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Tuesday 17 June 2008

The glory that is the NHS

The Telegraph had a wonderful article last week by someone who has experienced the state health services in France and the UK for the same operation, a hip replacement. Do read the whole article and wonder how anyone could think that the NHS was the "envy of the world". Here's a long extract:

"Four years ago I fell off my bicycle outside my flat in west London and fractured my left hip. I called an ambulance, which arrived within 15 minutes and took me to a leading London teaching hospital. After arriving at around 4.30pm, I was admitted, assessed, X-rayed and operated on at midnight, under an epidural anaesthetic. So far, so good.

Then I woke up the following morning. I was on a mixed sex ward. Four men were in a curtained-off section, although women were clearly visible, as the curtains of their cubicles were often left open. The ward was filthy, with a dirty lavatory that was never properly cleaned.

I had been given a screw and plate in my femur, which left me in great pain, but I and my fellow patients were all assured that the "pain team" was on its way. I never saw it. I was given the painkiller Tremedol plus paracetamol, but whenever the effects started wearing off and I asked for more, I would be told there was no doctor available to authorise it. I was released after a week. I had had only one cursory 10-minute physiotherapy session and couldn't get a follow-up appointment for three months.

Compare that with the French health service. On Easter Sunday, I fell off a ladder at a friend's house in south Brittany. Although we were 6km from the nearest town, les pompiers (the paramedic ambulance service attached to the fire brigade) arrived within 10 minutes. I was checked out and loaded into the ambulance. As we reached the highway, a doctor met us in order to assess me. He told the crew I should be taken to the hospital in Lorient because it could deal with my injury better than the nearer one in Pontivy.

On arrival I was assessed, X-rayed and had my leg put in traction. I was constantly asked about my level of pain and was in the operating theatre within two hours. The surgeon told me there were two full orthopaedic teams on stand-by in the hospital, even though it was a holiday weekend.

In theatre, I was offered the option of an epidural anaesthetic - then the theatre sister produced an iPod and said: "You don't want to hear us working." I listened to jazz while they fixed my hip.

Not long after I came out of theatre, a "pain doctor" gave me Tremedol and paracetamol. "If you feel any pain at all, push the button and ask the nurse to call me. I will come right away," he said. On day three, when I did have some pain, they set up a small morphine drip immediately.

Unlike in Britain, hygiene was taken extremely seriously. Every morning, the nurses got me out of bed, stripped it down to the frame and gave the entire room, furniture and floor a thorough clean. I was in a two-bed room with shower en suite; the nurses shook their heads at the idea of lumping patients together in a large room. (This 1,000-bed hospital had only one- and two-bed en-suite rooms.)

A physiotherapist helped me to exercise daily. The food was tasty and varied (in London, I was never given what I requested because it had always ''run out"). On Sunday in France you even got a half bottle of wine with your meal.

In France, the patient's ongoing care and individual well-being was paramount. On the morning after I arrived at my French house, the district nurse came to give me the first of 15 daily injections. She asked me what time I would like her to call.

All this was free courtesy of my Europe Health Insurance Card (which gives British citizens the right to free or reduced-cost emergency treatment across the EU). Why can't we get it right in Britain, despite the billions that the Government has poured into the increasingly creaky NHS? Are there too many managers? Too much central control, perhaps? Or has the NHS simply forgotten to put the patient first?"


I have blogged before about my and Mrs NotaSheep's recent experiences of the NHS, maybe we should move to France.

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