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Being here

Have been pondering the ups and downs of being here, as I often do. On the plus side, no more wrangling with the NHS. Have been following a couple of medical dramas on my f-list, one person with an eye problem which was eventually (and quickly) diagnosed by going private, another simply trying to get a repeat prescription for the Pill from her local GP but being told she had to wait ten days - I mean, what is that about? Enforcing chastity and continence on young British women? I remember having to argue with the doctor's receptionist in Belfast about whether I was ill enough to deserve an appointment at the end of the following week.

At least here in Belgium, I've never had to wait even 24 hours to see the doctor, and never more than a week to see a specialist. It isn't free at the point of service - you pay about 20 euro per consultation, 80% of which then gets refunded to you - but I think that the defenders of the NHS have fetishised the "free at the point of service" mantra to the point that it obscures the lousy qualities of the free service you get. (And of course the care available to us for our children is way in advance of what we would get in the UK.)

On the other hand, one of the Belgians on my f-list has just been deprived of two months' worth of state benefits due to a bureaucratic slip-up, with, of course, no information given to her about how she might appeal against the decision. My experience with Belgian bureaucracy is that once you threaten them with the ombudsman they cave pretty fast, but only because most Belgians don't even think to do that. The Belgian state services may be efficient and generously funded, but they are also paternalistic and rather inhuman.

There are, of course, other upsides of living here. I went for a good long bike ride in the woods yesterday, as the first step in my spring keep-fit programme. (Must go and do it again once I've finished writing this.) crazysoph came over in the afternoon, which was very nice. (She has written her visit up in much detail on her own journal.) We went out for dinner last night, and then came home and watched Doctor Who (having taped it). And the Sky and Telescope page tells me that if this evening is clear - which it looks like it may well be - we have a good chance of seeing the International Space Station in the southern sky at about 2140. Will report back.


( 8 comments — Leave a comment )
Apr. 23rd, 2006 10:29 am (UTC)
My experience with the NHS is generally good. If I want to see my GP, and it's urgent, I can always get to see one of the doctors in the group practice the same day, and I can usually (80% of the time) see my own GP within 24 hours. When I went in with my blood pressure problem, I was seen by my GP within 6 hours of calling the surgery, in hospital for an ECG within one hour of being seen by my GP, and in a bed in the acute observation unit within three hours of that (despite showing up in the middle of a glut of patients during a shift change).

Non-threatening stuff, and opthalmology services in general, seem to be slower. A couple of years ago I was worried about my right eye (dormant retinitis); according to my GP there was a 10-week waiting list for non-emergency consultations in my area. On the other hand, a colleague of his at another practice was a part-time opthalmology consultant, so he cross-referred me to another GP practice where I was seen by the opthalmologist about 3 weeks later.

Basically, how well the NHS works depends on (a) how efficient your GP is (an efficient GP coordinates local resources and makes long delays disappear), and (b) how well funded the local hospital trusts are in certain areas. (Edinburgh: very efficient cardiology services, poor-to-sub-average opthalmology services.)
Apr. 23rd, 2006 11:00 am (UTC)
All I've really got to compare the NHS to is Ireland's system (though my only hospitalisation happened in Belgium and they majorly messed up in one respect) and I'll take the NHS any day.

It costs from 40 euros up for a GP visit in Dublin if you don't qualify for a medical card and I know for a fact people get put off checking things out because they just can't afford it. And if you earn enough to not qualify for a medical card but can't afford VHI you can be in serious trouble.

That said, the NHS didn't help at all when my hand problems were acute - all they managed to do was throughly scare me with predictions I would never be able to work again. But I don't think there's anywhere in the world that deals with RSI/chronic pain well, so I'm willing to cut them slack on that, though not on the crap attitude of the GP. How good your GP is seems to make such a difference and it's difficult to shop around because of the catchment area thing.
Apr. 23rd, 2006 02:44 pm (UTC)
I confirm everything above about GP visits in Dublin. We are lucky to have a GP that is really interested in his patients. He also has the facilities and qualifications to do minor surgery on his premises. He also has the unusual habit of not charging for return visits which, in Dublin, helps a lot.

The whole private/public thing in ROI is a bit on its head compared to the UK. The public services are under severe pressure and people try every opportunity to avoid them. However, VHI, even with competition from BUPA, is getting expensive.

Nephews and neices of mine have asked advice about moving from Northern Ireland to Dublin. I have given them all the news on medical expenses, property costs (including rental), transport costs, etc... and some of them had still tried out life South of the border. All have retreated. Well, one went to Glasgow and never looked back.
Apr. 23rd, 2006 01:25 pm (UTC)
*psst* ooopsie, we forgot about Dr. Who last night... what are the chances of borrowing that tape off you?

Crazy(and trying to make you regret putting me in the plus column, maybe! *wink*)Soph
Apr. 23rd, 2006 03:22 pm (UTC)
From what I can see from my layman's point of view, there is no good healthcare payment system anywhere in the world. Socialized medicine, it seems, is plagued by beaurocracy and inefficiency, and it's expensive to the state. Here in the U.S., though, tens of millions of people have no kind of health insurance at all, and the people who have it tend to pay a lot for it.

I have good insurance, but only because my employer offers it, and I'm willing to pay a little more to be on a PPO (preferred provider) plan as opposed to an HMO. I dislike the fact that health insurance is a business over here -- essentially corporations trying to attract healthy, wealthy people and gambling on their continued health.

Maybe there's no one system that works for everyone. I don't know. Maybe what every country needs is a patchwork of treatment options -- and with the public/private thing in Britain, it sounds like that's evolving on its own.
Apr. 23rd, 2006 03:47 pm (UTC)
Socialized medicine, it seems, is plagued by beaurocracy and inefficiency, and it's expensive to the state.

Actually, it's not plagued by bureaucracy or expensive to the state. The UK spends about 60% per capita as much as the USA on healthcare and provides cover for everyone rather than just 75% of the population. Nor are the patients plagued by bureaucracy -- the service is free at the point of delivery, there's a fixed-rate fee for prescriptions (payable on a seasonal basis if you need a lot of meds, which caps the bill at a maximum of £103 per year for everything), and so on. And if you don't get on with your GP, you just go looking for another one in your catchment area who's got room to take on new patients. The transfer is automatic and the only paperwork you have to do is giving your new GP's receptionist your name and address, and that of your old GP.

Where the NHS runs into bureaucracy is at the administrative side where the hospital trusts are juggling their budgets for a region. But it's still not a patch on the humongous American health insurance industry, which (as far as I can tell) is just parasitic deadweight.

Unfortunately we've now had 27 consecutive years of governments who are viscerally opposed to the public service ethos of universal healthcare. First the tories tried to strangle the NHS, with cumulative spending shortfalls of close to £240Bn over nearly two decades (relative to the amount needed to maintain the 1979 levels of service). Then New Labour is ideologically committed to outsourcing everything to the private sector, funding this by dodgy bookkeeping that effectively borrows from future generations to fund expansion in the present (while paying large profit margins to their cronies on the contractor side).

There's nowt wrong with the NHS that couldn't be cured by a short, sharp dose of socialism and, if necessary, a brisk income tax rise.
Apr. 24th, 2006 10:08 am (UTC)
My problem was more with the limited opening hours and the unhelpful receptionist who seemed to have trouble explaining that I didn't actually need an appointment.
Apr. 24th, 2006 12:24 pm (UTC)
Makes me very grateful for the comparitvely wonderful Medicare system we have here. Of course. I will be even happier when they stopp mucking around with it thus making me nervous about where it is going...
( 8 comments — Leave a comment )

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