Health (And immigration)

Health Here And There (And Immigration)

With the junior doctors' strike in the UK in the news, the following experience of my friend Steve has immediate resonance. Steve picked up on article in The Telegraph which stated, quoting an NHS survey, that 18.1% of people in the UK have to wait more than a week to see their GP and 11% don't get an appointment (who then swell the numbers going to A & E?). He contrasted that with his experience here in France when he fell over last weekend and ended up in pain. I'll state it in his own words.

“Jo phoned our GP at 8.30 Monday asking for an early appointment as I was in pain from the fall on my side. She was offered an appointment at 10.30 later the same morning, after scheduled patients.

I was seen at 11.15, examined and suspected broken ribs diagnosed. Our GP then phoned the nearest X ray hospital department and made an appointment for later in the day at 4pm. We returned home via a pharmacy to pick up bandages and pain killers as prescribed by the doctor. We arrived for the Xray at 4pm, I was called at 4 minutes past and had 8  xrays taken by 4.15. After 10 minutes wait the consultant arrived with the Xrays and confirmed that I had broken 3 ribs. We were home by 5pm. As an aside, this cost me nothing as the costs were covered by the government and my supplementary health insurance”.

As Steve also pointed out, he was confident he would have received the same treatment in the UK; the difference was in the waiting (or lack of it). I've stated before that I think health services have to be limited in some way, but a great deal depends on how. In the USA it is simply money, a policy unacceptable in Europe (rightly, I believe). In the UK, the shibboleth of a totally(?) free health service means that waiting is the only possible restriction, apart from restricting drugs that can be supplied on the basis of some form of cost/benefit analysis (benefit to whom?). The French have had to tighten up on what has been an extremely generous health service but seem still to be achieving a good balance between service and cost. Here you need a health insurance policy (very cheap by UK standards) to supplement what the State pays but what Steve would have had to pay in the UK in prescription costs for his bandages and painkillers was probably less than his weekly health insurance payment here. And there his waiting time would have been……..who knows?

What seems to be happening in the UK, apart from the waiting, is supplementary payments by stealth (e.g. prescription charges) and ad hoc use of private services at generally huge cost to the State. A recent investigation found that the NHS had paid £1 billion over a year in private agency fees, excluding the direct costs of the staff supplied. The current government doesn't care and Corbyn and the opposition are very unlikely to ditch the shibboleth. Moreover, there seems to be much more emphasis here on early detection of illness than in the UK. It follows that if you are constantly fightng fires, as seems to be happening in the UK, you don't have a lot of time or resources for fire prevention. That costs you more in the long run and shows in comparative figures between the UK and the rest of Europe regarding cancer and other illnesses where survival rates depend on early diagnosis. It is all a very great shame.

There is an immigration footnote to all this. Polio, tuberculosis, small pox and various other nefarious diseases have largely been eradicated from Europe, primarily through inoculation programmes. So how many of the current influx of immigrants do you imagine have been through such programmes? And how rigorous do you imagine screening is when a new wave of immigrants arrive? Germany seems to be more thorough on screening than most other countries and is thus proving a useful source for discovering time-bombs. It recently reported finding a number of cases of these “vanished” diseases among the recent influx of immigrants; and Germany found them because it screened for them. How many other countries are doing likewise?

Perhaps I should add, in case it is not already clear, is that I am not against any European country taking the proportion of the recent influx of immigrants that it can reasonably accommodate. On the contrary, particularly in the case of the UK which did much to help create the current crisis. What worries me is the focus on such matters as benefits payments and terrorist infiltration and apparent total disregard and complete unpreparedness for the social impact.