I have for over twenty years lived under the French health system which is a mix of public and private funding.The French health care system is one of universal health care largely financed by government national health insurance.In all those years I have never had to wait for an appointment to see a GP. (if one is busy just go to another one, carrying our own notes and a centralised computer system makes this easy.) You do pay to see the GP, but this is reimbursed part by the state and part by private insurance . The French government generally refunds patients 70% of most health care costs, and 100% in case of costly or long-term ailments. Supplemental coverage may be bought from private insurers, most of them nonprofit, mutual insurers. Primary health care is provided by a network of 23,000 general practitioners (in French, médecins généralistes) (a ratio of 1 GP per 2600 inhabitants). Most GPs are self-employed professionals, and work either on their own, or in group practices

Hospitals are superb although we do pay a “bed and board” fee, after all if you were at home you would be paying for heating and food  – why do you expect it to be free when in hospital. I can go directly to any specialist or consultant. I do not have to be “referred”. GPs do not exercise gatekeeper functions in the French medical system and people can see any registered medical practitioner of choice including specialists. I can ring up today and see a cancer specialist tomorrow. Sure it is not cheap but then you usually get what you pay for. I think French spending on health is a couple of points higher as a percentage of GDP. Of course the NHS is “the best in the world” (except on the saving lives measure) whilst not wishing to dispute this claim I do believe the French NHS is on a par…

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12 Comments

  1. Eric Watts says:

    Interesting – is the bed and board fee means tested?
    Being able to see a specilaist tomorrow may seem attarctive but is it the best use of their time to see unselecected patients i.e. people who do not have cancer – are their any criteria to fulfil beyond the wish to see a specialist?

  2. duncanenright says:

    We argue sometimes that privatisation fragments care, and that there is no profit to be made in the NHS (nor should there be). But in the NHS as in France GPs are private contractors and private practice is normal for consultants. In care the third non-profit sector has a huge share. What are we to make of this?

  3. john locke says:

    yes the “bed and board is means tested..you wouldnt expect anything less from a socialist country..re visiting a specialist, most people would visit the generalist first then on advice visit the specialist..but if you want to go direct you have the choice..I forgot to mention the amazing role that Pharmacists play as the first port of call; many people with a problem will visit a pharmacy before visiting the doctor.. pharmacists are qualified to interpret symptoms and will give advice on anything from a rash to whether the fungi you found in the woods is edible.

  4. Martin Rathfelder says:

    There are regular calls for pharmacists in UK to do likewise, but they don’t seem to have much effect. And I’m told the French consume much more medication than the British – perhaps because of this?

  5. Martin Rathfelder says:

    One of the keys to integrated care is shared records. The French seem to have cracked that – some time ago.

  6. ” You do pay to see the GP, but this is reimbursed part by the state and part by private insurance . The French government generally refunds patients 70% of most health care costs, and 100% in case of costly or long-term ailments. Supplemental coverage may be bought from private insurers, most of them nonprofit, mutual insurers.”

    I would remind you, this is a Socialist Health Association, Nye Bevan understood meaning of health provision and that was why he resigned from the then Labour government for introducing charges into the system.

    The other small point is that the NHS has been deliberately underfunded to create the conditions of rationing and waiting times to force people into going private.

    New Labour’s preferred provider means the tendering process will be left in place, this means additional costs to the system and takes money away from front line care, a child falling out of a cradle can see it, why can’t people like you?

    The NHS is being destroyed by Neo-Liberal dogma.

    If you want a private health care system then at least have the honesty to say so, not pretend that you are seeking to improve it by raising unnecessary tendering costs.

    We need to get the private sector out of our health service not re-enforce it.

    This article might point you in the right direction:
    Safety of private hospitals questioned as report reveals hundreds die unexpectedly
    More than 800 people died unexpectedly and almost 1,000 injured in private hospitals in four years, a report found, amid calls for greater transparency on patient safety outside the NHS

    This is the article in full: http://www.telegraph.co.uk/health/healthnews/11043262/Safety-of-private-hospitals-questioned-as-report-reveals-hundreds-die-unexpectedly.html

    Socialism works capitalism doesn’t.

  7. Martin Rathfelder says:

    Mervyn’s comment does not seem to address any of the interesting issues raised in this post. Most people regard France as rather more socialist than the UK these days. Their health system is pretty successful. Their hospitals are nothing like the private hospitals we have in the UK, which are essentially parasitic on the NHS.

  8. john locke says:

    “Socialism works capitalism doesn’t”…I would like to see the evidence of this..Capitalism has lifted more people out of poverty than any socialist system…

  9. Martin: You appear to even forget the evidence provided by the NHA namely Rob Yates tweet of the NHS support provided by the users in their respective countries. https://twitter.com/yates_rob/status/555007269042409473/photo/1

    Which clearly contradicts what you say.

    John: firstly I am amazed you seek to defend the capitalist system on a socialist platform, but that said if you want some evidence of why Socialism works and capitalism doesn’t here is a window on what socialist understand.

    http://en.wikipedia.org/wiki/Mondragon_Corporation

    The Mondragon cooperative which was started in the 1950s by six people and has grown to employ over 70,000 and has some 200 companies to it’s name. Most of the workers are members of the co-op and vote on all policies associated with it, including how much they pay themselves.

  10. john locke says:

    So different views are not welcome. Are your beliefs so fragile.? You seem to think I was attacking the NHS, I wasn’t. my purpose in writing the piece was just as the title said to show how different the French system is….I know you are sensitive to criticism of the NHS but seriously as I said I don’t queue for a GP, I am not stacked on trolleys in A&E… Open you eyes and embrace that there may be ways to improve the NHS without forever throwing money at the problem.
    Regarding capitalism v socialism. China is a prime example of how capitalism is helping end global poverty. The country has one of the most impressive “rags to riches” stories, bringing 680 million people out of extreme poverty from 1981 to 2010. Furthermore, a staggering 84% of China’s massive population used to live in extreme poverty, and that number has now been reduced to 10%. Most of the reasoning behind this incredible transformation lies in the fact that China’s productivity level drastically increased towards the end of the 20th century, embracing capitalism, supplying people with jobs to bring them out of extreme poverty.

    .One example of a socialist company set against the millions of successful capitalist companies is not a great advertisement for socialism…neither are Cuba, Venezuela, North Korea, ex USSR, and every other failed socialist society..

  11. John you talk on the one hand at not throwing money at the NHS and yet forget that the NHS is cheaper per head of population than the French version, perhaps we could at least spend as much on the NHS as they do in the French system, perhaps that would create the same results that you mention ????

    Sadly John you are not a socialist are you?

  12. john locke says:

    I am apolitical…my criticism of one party does not mean support of the other.. however you are right I have never been called a Socialist…..

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