's son, was in charge of the project. To smooth over relations with the workers (who had been treated poorly by their earlier employer), Hatch and Ordway persuaded Edgar to meet with Garfield, and in turn Edgar persuaded Garfield to tour the Grand Coulee site. Garfield subsequently agreed to reproduce at Grand Coulee Dam what he had done on the Colorado River Aqueduct project. He immediately spent $100,000 on renovating the decrepit Mason City Hospital and hired seven physicians.[14]
Unlike the workers on Garfield's first project, many workers at Grand Coulee Dam had brought dependents with them. The unions soon forced the Kaiser Company to expand its plan to cover dependents, which resulted in a dramatic shift from industrial medicine into family practice and enabled Garfield to formulate some of the basic principles of Kaiser Permanente. It was also during this time that Henry Kaiser personally became acquainted with Garfield and forged a friendship which lasted until Kaiser's death.[15]
World War II[edit]
Kaiser Field Hospital in Richmond, California. Defunct since 1995
In 1939, the Kaiser Company began work on several huge shipbuilding contracts in Oakland, and by the end of 1941 would control four major shipyards on the West Coast. During 1940, the expansion of the American defense-industrial complex in preparation for entrance into World War II resulted in a massive increase in the number of employees at the Richmond shipyard.[16] In January 1941, Henry Kaiser asked Garfield to set up an insurance plan for the Richmond workers (this was merely contract negotiation with insurance companies), and a year later Kaiser asked Garfield to duplicate at Richmond what he had done at Desert Center and Mason City.[17] Unlike the two other projects, the resulting entity lived on after the construction project that gave birth to it, and it is the direct ancestor of today's Kaiser Permanente.[18]
On March 1, 1942, Sidney R. Garfield & Associates opened its offices in Oakland to provide care to 20,000 workers, followed by the opening of the Permanente Health Plan on June 1.[19] From the beginning, Kaiser Permanente strongly supported preventive medicine and attempted to educate its members about maintaining their own health.[20]
In July, the Permanente Foundation formed to operate Northern California hospitals that would be linked to the outpatient health plans, followed shortly thereafter by the creation of Northern Permanente Foundation for Oregon and Washington and Southern Permanente Foundation for California. The name Permanente came from Permanente Creek, which flowed past Henry Kaiser's first cement plant on Black Mountain in Cupertino, California. Kaiser's first wife, Bess Fosburgh, liked the name. An abandoned Oakland facility was modernized as the 170-bed Permanente Hospital opened on August 1, 1942. Three weeks later, the 71-bed Richmond Field Hospital opened. Six first aid stations were set up in the shipyards to treat industrial accidents and minor illness. Each first aid station had an ambulance ready to rush patients to the surgical field hospital if required. Stabilized patients could be moved to the larger hospital for recuperative care.[21] The Northern Permanente Hospital opened two weeks later to serve workers at the Kaiser shipyard in Vancouver, Washington.[22] Shipyard workers paid seven cents per day for comprehensive health care coverage; and within a year the shipyard health plan employed sixty physicians with salaries between $450 and $1,000 per month. These physicians established California Physicians Service to offer similar health coverage to the families of shipyard workers.[21] In 1944, Kaiser decided to continue the program after the war and to open it up to the general public.[18]
Meanwhile, during the war years, the American Medical Association (AMA) (which opposed managed care organizations from their very beginning) tried to defuse demand for managed care by promoting the rapid expansion of the Blue Cross and Blue Shield preferred provider organization networks.[23]
Courage to Heal, a novel by KP Historical Society President, Paul Bernstein, MD, is based on the story of Garfield's life, his struggles with the AMA, and the origins of Kaiser Permanente.
Postwar growth[edit]
In 1948, Kaiser established the Henry J. Kaiser Family Foundation, (also known as Kaiser Family Foundation), a U.S.-based, non-profit, private operating foundation focusing on the major health care issues facing the nation.[24] The Foundation, not associated with Kaiser Permanente or Kaiser Industries, is an independent voice and source of facts and analysis for policymakers, the media, the health care community, and the general public.[24]
The end of World War II brought about a huge plunge in Kaiser Permanente membership; for example, 50,000 workers had left the Northern California yards by July 1945. Membership bottomed out at 17,000 for the entire system but then surged back to 26,000 within six months as Garfield aggressively marketed his plan to the public.[25] Sidney Garfield & Associates had been a sole proprietorship, but in 1948, it was reorganized into a partnership, Permanente Medical Group.[26]
During this period, a substantial amount of growth came from union members; the unions saw Kaiser Permanente care as more affordable and comprehensive than what was available at the time from private physicians under the fee-for-service system. For example, Fortune magazine had reported in 1944 that 90% of the U.S. population could not afford fee-for-service healthcare. Kaiser Permanente membership soared to 154,000 in 1950, 283,000 in 1952, 470,000 in 1954, 556,000 in 1956, and 618,000 in 1958.[27]
From 1944 onward, both Kaiser Permanente and Garfield fought numerous attacks from the AMA and various state and local medical societies. Henry Kaiser came to the defense of both Garfield and the health plans he had created.[28]
In 1951, the organization acquired its current name when Henry Kaiser unilaterally directed the trustees of the health plans, hospital foundations, and medical groups to add his name before Permanente.[29] However, the physicians in the Permanente Medical Group deeply resented the implication that they were directly controlled by Kaiser, and successfully forced him to back off with respect to their part of the organization. That same year, Kaiser Permanente also began experiments with large-scale multiphasic screening to identify unknown conditions and to facilitate treatment of known ones.[30] Simultaneously, although no one questioned his medical competence, Garfield's deficiencies as an executive were becoming apparent as the organization expanded far beyond his ability to manage it properly.[31]
Henry Kaiser became fascinated with the healthcare system created for him by Garfield and began to directly manage Kaiser Permanente and Garfield. This resulted in a financial disaster when Kaiser splurged on the new Walnut Creek hospital; his constant intermeddling led to significant friction at every level of the organization. The situation was not helped by Kaiser's marriage to Garfield's head administrative nurse (who had helped care for Kaiser's first wife on her deathbed), convincing Garfield to marry the sister of that nurse, and then having Garfield move in next door to him. Clifford Keene (who would eventually serve as president of Kaiser Permanente) later recalled that this arrangement resulted in a rather dysfunctional and combative family in charge of Kaiser Permanente.[32]
Keene was an experienced Permanente physician whom Garfield had personally hired in 1946. During 1953 he had been trying to get a job at U.S. Steel, but on the morning of December 5, 1953, with internal tensions worsening day by day, Garfield met with Keene at the Mark Hopkins Hotel in San Francisco and asked him to turn around the organization. It took Keene 15 years to realize that Kaiser had forced Garfield to ask Keene to become his replacement. Due to the chaos on the board, Keene at first took control with the vague title of Executive Associate, but it soon became clear to everyone that he was actually in charge and Garfield was to become a lobbyist and "ambassador" for the HMO concept.[33]
However, even with Garfield relieved of day-to-day management duties, the underlying problem of Henry Kaiser's authoritarian management style continued to persist. After several tense confrontations between Kaiser and Permanente Medical Group physicians, the doctors met with Kaiser's top adviser, Eugene Trefethen, at Kaiser's personal estate near Lake Tahoe on July 12, 1955. Trefethen came up with the idea of a contract between the medical groups and the health plans and hospital foundations which would set out roles, responsibilities, and financial distribution.[34] Trefethen, already a successful attorney, went on to a successful career with Kaiser Permanente and in retirement became a famous vintner.
While Keene and Trefethen struggled to fix the damage from Kaiser's micromanagement and Garfield's ineffectual management, Henry Kaiser moved to Oahu in 1956 and insisted on expanding Kaiser Permanente into Hawaii in 1958. He quickly ruined what should have been a simple project, and only a last-minute intervention by Keene and Trefethen in August 1960 prevented the total disintegration of the Hawaii organization.[35] By that year, Kaiser membership had grown to 808,000.[36]
Managed care era[edit]
Having overseen Kaiser Permanente's successful transformation from Henry Kaiser's healthcare experiment into a large-scale self-sustaining enterprise, Keene retired in 1975.[37] By 1976, membership reached three million. In 1977, all six of Kaiser Permanente's regions had become federally qualified health maintenance organizations. Historians now believe then-President Richard Nixon specifically had Kaiser Permanente in mind when he signed the Health Maintenance Organization Act of 1973, as the organization was mentioned in an Oval Office discussion of the Act, where John Ehrlichman characterized Kaiser's philosophy thus: "All the incentives are toward less medical care, because the less care they give them, the more money they make."[38] In 1980, Kaiser acquired a non-profit group practice to create its Mid-Atlantic region, encompassing the District of Columbia, Maryland, and Virginia. In 1985, Kaiser Permanente expanded to Georgia.
Regional evolution[edit]
By 1990, Kaiser Permanente provided coverage for about a third of the population of the cities of San Francisco and Oakland; total Northern California membership was over 2.4 million.[39]
Elsewhere, Kaiser Permanente did not do as well, and its geographic footprint changed significantly in the 1990s. The organization spun off or closed outposts in Texas, North Carolina, and the Northeast. In 1998, Kaiser Permanente sold its Texas operations, where reported problems had become so severe that the organization directed its lawyers to attempt to block the release of a Texas Department of Insurance report. This prompted the state attorney general to threaten to revoke the organization's license.[40] Kaiser Permanente closed health plans in Charlotte and Raleigh-Durham[41] in North Carolina four years later. The organization also sold its unprofitable Northeast division in 2000. The Ohio division was sold to Catholic Health Partners in 2013.[42]
In 1995, Kaiser Permanente celebrated its fiftieth anniversary as a public health plan. Two years later, national membership reached nine million. In 1997, the organization established an agreement with the AFL-CIO to explore a new approach to the relationship between management and labor, known as the Labor Management Partnership. Going into the new millennium, competition in the managed care market increased dramatically, raising new concerns. The Southern California Permanente Medical Group saw declining rates of new members as other managed care groups, notably DaVita HealthCare Partners, flourished.
KP HealthConnect[edit]
In 2002, Kaiser Permanente abandoned its attempt to build its own clinical information system with IBM, writing-off some $452 million in software assets. This information technology failure led to major changes in the organization's approach to digital records. Under George Halvorson's direction, Kaiser looked closely at two medical software vendors, Cerner and Epic Systems, ultimately selecting Epic as the primary vendor for a new system, branded KP HealthConnect. Although Kaiser's approach shifted to "buy, not build," the project was unprecedented for a civilian system in size and scope. Deployed across all eight regions over six years and at a cost of more than $6 billion,[43] by 2010, it was the largest civilian electronic medical record system, serving more than 8.6 million Kaiser Permanente members, implemented at a cost exceeding a half million dollars per physician.[44]
International reputation[edit]
Early in the 21st century the NHS and UK Department of Health became impressed with some aspects of the Kaiser operation, and initiated a series of studies involving several healthcare organizations in England.[45][46] Visits occurred and suggestions of adopting some KP policies are currently active. The management of hospital bed-occupancy by KP, by means of integrated management in and out of hospital and monitoring progress against care pathways has given rise to trials of similar techniques in eight areas of the UK.
In 2002, a controversial study by California-based academics published in the British Medical Journal compared Kaiser to the British National Health Service, finding Kaiser to be superior in several respects.[45] Subsequently, a group of health policy academics who were experts on the NHS published a competing analysis claiming that Kaiser's costs were actually substantially higher than the NHS and for a younger and healthier population.[47]
Quality of care[edit]
In the California Healthcare Quality Report Card 2013 Edition, Kaiser Permanente's Northern California and Southern California regions, Kaiser received four out of four possible stars in Meeting National Standards of Care. Kaiser North and South also received three out of four stars in Members Rate Their HMO.[48] KP's performance has been attributed to three practices: First, KP places a strong emphasis on preventive care, reducing costs later on. Second, its doctors are salaried rather than paid per service, which removes the main incentive for doctors to perform unnecessary procedures. Thirdly, KP attempts to minimize the time patients spend in high-cost hospitals by carefully planning their stay and by shifting care to outpatient clinics. This practice results in lower costs per member, cost savings for KP and greater doctor attention to patients. A comparison to the UK's National Health Service found that patients spend 2–5 times as much time in NHS hospitals as compared to KP hospitals.[49][50]
In June 2013, the California Department of Managed Health Care (DMHC) levied a $4 million fine, the second largest in the agency's history, against Kaiser for not providing adequate mental health care to its patients. Alleged violations of California's timely access laws included failures to accurately track wait times and track doctor availability amid evidence of inconsistent electronic and paper records. It was also found by the DMHC that patients received written materials circulated by Kaiser dissuading them from seeking care, a violation of state and federal laws. DMHC also issued a cease and desist order for Kaiser to end the practices.[51][52] DMHC conducted a follow up investigation which published in April 2015. The report found Kaiser had put systems in place to better track how patients were being cared for, but still had not addressed problems with actually providing mental health care that complied with state and federal laws.[52] Kaiser's challenges on this front were exacerbated by a long, unresolved labor dispute with the union representing therapists.[52]
Kaiser appealed the findings, the order, and the fine, and sought to keep the proceedings closed, but in September 2014, in the face of the administrative judge's order to keep the proceedings open, and facing the beginning of public testimony, Kaiser withdrew the appeal and paid the $4 million. It also issued a statement which denied much of the wrongdoing. Kaiser faces ongoing inspections by DMHC and three class-action lawsuits related to the issues identified by the DMHC.[53]
Historical issues[edit]
In 2006 Kaiser settled five cases for alleged patient dumping—the delivery of homeless hospitalized patients to other agencies or organizations in order to avoid expensive medical care—between 2002 and 2005. Los Angeles city officials had filed civil and criminal legal action against Kaiser Permanente for patient dumping, which was the first action of its kind that the city had taken.[54] The city's decision to charge Kaiser Permanente reportedly was influenced by security camera footage, allegedly showing a 63-year-old patient, dressed in hospital gown and slippers, wandering toward a mission on Skid Row (this footage was prominently featured in the Michael Moore 2007 documentary Sicko). At the time that the complaint was filed, city officials said that 10 other hospitals were under investigation for similar issues.[54] Kaiser settled the case, paying $5,000 in civil penalties and agreeing to spend $500,000 on services for the homeless.[55] During that same period, the Department of Health and Human Services' Office of the Inspector General settled 102 cases against U.S. hospitals which resulted in a monetary payment to the agency.[56][57]
In 2004, Northern California Kaiser Permanente initiated an in-house program for kidney transplantation. Prior to opening the transplant center, Northern California Kaiser patients would generally receive transplants at medical centers associated with the University of California (UC San Francisco and UC Davis). Upon opening the transplant center, Kaiser required that members who are transplant candidates in Northern California obtain services exclusively through its internal KP-owned transplant center.
While it was in operation, the Kaiser program had a 100% survival rate, which is better than other transplant centers. However, patients who needed a kidney were less likely to be offered one.[58] Northern California Kaiser performed 56 transplants in 2005, and twice that many patients died while waiting for a kidney. At other California transplant centers, more than twice as many people received kidneys than died during the same period. Unlike other centers, the Kaiser program did not perform riskier transplants or use donated organs from elderly or other higher-risk people, which have worse outcomes. Northern California Kaiser closed the kidney transplant program in May 2006. As before, Northern California Kaiser now pays for pre-transplant care and transplants at other hospitals. This change affected approximately 2,000 patients.[59][60]
Research and publishing[edit]
Kaiser operates a Division of Research, which annually conducts between 200 and 300 studies, and the Center for Health Research which in 2009 had more than 300 active studies. Kaiser's bias toward prevention is reflected in the areas of interest—vaccine and genetic studies are prominent. The work is funded primarily by federal, state, and other outside (non-Kaiser) institutions.[61]
Controversies[edit]
Mandatory arbitration[edit]
In order to contain costs, Kaiser requires an agreement by planholders to submit patient malpractice claims to arbitration rather than litigating through the court system. This has triggered some opposition.[62]
Wilfredo Engalla is a notable case. In 1991, Engalla died of lung cancer nearly five months after submitting a written demand for arbitration. The California Supreme Court found[63] that Kaiser had a financial incentive to wait until after Engalla died; his spouse could recover $500,000 from Kaiser if the case was arbitrated while he was alive, but only $250,000 after he died. The Foundation for Taxpayer and Consumer Rights contends that Kaiser continues to oppose HMO arbitration reform.[64]
Watchdogs have accused Kaiser of abusing the power imbalance inherent in the arbitration system. Kaiser engages in many cases whereas a customer will usually engage in just one and Kaiser can reject any arbitrator unilaterally, thus they can select company-friendly arbitrators over those that rule in favor of customers. As a large organization, Kaiser can also afford to spend much more on lawyers and orators than the customer, giving them more advantages. In response to criticisms, Kaiser established an Office of Independent Administrators (OIA) in 1999 to oversee the arbitration process. The degree to which this office is actually independent has been questioned.[65]
Patients and consumer interest groups sporadically attempt to bring lawsuits against Kaiser Permanente. Recent lawsuits include Gary Rushford's 1999 attempt to use proof of a physician lie to overturn an arbitration decision.[66]
In one case, Kaiser attempted to significantly expand the scope of its arbitration agreements by arguing it should be able to force nonsignatories to its member contracts into arbitration, merely because those third parties had allegedly caused an injury to a Kaiser member which Kaiser had then allegedly exacerbated through its medical malpractice. The California Court of Appeal for the First District did not accept that argument: "Absent a written agreement—or a preexisting relationship or authority to contract for another that might substitute for an arbitration agreement—courts sitting in equity may not compel third party nonsignatories to arbitrate their disputes."[67]
Labor unions[edit]
While Doctors of Medicine (M.D.) and Doctors of Osteopathic Medicine (D.O.) are partners within the for-profit physician groups, many employees are members of various unions and guilds, depending on their role and service area.
KP's California operations were the target of four labor strikes in 2011 and 2012 — two (September 2011, January 2012) involved more than 20,000 nurses, mental health providers, and other professionals.[68] The National Union of Healthcare Workers (NUHW) has accused Kaiser of deliberately stalling negotiations while profiting $2.1 billion in 2011 and paying its CEO George Halvorson $9 million annually. The workers were dissatisfied with proposed changes to pensions and other benefits.[69]
On November 11, 2014, up to 18,000 nurses went on strike at KP hospitals in Northern California over Ebola safeguards and patient-care standards during union contract talks. 21 hospitals and 35 clinics in the San Francisco Bay Area were affected.[70]
Cash reserves[edit]
Jamie Court, president of the Foundation for Taxpayer and Consumer Rights has said that Kaiser's retained profits are evidence that Kaiser policies are overpriced and that health insurance regulation is needed.[71]
State insurance regulations require that insurers maintain certain minimum amounts of cash reserves to ensure that they are able to meet their obligations; the amount varies by insurer, based on its risk factors, such as its investments, how many people it insures, and other factors; a few states also have caps on how large the reserves can be.[72]
Kaiser has been criticized by activists and state regulators for the size of its cash reserves. As of 2015, it had $21.7 billion in cash reserves, which was about 1,600% the amount required by California state regulations.[73] Its reserves had been a target of advertising by Consumer Watchdog supporting Proposition 45 in California's 2014 elections.[73] At the end of 2010 Kaiser held $666 million in reserves, which was about 1,300% of the minimum required under Colorado state law.[72] Those funds were in Kaiser's risk-based capital account, held to pay for disasters or major projects.[72] In 2008, the Colorado regulator required Kaiser to spend down its reserves; after negotiations Kaiser agreed to spend $155 million of its reserves giving credits to its clients and building clinics in underserved parts of the state.[72]
See also[edit]
Health portal
Medicine portal
Heather O'Rourke (1975–1988) – child actress who became ill in 1987 and was misdiagnosed by doctors of Kaiser Permanente Hospital. She died on February 1, 1988 and a lawsuit followed shortly.
References[edit]
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Jump up ^ Hendricks, 185
Jump up ^ Hendricks, 66-75
Jump up ^ Hendricks, 96-101, 142-150
Jump up ^ Hendricks, 111
Jump up ^ Hendricks, 123-124
Jump up ^ Hendricks, 133
Jump up ^ Hendricks, 165-167
Jump up ^ Hendricks, 174-180
Jump up ^ Hendricks, 189-190
Jump up ^ Hendricks, 199-203
Jump up ^ Hendricks, 209
Jump up ^ Hendricks, 205
Jump up ^ Transcript of taped conversation between President Richard Nixon and John D. Ehrlichman
Jump up ^ Hendricks, 209, 215
Jump up ^ Olmos, David (April 3, 1997). "Kaiser Is Facing Threat of a Shutdown in Texas". Los Angeles Times. LAtimes.com. Retrieved January 22, 2014.
Jump up ^ Freudenheim, David (June 19, 1999). "Kaiser Permanente Is Shutting Down Its H.M.O. In The Northeast". The New York Times. NYTimes.com. Retrieved January 22, 2014.
Jump up ^ Magaw, Timothy (September 4, 2013). "Kaiser Permanente's Ohio operations to be renamed HealthSpan". Crain's Cleveland Business. crainscleveland.com. Retrieved January 22, 2014.
Jump up ^ Rauber, Chris (August 12, 2009). "More details on Kaiser Permanente job cuts, 650 to come in SoCal". San Francisco Business Times. Retrieved January 22, 2014.
Jump up ^ Monegain, Bernie (March 29, 2010). "Kaiser KP HealthConnect rollout done". Healthcare IT News. healthcareitnews.com. Retrieved January 22, 2014.
^ Jump up to: a b Feachem, Richard G.A.; Sekhri, Neelam K.; White, Karen L. (January 19, 2002). "Getting more for their dollar: a comparison of the NHS with California's Kaiser Permanente". British Medical Journal. 324 (330): 135–143. doi:10.1136/bmj.324.7330.135. PMC 64512  . PMID 11799029.
Jump up ^ "NHS 'worse value than US provider'". BBC News. BBC.co.uk. January 17, 2002. Retrieved January 22, 2014.
Jump up ^ Talbot-Smith, Alison; Gnani, Shamini; Pollock, Allyson M; Pereira Gray, Denis (2004). "Questioning the claims from Kaiser". The British Journal of General Practice. 54 (503): 415–21; discussion 422. ISSN 0960-1643. PMC 1266198  . PMID 15186560.
Jump up ^ "HMO Quality Ratings Summary 2013 Edition". California Office of the Patient Advocate. Retrieved January 22, 2014.
Jump up ^ Feachem RG, Sekhri NK, White KL (January 2002). "Getting more for their dollar: a comparison of the NHS with California's Kaiser Permanente". 324: 135–41. doi:10.1136/bmj.324.7330.135. PMC 64512  . PMID 11799029.
Jump up ^ "The health of nations". The Economist. Economist.com. July 15, 2004. Retrieved January 22, 2014.
Jump up ^ Nicol, Jake. "A Flawed Model for Care". www.eastbayexpress.com. Retrieved March 22, 2015.
^ Jump up to: a b c Jenny Gold for the Kaiser Health News. February 25, 2015 [http://kaiserhealthnews.org/news/kaiser-permanente-faulted-again-for-mental-health-care-in-california/ Kaiser Permanente Faulted Again For Mental Health Care Lapses In California
Jump up ^ Cynthia H. Craft for the Sacramento Bee. September 9, 2014 Kaiser to pay $4 million fine over access to mental health services
^ Jump up to: a b Jaffe, Melissa; Block (November 16, 2006). "Kaiser Faces Charges for Dumping Homeless Patient". All Things Considered. NPR. Retrieved January 23, 2014.
Jump up ^ Bob Herman for Modern Healthcare. August 28, 2014 Los Angeles goes after patient-dumping for a third time
Jump up ^ "Archives — Patient Dumping 2002-2007". HHS Office of Inspector General. Retrieved January 23, 2014.
Jump up ^ Marquez, Miguel (March 24, 2006). "Trend: 'Dumping' Homeless on L.A.'s Skid Row". ABC News. Retrieved January 23, 2014.
Jump up ^ Ornstein, Charles; Weber, Tracy (May 3, 2006). "Kaiser Put Kidney Patients at Risk". Los Angeles Times. LATimes.com. Retrieved January 23, 2014.
Jump up ^ Colliver, Victoria (August 10, 2006). "Record Kaiser fine expected". San Francisco Chronicle. SFgate.com. Retrieved January 23, 2014.
Jump up ^ "Agency ignored organ transplant problems". NBC News. Associated Press. October 22, 2006. Retrieved January 23, 2014.
Jump up ^ "About the Division of Research". Kaiser Permanente. Retrieved January 22, 2014.
Jump up ^ Rauber, Chris (February 20, 1998). "Kaiser fires back in arbitration suit". San Francisco Business Times. Retrieved January 22, 2014.
Jump up ^ Engalla v. Permanente Medical Group, Inc. , 15 Cal 451 (Cal 4th June 30, 1997).
Jump up ^ "Placebo Kaiser Arbitration Bill Killed In Senate Committee" (Press release). The Foundation for Taxpayer & Consumer Rights. April 26, 2000. Retrieved January 22, 2014.
Jump up ^ ""Independent" Administrator Of Kaiser Arbitration System Is Rep For Corporate Lobby" (Press release). The Foundation for Taxpayer & Consumer Rights. January 8, 2003. Retrieved January 22, 2014.
Jump up ^ Gary Rushford v. Kaiser Foundation Hospitals , A104598 (Cal Appeal May 31, 2005).
Jump up ^ County of Contra Costa v. Kaiser Foundation Health Plan, Inc. , 47 (Cal. Appeal 4th).
Jump up ^ Hay, Jeremy (January 31, 2012). "Two Kaiser unions strike in Santa Rosa, Northern California". The Press Democrat. pressdemocrat.com. Retrieved January 23, 2014.
Jump up ^ "Kaiser workers on strike". Roseville Press-Tribune. thepresstribune.com. January 31, 2012. Retrieved January 23, 2014.
Jump up ^ "Kaiser Nurses Holding 2-Day Strike Over Staffing Levels, Ebola Protections". NBC Bay Area.
Jump up ^ http://www.insidebayarea.com/sanmateocountytimes/ci_6544372
^ Jump up to: a b c d Michael Booth for The Denver Post. March 13, 2011. Insurers' enormous cash surpluses prompt calls for rebates or community spending
^ Jump up to: a b Tracy Seipel for Mercury News. March 19, 2015 California drops hammer on Blue Shield tax-exempt status
External links[edit]
Official website
The Permanente Federation, which represents the Permanente Medical Groups
Search all Kaiser hospitals in the CA Healthcare Atlas A project by OSHPD
Nightly News with Brian Williams Report on successful Kaiser Permanente initiatives including declaration by Louise Liang falsely attributing Vioxx discovery to KP HealthConnect even though it was not yet in production use in Northern California
Health Administration Responsibility Project Home page of a group scrutinizing managed care and its failures, contains links to several pages about issues involving Kaiser Permanente
Wikimedia Commons has media related to Kaiser Permanente.
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WorldCat Identities
VIAF: 147877401
LCCN: n90644002
ISNI: 0000 0000 9957 7758
Retrieved from "https://en.wikipedia.org/w/index.php?title=Kaiser_Permanente&oldid=821975430"
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text:
List of Gavin & Stacey characters
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Gavin & Stacey main characters, left to right: Bryn (Rob Brydon), Gwen (Melanie Walters), Nessa (Ruth Jones), Stacey (Joanna Page), Gavin (Mathew Horne), Smithy (James Corden), Pam (Alison Steadman) and Mick (Larry Lamb)
Gavin & Stacey is an award winning British television comedy series, following the lives of the title characters Gavin (Mathew Horne) and Stacey (Joanna Page), who, before marrying, live on opposite sides of the country, Gavin in Billericay, Essex, and Stacey in Barry, Vale of Glamorgan. During the first two series Gavin lives with his parents Mick (Larry Lamb) and Pam (Alison Steadman) but in the third series he has moved, with Stacey, to Barry and lives with Stacey's mum. He has a best friend Neil "Smithy" Smith (James Corden). For most of the episodes Stacey lives in Barry with her mum Gwen (Melanie Walters), with an extended family of Uncle Bryn (Rob Brydon) across the street, and best friend Vanessa Shanessa "Nessa" Jenkins (Ruth Jones), but for a short while during series two she lived with Gavin, Pam and Mick in Essex.
Contents
[hide]
1 Characters
1.1 Main characters
1.2 Other characters
1.2.1 Gavin and Smithy's Friends
1.3 Minor and unseen characters
2 References
3 External links
Characters[edit]
Actor/Actress
Character
First Appearance
Last Appearance
Duration
Total
Mathew Horne Gavin Shipman 13 May 2007 1 January 2010 2007–2010 20
Joanna Page Stacey Shipman 13 May 2007 1 January 2010 2007–2010 20
James Corden Neil "Smithy" Smith 13 May 2007 1 January 2010 2007–2010 20
Ruth Jones Nessa Jenkins 13 May 2007 1 January 2010 2007–2010 20
Rob Brydon Bryn West 13 May 2007 1 January 2010 2007–2010 20
Larry Lamb Mick Shipman 13 May 2007 1 January 2010 2007–2010 20
Alison Steadman Pam Shipman 13 May 2007 1 January 2010 2007–2010 20
Melanie Walters Gwen West 13 May 2007 1 January 2010 2007–2010 20
Steffan Rhodri Dave Coaches 13 May 2007 1 January 2010 2007–2010 11
Margaret John Doris O'Neill 13 May 2007 1 January 2010 2007–2010 8
Adrian Scarborough Pete Sutcliffe 13 May 2007 17 December 2009 2007–2009 7
Julia Davis Dawn Sutcliffe 13 May 2007 17 December 2009 2007–2009 7
Sheridan Smith Ruth "Rudi" Smith 16 March 2008 1 January 2010 2008–2010 7
Robert Wilfort Jason West 3 June 2007 1 January 2010 2007–2010 6
Mathew Baynton Deano 11 November 2008 10 December 2009 2008–2009 4
Russell Tovey Budgie 3 June 2007 10 December 2009 2007–2009 4
Andrew Knott Dirtbox 3 June 2007 10 December 2009 2007–2009 4
Samuel Anderson Fingers 3 June 2007 10 December 2009 2007–2009 3
Ifan Huw Dafydd Neil Jenkins 26 November 2009 1 January 2010 2009–2010 3
Pam Ferris Cath Smith 26 November 2009 17 December 2009 2009 2
Main characters[edit]
Gavin Shipman (Mathew Horne) - Gavin is 28 when the series starts. He is an only child, and when the series starts he still lives with his loving mother and father in Billericay, Essex. He gets on well with his parents. He works for a company called ICB and spends his spare time with his best friend Smithy (James Corden) along with his other friends Gary & Simon, Dirtbox, Fingers, Budgie, Swede, Chinese Alan and Jesus. He is a big fan of Tottenham Hotspur (as is Mathew Horne) and is often seen wearing his Spurs shirt. In the course of his job, he had to deal with a company called Bedmores, based in Barry. The Bedmores representative he had to correspond with was a woman called Stacey West (Joanna Page). Gavin and Stacey had to speak regularly because of their jobs, and they found they got on very well. After months and months of talking and flirting, they agreed to meet up in London. They agreed that Gavin would bring his best friend Smithy with him, and Stacey would bring her best friend Nessa (Ruth Jones) with her. They met up and went clubbing. They had a great time, and got on very well. They went back to Stacey's hotel room and had sex. The next day, Stacey had to go back to Barry, but she and Gavin promised to keep ringing each other and that this would not be the end of their relationship. While Stacey and Nessa boarded the coach back to Barry, Gavin and Smithy got a cab back to Billericay. Without waiting for Smithy, Gavin jumped in his car and drove all the way to Barry, and met Stacey when her coach pulled into the station, to her surprise. He and Stacey told each other they loved each other for the first time. Within 9 weeks, they had got engaged and married. Despite a few initial problems regarding Stacey being homesick, their relationship was successful, and Stacey became eventually pregnant. Gavin, and his father Mick (Larry Lamb), often play the "straight men" in the series. Much of the comedy comes from the actions of those around them (especially his mother Pam (Alison Steadman) and Smithy). It is clear that Gavin loves his friends and family very much. Despite the fact that his mother Pam often overreacts and acts without thinking, Gavin still loves her, despite being occasionally exasperated by her. His best friend Smithy is also prone to overreact, but Gavin sticks with him and loves him like a little brother. Gavin's main personality flaw is that he is slightly spoiled, possibly due to being an only child, and reacts with irritation when he doesn't get his way. He is also not particularly sensitive - he sometimes fails to understand the much more emotional Smithy and Stacey, and this occasionally puts strain on his relationship with both of them - when Stacey, who is very attached to her hometown of Barry, gets depressed and homesick upon moving to Billericay after she and Gavin marry, Gavin is more confused than concerned about this, and his responses are lacking in sensitivity about the matter. This can also be seen in the fact that Gavin is less talkative and expressive than Stacey is - while at dinner with their families after their honeymoon, Stacey is excited and full of conversation, while Gavin simply sits and listens to her. Despite all of this, Gavin loves Stacey enormously, and is very affectionate towards her, and his greatest display of love for her is when he decides to move to Barry with her despite having expressed a dislike of it previously, and he manages to get himself a new job in Wales so he can reside there. There, his boss Huw Davies and colleague Owain Hughes (Steven Meo) act very similar to Stacey's uncle, Bryn (Rob Brydon), talking incessantly and being over-friendly, personality traits that bewilder Gavin. Gavin is more reserved and less willing to discuss his private life than his wife. He finds it odd that Stacey is so eager and ready to spill information about their private life to Nessa, Bryn, her mother Gwen (Melanie Walters) and her brother Jason (Robert Wilfort). When Gavin is applying for a job in Cardiff, the only people who know are Stacey and Mick. When he and Stacey announce it to the rest of the characters, Gwen announces that she knew as well, because Stacey told her. Gavin is annoyed that Stacey told Gwen, and by the fact that Stacey did not tell him she had told Gwen. He doesn't understand why Stacey always has to be so close to her family. It isn't that he is distant from his family, he just doesn't depend on his as much as Stacey does hers. In Series 3, he agrees with Stacey to try to have a baby, only to discover she stopped taking the pill a year ago. Although he is very angry about Stacey not telling him the truth, he becomes much more depressed when he learns that he has fertility problems. However, he eventually comes round, and has a serious discussion with Stacey about the problem, deciding they will carry on trying to conceive for a few months, and if that doesn't work, they should start looking at alternatives. However, in the final episode, Stacey discovers she pregnant, and Gavin is completely as overjoyed.
Stacey Shipman (née West) (Joanna Page) - Stacey is 26 and is from Barry, near Cardiff. Her father, Trevor, died three years ago, and she lived at home with her mother in Barry until her marriage. Her gay brother, Jason (Robert Wilfort), lives in Spain. She had been engaged five times before meeting Gavin Shipman (Mathew Horne), something she preferred to forget and kept from him. She is very bubbly, excitable and full of conversation but also slightly fragile and prone to overreacting. An example is her misreading Gavin's sudden businesslike tone during a call from work, when his boss appears over him, as him being distant and breaking up with her and he has to drive all the way to Barry to reassure her in person. She confides frequently in her best friend, Nessa (Ruth Jones). Stacey has never been away from Barry Island before she visits Gavin, and becomes very homesick when she marries him and moves to Essex. After a few months of finding no work, she tells Gavin she can no longer live in Essex and will be moving back home. During the course of their separation, Stacey decides their selfishness about where they'll live means they aren't meant to be together and she gives Gavin his wedding ring back. They are able to work things out and Gavin decides to get a job in Cardiff so he can move to Barry Island to keep Stacey happy. Stacey discovers she is pregnant in the final episode of Series 3, after desperately taking a large number of pregnancy tests.
Neil "Smithy" Smith (James Corden) - Smithy is 28 and Gavin's (Mathew Horne) best friend, and they've known each other since primary school. He is a self-employed builder and decorator. He is very protective of Gavin - he is disappointed when Gavin gets engaged to Stacey (Joanna Page) and when Gavin and Stacey go on a honeymoon, he calls Gavin every day for the 3 weeks they are there, and gets angry at Gavin for leaving his phone off. He loves Gavin's parents more than his own, and has an unseen girlfriend called Lucy, who, according to Smithy, is seventeen years and three quarters old. He loves unusual beer, paintball and West Ham United. When Nessa (Ruth Jones) gives birth to their son, they name him Neil after himself and Nessa's father. In the series finale, Smithy stops Nessa's wedding declaring his feelings for her, thus causing Nessa and Dave (Steffan Rhodri) not to get married. He is shown to have obvious similarities to Nessa, such as: refusing to share food, being very upfront, protective of their best friends, and they like most of the same food and drink, such as KFC, corn on the cob, and Irn-Bru. Smithy wears his heart on his sleeve and is given to intense public displays of emotion, and will cry or sulk with little provocation. Smithy eats, drinks and smokes to excess and is overweight.
Vanessa Shanessa "Nessa" Jenkins (Ruth Jones) - Nessa is Stacey's (Joanna Page) best friend, also from Barry. She discovers she is pregnant in the fourth episode of Series 1 and it is later revealed that Smithy (James Corden) became the father the second time they were intimate at Pam (Alison Steadman) and Mick's (Larry Lamb) house. She speaks fluent Italian and Welsh, has several tattoos, most notably a large red dragon on her right upper arm. She is a chain smoker (except during her pregnancy) and was one of the original members of All Saints (but didn't get along with Shaznay). She works at the Barry Island Amusement Arcades or "The Slots". Nessa regularly recalls strange and often lewd experiences with celebrities. She gives birth to baby Neil in the series finale of Series 2 and becomes engaged to Dave Coaches (Steffan Rhodri) in the 2008 Christmas special. In the series finale, Smithy declares his feelings for Nessa at her wedding, and Dave accepts that the feelings he and Nessa share are not as strong as hers and Smithy's. Nessa's age is unknown throughout the show even to Stacey. To date she has slept with Gavin's (Mathew Horne) best friend Smithy four times. Her catchphrases include "Ohhhh", "Tidy", "Genuine", "Truth be told", "Immense", "I'm not going to lie to you" and "What's occurring?". In the third series, it was discovered that she is an Aston Villa fan. She has a jet black bob-style hair and wears Gothic style make up. She is serious, ongoing and surprisingly intelligent at times. She has had a number of interesting occupations including being a BBC radio producer, a roadie for a major band, and driving trucks for Eddie Stobart (who gave her two trucks to keep when she left,) and a running feature of the programme is her wide range of impressive occupations, abilities (apart from speaking fluent Italian she is an excellent ten pin bowler) and acquaintance or relationships with various famous people. The reaction of those around her to mention of these invariably suggests that they are factual rather than a fantasy, despite the rather incongruous fact that she now works as a cashier at an amusement arcade in Barry.
Michael "Mick" Shipman (Larry Lamb) - Mick is Gavin's (Mathew Horne) father. He is often mistaken to be 53 and is a down-to-earth bloke, like his son. He's happy with his life — running his own company, playing golf and going to the pub quiz every Tuesday. He is something of a calming influence on his wife, Pam (Alison Steadman).
Pamela Andrea "Pam" Shipman (née Griggell-Eschefska) (Alison Steadman) — Pam is Gavin's (Mathew Horne) proud and doting mother. She is in her fifties, though her exact age is unknown as, according to her husband, she has claimed to be 51 on her past five birthdays. She is a stereotypical Essex wife and is very house-proud. She is also very caring of Smithy (James Corden), Gavin's best friend, and treats him as if he were her own son. Pam adores Camilla, Duchess of Cornwall (referring to Princess Diana as a "hussy") and acts out sexual fantasies of Charles and Camilla with her husband, Mick (Larry Lamb). She dotes on Gavin, who she calls her "Little Prince". She is very welcoming of Stacey (Joanna Page) into the family - the first time Stacey meets her, she helps her with a pimple on her face, in a motherly fashion, which allows the two to bond. Although she is initially angry at Stacey when Gavin announces they're moving back to Barry, accusing Stacey of 'stealing' her son, she apologises the next morning for overreacting. Pam is prone to malapropisms, such as saying "ours is not to question while" (instead of "why") or "Barry's Island" instead of "Barry Island". She is often nervous and excitable and this leads her into awkward social situations, such as forcing Mick to go food shopping in response to an attack of paranoia about her guests' dietary requirements, and then falsely claiming to be newly vegetarian (a pretence she is forced to maintain, much to her frustration because she craves meat) in order to explain why he has arrived with several bags of vegetarian food. Her catchphrases include "Oh My Christ", "I panicked (name)" and "Mick! Michael!"
Brynfor "Bryn" West (Rob Brydon) - Bryn is Stacey (Joanna Page) and Jason's (Robert Wilfort) uncle. He is the brother of Stacey's deceased father, Trevor and is a single man in his late forties. He lives across the road from Stacey and his sister-in-law, Gwen (Melanie Walters) and is very protective of them. In Series 1 and 2, he had a strained relationship with his nephew Jason due to an unspecified but clearly disturbing incident on a fishing trip. He leads a very simple life and often gets excited about trivial things such as his Sat Nav or the Internet. He also enjoys typically female-oriented TV shows such as Desperate Housewives and Sex and the City. He is a keen singer and sings with Stacey's best friend, Nessa (Ruth Jones). In Series 2, he puts a home gym in his house that is "the talk of the street". Bryn also displays latent homosexual tendencies but is seemingly too innocent and childlike to address them. For instance, Bryn converted one of the bedrooms in his home into a gym and invites Smithy (James Corden) over where they strip shirtless and have a close workout followed by a "warm down" that involves rubbing each other. Smithy does not see this as a sexual thing at all, even though it makes Gavin (Mathew Horne) uncomfortable. It has been implied a number of times that Bryn was abused by his brother Trevor as a child, such as Trevor leaving him terrified on a ghost train or hanging him by his ankles and swinging him against rocks, resulting in two broken arms. He claims he "rather enjoyed the experience" as it was only "tomfoolery" but it shocks everyone and horrifies Pam (Alison Steadman).
Gwen West (Melanie Walters) - Gwen is Stacey (Joanna Page) and Jason's (Robert Wilfort) mother. She is a widow in her late forties and has two children, Jason and Stacey. She is a housewife and regularly offers to cook omelettes. She's a caring, kind woman who lets herself be taken advantage of by Stacey's best friend, Nessa (Ruth Jones). She's very close to Stacey as they spent many years living together. In Series 3, she lives with Stacey and her husband Gavin (Mathew Horne). On the day of Nessa's wedding, Nessa told Gwen that she was like a mother to her before kissing her on the lips, which gobsmacks Gwen but does not affect Nessa.
Other characters[edit]
David "Dave Coaches" Lloyd Gooch (Steffan Rhodri) - Coach driver in Barry and Nessa's (Ruth Jones) fiancé, after they got engaged in the Christmas special. Aspersions are cast regarding his sexual health in Series 1, although it is revealed in Series 2 that he has been to "the clinic". He is the only person, other than Bryn (Rob Brydon) and Jason (Robert Wilfort), who knows what happened on the fishing trip, after Bryn told him to get the matter off his chest. His relationship with Nessa results in both Bryn and Jason being incredibly nervous about him telling their friends what happened, although he makes it very clear to Bryn he wouldn't tell anyone about it. He also has his own company named Dave Coaches. He often shows jealousy towards Smithy (James Corden) for being the father of Nessa's child. Smithy gets jealous of him for always spending time with his son and treating him like his own, and in the final episode leaves Nessa at the altar as he doesn't believe she loves him. Nessa's father mentions him having "blood on his hands", but says he was joking, knowing that "nothing was proven". Dave often has a strained relationship with the other characters, and has publicly had angry exchanges with Bryn, Smithy and Pete (Adrian Scarborough), who punched him in the face after he made an uncharitable remark about his wife, Dawn (Julia Davis).
Jason West (Robert Wilfort) - Stacey's (Joanna Page) elder brother, son of Gwen (Melanie Walters) and her late husband, Trevor. Lives in Spain with his boyfriend, José. He and Bryn (Rob Brydon) share a rather awkward relationship due to some mysterious goings-on on the fateful fishing trip. Although the events of the fishing trip are never explicitly revealed, it is strongly implied that there was a close and intimate encounter between Jason and Bryn. When they attempt to explain to Dave the reason for what they did that night, Bryn says "It was freezing cold...and when you're that cold you-" before being cut off by Gavin entering the room. He is disappointed in the first series when Gavin (Mathew Horne) and Stacey get married and he is not chosen to take Stacey down the aisle. He and Bryn eventually become friends again, something they are both glad about.
Peter "Pete" Sutcliffe (Adrian Scarborough) and Dawn Sutcliffe (Julia Davis) - Friends of Pam (Alison Steadman) and Mick's (Larry Lamb). They have a very strained marriage and regularly insult each other in public. Also part of the ongoing joke that characters share their surnames with serial killers — in this case Peter Sutcliffe, the Yorkshire Ripper. He punches Dave in the Christmas special. He also attempts a threesome in the beginning of Series 2 with his wife Dawn and a man named Seth. It didn't work out as Seth said the photo was not representative of them as a couple. The couple renewed their vows in Series 3. They have two children, Fiona and Alex. In the series finale of Series 1, their surname is revealed to be Whitely, but in the 2008 Christmas Special, it is revealed to be Sutcliffe.
Catherina "Cath" Smith (Pam Ferris) - Smithy (James Corden) and Rudi's (Sheridan Smith) mother who first appears in the first episode of Series 3. She is rumoured to have had a lesbian relationship with the headteacher of Gavin (Mathew Horne) and Smithy's primary school. She claims to suffer from narcolepsy, though Pam (Alison Steadman) attributes this to her excessive drinking. She attends single mother support groups and has been known to perform lewd acts on webcam, having once accidentally exposed herself to Nessa (Ruth Jones) thinking she was a man named John.
Doris "Dor" O'Neill (Margaret John) - Gwen's (Melanie Walters) elderly next door neighbour. She looks like a stereotypical "little old lady", in sharp contrast to her behaviour and blunt, profanity-littered conversational style. Doris regularly dates younger men, even offering herself up to Gavin (Mathew Horne) for "discreet" extramarital relations, and is described by Bryn (Rob Brydon) as "a player". She has a daughter named Moira, whom she loathes and would like to "smother" if she saw her again. Gwen even goes so far as to say "she was a nasty piece of work". It is Doris who spots the unfortunate coincidence of Gavin and Stacey (Joanna Page) sharing the West and Shipman surnames with serial murderers Fred and Rose West and Harold Shipman.
Ruth "Rudi" Smith (Sheridan Smith) - Smithy's (James Corden) sister, also likes to be called "Smithy" in an attempt to imitate her brother, with whom she often fights.
Neil Noel Edmund Smith aka Neil, the Baby - The son of Smithy (James Corden) and Nessa (Ruth Jones), named after both Smithy and Nessa's father. His middle names come from Smithy's uncle Edmund and Nessa's friend Noel from Hear'Say.
Neil Jenkins (Ifan Huw Dafydd)[1][2]- Nessa's (Ruth Jones) father; appears at the Christening but is obviously uncomfortable at being back in Barry due to unknown previous events. He is a part-time actor who has appeared as an extra in Lark Rise to Candleford and as a man in a coma in Holby City.
Dick Powell (Gwynfor Roberts) The only exclusively Welsh-speaking inhabitant of Barry. Sells items on the black market such as satellite navigation systems and meat that his brother steals from the slaughterhouse where he works. He enjoys chicken and Glamorgan sausage sandwiches.
Deano (Mathew Baynton) is a friend of Gavin (Mathew Horne) and Smithy's (James Corden). He works with Smithy and is known for being gormless and somewhat naïve. He learnt Welsh prior to coming over to Wales with the "Essex Lads". He wasn't at Gavin's stag, but got a T-shirt made afterwards when they went to the foam party. Among his idiosyncrasies is a fondness for drinking a mixture of equal parts tea and coffee, which he calls a "toffee" or a "cea" (pronounced "key").
Owain Hughes (Steven Meo) - one of Gavin's (Mathew Horne) co-workers at his new job in Cardiff in Series 3. Constantly the subject of an unclear joke - "My name is Owain Hughes and before you ask, no I don't!".
Gavin and Smithy's Friends[edit]
Budgie (Russell Tovey) - A friend of Gavin (Mathew Horne) and Smithy's (James Corden). He is nicknamed as such because he has big ears. He has a brother called Magpie, who works as a DJ.
Chinese Alan (Dominic Gaskell) - A friend of Gavin (Mathew Horne) and Smithy's (James Corden). His catchphrase is "Did someone order a Chinese?"
Fingers (Samuel Anderson) - A friend of Gavin (Mathew Horne) and Smithy's (James Corden). He is so named because of his womanizing attitude. He has an on-off relationship with Stacey's (Joanna Page) friend, Louise.
Dirtbox (Andrew Knott) - A friend of Gavin (Mathew Horne) and Smithy's (James Corden). He seems to be somewhat short tempered and snappy.
Jesus (Daniel Curtis) - A friend of Gavin (Mathew Horne) and Smithy's (James Corden). He only appears in the stag episode; most likely owing to the fact that no one in the group really seems to like him.
Swede - (John Grisley) A friend of Gavin (Mathew Horne) and Smithy's (James Corden). He rarely says anything.
Gary (Jason Gregg) - A friend of Gavin (Mathew Horne) and Smithy's (James Corden). He has been friends with them since primary school. He is never seen without his best friend Simon; except for in Series 3, where it appears they have had an argument.
'N' Simon - A friend of Gavin (Mathew Horne) and Smithy's (James Corden). He has been friends with them since primary school. He is never seen without his best friend Gary (Jason Gregg); but he does not appear in Series 3, as it appears he has had an argument with Gary.
Luggy - A friend of Gavin (Mathew Horne) and Smithy's (James Corden). He has glasses and is quite tall. He is relatively quiet when compared to the rest of Gavin's friends as he is often seen in the background of the conversation and has no dialogue. He is not seen in Series 3 for unknown reasons.
Minor and unseen characters[edit]
Japanese Margaret - A friend of Pam (Alison Steadman) and Dawn's (Julia Davis) whose name came up during the protest over the telephone mast.
No Man Jan - A friend of Pam's (Alison Steadman) who told her about the rumour of Cath's (Pam Ferris) lesbian relationship with Smithy (James Corden) and Gavin's (Mathew Horne) headmistress. Mick (Larry Lamb) claims she can't be trusted - "that's why she's been divorced three times".
Big Fat Sue - Pam's (Alison Steadman) overweight friend. Pam calls her "Susan" to her face; however, other characters such as Dawn (Julia Davis) directly address her as "Big Fat Sue".
Fat No More Pat - Pam's (Alison Steadman) friend from her Fencing class. She was mentioned when Pam asked Stacey (Joanna Page) if she would like to come along in Pat's absence.
Seth - Swinger who responded to Dawn (Julia Davis) and Pete's (Adrian Scarborough) request for a threesome partner, he denied because the picture of Dawn and Pete was 15 years old.
Nigel Havers - Actor, Nessa's (Ruth Jones) ex-boyfriend
Tom Jones - Singer, Nessa's (Ruth Jones) ex-boyfriend
John Prescott - Politician, Nessa's (Ruth Jones) ex-boyfriend
Noel Sullivan - Singer, Nessa's (Ruth Jones) close friend. Nessa's son, Neil's middle name is after him.
Griff (Alan David) - Bryn (Rob Brydon) and Doris' (Margaret John) friend. He attended Gavin (Mathew Horne) and Stacey's (Joanna Page) wedding with Doris in Series 1.
Father Chris (William Thomas) - A vicar in Barry.
José - Jason's (Robert Wilfort) boyfriend, who attends Gavin (Mathew Horne) and Stacey's (Joanna Page) wedding.
Edna Sutcliffe (Edna Doré) - Pete's (Adrian Scarborough) mother, only seen once in the Christmas Special, where Pete forgot her and she stayed behind the bar over night
Betty (Hazel Douglas) - A neighbour of Pam (Alison Steadman) and Mick's (Larry Lamb). She is only seen talking to Pam about Mick's short stint on a news broadcast.
Scott - One of Doris' (Margaret John) much younger boyfriends, whom she casually describes as "a bit of a pothead".
Natalie Lewis - Sales assistant whose brother and father once had a fight with Nessa (Ruth Jones)
Lucy - Smithy's (James Corden) much younger girlfriend, who is still in secondary school. She is never seen on-screen, and dumps Smithy in Series 2 when he discovers that she has been seeing somebody else. In a running joke meant to illustrate the age gap between her and Smithy, she is often mentioned to be doing activities that would normally be associated with younger people (such as Brownies or trampolining).
Jean - A character who Bryn (Rob Brydon) invites to Gwen's birthday party, due to guests he'd already invited saying they can't attend. Jean is hated to Gwen however for reasons that weren't really mentioned. Doris warns Bryn not to invite her and does not like her. Jean is not seen on screen, however Gwen sees her and it is unknown what happened next.
Glenda - In series 3 episode 4, Glenda gets in contact with Bryn (Rob Brydon), Doris (Margaret John) and Gwen (Melanie Walters) almost immediately after Pam (Alison Steadman) and Mick (Larry Lamb) arrive outside Gwen's house all via different forms of contact. It is not mentioned where Glenda lives, though she is within hearing range as she heard that Pam and Mick were going to the beach, nor is she ever mentioned again.
References[edit]
Jump up ^ "Ifan Huw Dafydd's details from the equity wales web site". Equity Oriel. Archived from the original on 5 December 2008. Retrieved 6 January 2010.
Jump up ^ "Ifan Huw Dafydd". Digiguide Library. Retrieved 6 January 2010.
External links[edit]
Full Gavin & Stacey Cast List
Wikiquote has quotations related to: Gavin & Stacey
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