Vive la France

Okay, so here’s how the Irish health service could/should operate if it was properly resourced and managed. The following article was published in the Irish Times and documents the experience of an Irish person who required emergency care in a hospital in France.  I’ll leave you to draw your own conclusions.

Vive la Différence

“No waiting room, no trolleys, no queues, no admission fee and free parking. It was very strange indeed”, writes Michael Foley

“It is 1.30 in the morning, the first night of the annual Feria, when Beziers, in the south of France, goes en fete for a week of partying. Getting to A&E through streets thronging with revellers is a feat in itself, but arriving at the hospital is an even more unusual experience.

I rushed to hospital, with what later turned out to be a blocked artery.

Where is the waiting room? And where are all the corridor trolleys gone? Well, there is no waiting room and no queue, no line of people drunk or groaning with pain, and facing a 12-hour wait, just a woman at a desk and a sliding door that lets you straight into your own single-occupancy examination room. Parking is free and there is no €60 admission fee either.

Very strange indeed. It is so strange that we waste valuable time assuming we are at the wrong place. Why no waiting area? Goodness me, said a French nurse, urgence, the French name for the A&E, means someone requires urgent treatment; you could hardly expect someone in need of immediate treatment to wait, now could you?

It has to be said that when I last attended a Dublin hospital, eight months previously, I did not have to wait either. As I pointed to my heart and handed over the €60 casualty charge, a wheelchair almost buckled my knees as it wheeled me into triage, but behind me were others who would be waiting and waiting and waiting – unlucky enough not to have chest pain.

Back in Beziers, and two-and-a-half hours later, I had blood taken, a brain scan, a chest X-ray, and all the test results returned, and was tucked up in bed. At no stage did I see anyone on a trolley in a corridor.

Trolleys were used to ferry people. Patients slept in beds. My room, in a public ward, was for two patients, with a toilet and shower en suite. The equipment was new and worked. The bed was high-tech and moved in almost every direction.

What followed were days of tests, done without delay, and all ordered by specialists, who personally delivered results, usually within the hour. I was given scans, X-rays, MRIs and investigations I thought I might have been given eight months previously in Dublin. “Should I have had this test before?”

The doctor was non-committal.

The first specialist was a neurologist. The Centre Hospitalier de Beziers has three (as opposed to a dozen for the whole of Ireland). The doctor was a quiet, respectful woman who was available throughout the day, and who delivered the test results she herself ordered.

There was no entourage, no one to fawn and laugh at her jokes. She even had office hours when family could call in for information or advice – no need for intervention, divine or otherwise here.

We kept checking as to her status with the nurses, because her availability was akin to that of a registrar or a junior doctor in an Irish hospital, but yes, she was everything one could possibly want in one’s neurologist – professional, available and attentive. Extraordinarily, if a test was required, it was done immediately, and she delivered and discussed the results in person.

The second specialist, a vascular surgeon, again was one of three. When surgery was decided, I was moved to another floor and opted for a private room. Cost €40 a night.

Surgery was successful and after a period of recovery, I was out. When discharged, I was given a slip that was officially stamped, this is France after all, and that was it; I paid not one cent.

Under the EU health insurance regulations, I received the same treatment as a French person – 80 per cent of the cost borne by the state – and like a French person, my insurance (in my case, the VHI) paid the rest, including the cost of the private room.

One of the most remarkable features of the hospital was the level of hygiene. And not a nun in sight. The corridors were completely clear. The cleaning trolleys, with their colour coded buckets for every individual surface, plied up and down the corridors.

Masks and sprays were used as appropriate, from one patient to another. Head-to-toe disinfection twice before surgery . . .

In the Dublin hospital I attended recently, there was one shower for some 50 patients. This was in a room with a bath fitted out for disabled use. There were cracked tiles around the shower. The bath/shower room was also used as a store. If you were able to walk, you washed and shaved at a row of washhand basins, like a 1960s boarding school.

The VHI was amazing, constantly phoning me and my wife to see if I was alright. Did I want a second opinion? Was I was satisfied with the doctor? Was everything explained adequately? It also had a French-speaking doctor contact the hospital doctors who came back to explain what was going to happen.

Isn’t it extraordinary that the VHI pays no such attention to the interests or concerns of their members in Irish hospitals?

Would I have returned home for treatment if it had been feasible? Not if the advice I was given was to be taken seriously. Proof of the serious lack of confidence there is in the health service in Ireland was evident in the number of calls I had, from friends, colleagues and family, telling me how lucky I was to be sick in France and not Ireland: “Stay where you are. It’s the best place to be.”

If I returned, they thought, I might not get a bed, and if I did, I would be at risk from MRSA. “MRSA is a given,” said one friend, whose mother recently contracted it.

For the next two weeks, a local nurse visited to clean the scar and eventually remove the staples holding the surgical opening together. Cost for a home visit, €5.50 a day. But it is not just money that is the main difference between the two systems as experienced by patients. I was treated as a critically ill patient, the same as if I were French, by nurses, doctors, specialists and home visits,

I even have a GP in France now, who gave me a free consultation, just to get to know me. I only hope we don’t get to know each other too well.”

With thanks to the Irish Times for their online publication.

12 Responses to Vive la France

  1. Ian says:

    Having experienced the completely disjointed nature of health provision here in Ireland over the past two days (I phoned the GP clinic to ask about getting a surgical dressing changed and was told that the practice nurse had no appointments until next week and that they had no idea where I might go), I am resolved to leave the State before I get old and need critical care, particularly after the Government’s vicious attack on the elderly.

  2. Baino says:

    I’m not a great fan of Michael Moore but his DVD “Sicko” highlighted the benefits of the French system. They pay a lot of tax . . but they seem to have an amazing hospital /health system. To have a baby is free and accessible. Everyone is treated equally. Child care is free! Can you imagine. Yet there are those who would poo poo them for being socialist. I tell you when Social Welfare works, it works! The French model (much as we hate to acknowledge it) is definitely superior to most. Actually, the Brits and the Canadians came off pretty well also! @Ian . .it’s a dressing . .get herself to change it for you! As a curer of horsey ailments, a bit of Betadine and a sanitary napkin work wonders!

    And I thought that the levy on elderly health was means tested? It’s not such a bad thing to prevent people going to A & E as you call it for sniffles and cuts when they could go to their GP. That’s a problem here . .Casualty (as we call it) being filled with people who are not actually emergency victims.

  3. Grannymar says:

    My Elly could tell a very similar story to Michael Foley about her experience with and in a French Hospital! They are the creme de la creme!

  4. Brian says:

    I live in France now and checked out the health service here before I came (case of having to really). I am now one of those tax payers that pay into the French national health service and yes it is a lot but quality costs and this is one of the best health systems in the world if not the best.

  5. Bendy Girl says:

    Wow! What a system, although I have read on several occasions that the health service in France is costing the country so much money it is unsustainable. I don’t know how true that is though

  6. Steph says:

    Thanks! Ian, Baino, Grannymar and BG and Welcome! to Brian

    The French system of healthcare is one which we in Ireland can only admire and envy. Yes, the French are highly taxed to subsidise this system but in return they enjoy a highly efficient health service that looks after all it’s citizens and not just those who can afford private healthcare.

    I have an American relative visiting at present who is temporarily residing in France and she informs me that even though she’s not paying French taxes, she is still able to access excellent out-patient healthcare at affordable prices. And she confirms that the service is efficient beyond belief!

    Ian’s experience (above) of our disjointed health service typifies the disarray that exists in a system that is in complete meltdown through overload.

    And our Minister for Health’s solution to this situation is to complicate things even further by promoting a system of private health care at the expense of our public health service 😦

  7. Unbelievable. We pay a fortune in taxes here but our health system is a shambles. One has to ask, if the French can get it so right, why can’t anyone else? I heard from a friend recently, who lives in Switzerland, that a colleague needed very particular surgery – he was recommended by his specialists to get it done in France. Speaks volumes.
    It must drive you nuts to know this kind of healthcare is possible, yet continually find yourself battling a system which seems to sink deeper into the mire.
    I’m at the hands of doctors and specialists this week – private healthcare, thank goodness, but no doubt it will be an “interesting experience”.

  8. Steph says:

    Hi! AV

    I too have a friend who had exhausted all expertise available in Ireland for an unusual heart condition and so his surgeon referred him to a highly specialised cardiac unit in France. He eventually had his surgery in this clinic with his Irish surgeon accompanying him to learn how it should/could be done. My friend could not believe the high level of care he received in France – even his wife was accommodated at the hospital!

    Sorry to hear you’re facing another session with docs – I do hope the outcome is good.

  9. Mike says:

    There is no reason why we shouldn’t have the same healthcare system as France
    Cuba has a fantastic healthcare system Why cant we

  10. Steph says:

    Hi! Mike

    I agree but until or unless the Government ideology changes to one of universality, we stand little chance of ever having an efficient and equitable health service.

    Germany and Canada also enjoy universal healthcare based on the acceptance of high taxes to pay for it. The evidence here is that the public wants universal provision but not the tax system to pay for it.

  11. annb says:

    I’ve been touring your archive and came across this post, ah it brings back lovely memories of when I lived in La Belle France. My sister is now residing in Havana Cuba, she had a fall recently, bajaxed her knee which swelled quite spectacularly, A&E Cuban style was called for. She was seen immediately, she had an x-ray, a full report on same, she saw a consultant, was given a prescription and a plan for follow up care. Total time spent in A&E? 45mins. Total cost? Nada
    Vive la revolution!

  12. Steph says:

    Annb – Glad to be of service! 😉

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