FRENCH NHS SICK AND NO ROLE MODEL FOR UK
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josephs@crit.univ-montp2.fr Comments welcome.It’s a sure sign that something is seriously wrong with the NHS when the French system is constantly held up as a system for us to emulate. ‘There are no waiting lists in France, you know.’ ‘I know of someone who went over to Bordeaux to have a hip replacement operation’. Everyone, apparently, has an Anglo-French health tale to tell. And the economic journals compound the misery by reliably reporting that the French spend almost twice as much as a percentage of GDP on health care. The message coming across the Channel is that France is at the cutting edge of modern medicine whilst Britain continues to drift relentlessly into a position of third world decline. Which leads one to conclude, does it not, that the French system is the next best thing to sliced baguette. And yet the truth is that whilst French patients have little cause to complain, health professionals are on the brink of despair.
Allow me to explain. I am an English journalist living in Montpellier, in the sunny south of France. A fortnight or so ago my son went into hospital to have his tonsils removed. At the same time, on the same day, a certain Monsieur Dupont was round at our house repairing an electrical fault in our dishwasher. Both the surgeon and the handy man took approximately half an hour to carry out their respective tasks. Tonsils were snipped, wires repaired – and both son and electrical appliance are fully functional again. Then the paperwork came in. Monsieur Dupont charged £40 – almost exactly the sum I was expecting to pay. Then the surgeon’s fee note arrived. It was for exactly the same amount. I immediately contacted his surgery pointing out that he had made a mistake – and probably left off an additional zero. A Londoner myself, I thought that going rate would be around £400. Non, non, non, I was informed. £40 was indeed the correct amount, out of which the clinic would be taking a 10% cut, and from which the surgeon would then have to deduct his own social charges and taxes. The anaesthetist then invoiced me for the grand sum of £35 – a fiver less than the dishwasher repairman.
This time I did not bother to check the figures. I had begun to get the picture. Health professionals in France are amongst the worst paid in Europe and completely fed up with a state-controlled system in which they are unable to increase their earnings. Superficially, its all very attractive from the patient’s point of view – its fast, cheap, reliable and efficient – but just take the trouble to scratch the surface of the much-vaunted French health system and you will find hundreds of thousands of health professionals on the brink of despair.
I told this tale of medicine-on-the-cheap to a colleague at the University of Montpellier, where I teach on a part-time basis. I rattled off the figures expecting my colleague to throw her hands up in horror – or at least show some sympathy for the doctors who are being taken for a ride by the State. Sympathy for the doctors? Forget it. "I know", she replied, "£40 to have your tonsils removed – medicine is terribly dear over here in France, you know."
French GPs are amongst the most disgruntled of the lot. A consultation with your doctor will cost you exactly £11.50, all but a few pennies of which will be ‘reimbursed’ by the Frency ‘secu’ – the French social security system which is on the brink of collapse. Mrs. Thatcher once memorably complained that Britain had become a nanny state – just as well she didn’t look to the other side of La Manche where the French will grumble at having to pay more than a few centimes for a prescription.
"Out of that £11.50 do you know how much ends up in my pocket", my own Dr. Pierre Bayard, asked me rhetorically? "£3. Exactly £3."
I changed GPs recently after my last previous doctor refused to come out on a home visit. "I would come, she informed me, but if I do I only get an extra £2, so its really not worth it at all. It actually costs me money." I protested that she sounded more like an accountant than a doctor – but the message was beginning to get home – that despite their long and arduous studies and years of experience – French health professionals are themselves being taken for a ride.
You might well be thinking, by now, that you are reading the confessions of an English hypochondriac in France. Which is not at all the case. But when a nurse recently came to our house to carry out a cholesterol test she invoiced us for £3.50 – the maximum allowed by the state. Half an hour with a physiotherapist will cost you around £8. Each and every time I allow these devoted medics to have their say. Not surprisingly, they all sing the same tune. They are fed up, feel as if they are being ripped off by the State, their morale has plummeted, the idealism which drove them into their respective professions has taken such a battering that it has long since been knocked for a six and unlikely therefore to return. That, surely, is no role model for the UK.
One final thought. Both the ENT man who operated on my son and the repair man who operated on my dishwasher both live in the same village. No prizes for guessing who lives in the stylish villa with a swimming pool with spectacular views out towards the Mediterranean and beyond.
The main Web site of freelance writer Jeremy Josephs is at
www.jeremyjosephs.com Please check there if you might be interested in engaging him as a writer.Many of his articles are available online. Please check the
sitemap for a complete list.