Tuesday, 9 February 2010

French Health Service - Is it really that good?!

I have asked Bram, one of my clients, to tell us what he thought about the French Health System. Here is his answer:

So; after a holiday here in 'Romantic Brittany' you've fallen in love with its lovely coast, with the green countryside behind it, and with its peaceful, relaxed market towns peopled with friendly and welcoming folks. The routine reaction for those of us who remember the UK of fifty years ago is to wonder where and why we Brits lost the unfailing politeness and consideration which is our daily experience here.

If you are retired or about to retire you may have decided that Brittany is the ideal place for doing so - the perfect environment, as a visiting friend suggested, for people who wish to live to be a hundred and fifteen - and if you're a family man capable of making a living here you may well think Brittany, with its splendid school system and ordered society, is a perfect place in which to bring up your young family. Among the Brits who live here few would challenge these views.

From your friends, though, you will have heard only discouragement. Moving into a new society across what the French call La Manche (The Sleeve) and what we Brits have always thought of as our very own channel fills them with horror. Every argument, reasonable and otherwise, is advanced to deter you. Finally, when every other has failed to shake your optimistic self-confidence, will come the ultimate one; you'll have to come home in the end, they say, for the National Health Service.

It's useless to tell them that France has what is acknowledged to be the finest health system in Europe. They won't believe that, since every British schoolboy knows that the French are incompetent at everything! Didn't we win at Waterloo and Trafalgar? Still, one's health is important, and a look at the French system may be useful. After house-purchase the gaining of admission to the health system is usually one's next encounter with the famous French bureaucracy. That bureaucracy is often disparaged in the UK. It really does work, however.
On entry one is given the Carte Vitale, a piece of green plastic card which can be read by every doctor, surgeon, pharmacist, etc in France. It is of the greatest service in the case of sudden illness or accident.

The carte vitale is required at each visit to the doctor or pharmacist, when it is computer-updated. It is also the means of obtaining, automatically, the rebate of funds paid to these people.
A rebate? The system is not, then, absolutely free? Indeed not; each time one visits the doctor he expects the sum of twenty-two Euros. This may seem a lot, but most of it is returned to one's bank in a matter of days. What of the small remainder? For the native French the problem is solved, almost universally, by insuring. This is cheap; all the cheaper for being begun early, of course, but anyway cheaper than the amount you and I have been paying weekly from our earnings to the NHS. Additionally, if one's problem is potentially life-threatening, as in the case of cardiac or vascular disease, treatment is entirely free; any sums paid are immediately returned by the system.

How is the service itself? Really splendid I'd say, and that's experience speaking. There is no shortage here of English-speaking doctors, and my doctor (doctors here are given time not only to examine patients thoroughly but to get to know them and their problems) spotted my own dodgy ticker before I realised the problem for myself. I was referred to a Cardiologist within hours and I was in hospital within an hour of that examination. Waiting-lists seem to be nonexistent, and hospitals here are a revelation of cleanliness, efficiency and privacy, two patients to a room being the general rule. An arterial bypass can never be a pleasure, but I found nothing to complain about there.

Still, for the aging - and many, perhaps most, Brits here are pensioners - the financial aspect of the health service does need some thought. Pensioners find that the cost of insuring the relatively small portion of the payments they make to the doctor, the specialist or the pharmacist is high. Often they don't insure; they gamble on the fact that the small residue of the sum they will occasionally pay will be less than the insurance premium. That usually proves to be true; but for the younger members of the family insurance is best. For them it's not prohibitively expensive. It's the French way and it works.

For the aging some extra services are offered, among them a free complete health check each year. I went through this interesting mill recently. It meant a whole day at a clinic in Rennes where we queued (in comfort, with a buffet service!) to be examined by a number of specialist doctors. Each part of the anatomy, from eyes and teeth to prostate, was carefully examined and subsequently a rendezvous (the odd name, Brits will think, given by the French to any appointment) offered where I discussed every aspect of what had been discovered with the leading doctor involved. A report was sent to my own doctor and, as always in the French way, also to me with recommendations for treatment including in my case a scan. In my case this found nothing disturbing. All this I found reassuring.

I need hardly say that the need to 'go home' to the NHS is not something I reckon with.

From Margaret and Bram, 35, Brittany France

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