Have we a choice?

[KathyC]

I still think that few of you have recent experience of the NHS, particularly in local hospitals. You make it sound as if it's exactly the same in the UK as in France, except for the familiar language. Have you all forgotten the large (often mixed) wards, the understaffing and the lack of cleanliness that's universal? Unfortunately it's all too familiar to me and so much different from what I've experienced in France.

[Russethouse]

Thats a huge generalization - it depends very much on your local hospital - I'm happy with mine:

http://www.royalberkshire.nhs.uk/about_us/our_performance.aspx

I know not everyones local hospitals are so good, but only Dorothy can know whether the hospital itself is an issue for her, furthermore, not everyone is always thrilled with French health care .

[KathyC]

[quote user="Russethouse"]

Thats a huge generalization - it depends very much on your local hospital - I'm happy with mine:

http://www.royalberkshire.nhs.uk/about_us/our_performance.aspx

I know not everyones local hospitals are so good, but only Dorothy can know whether the hospital itself is an issue for her, furthermore, not everyone is always thrilled with French health care .

[/quote]

 

You're right, it is a generalisation, but so is everyone else's. I've seen a lot of NHS hospitals over the last 20 years (12 at the last count) with parents', husband's and own health problems and I wouldn't voluntarily go back to any of them. I've only experience of 3 so far in France but I'd rather have been in any of them here than those in the UK.

I'm  not totally over the moon about all French healthcare (our difficulties in finding a half way competent respiratory specialist would make a very long post!) but I've found the hospitals to be generally a great improvement on those I know in the UK.

[Ron Avery]

"I've seen a lot of NHS hospitals over the last 20 years"

So have we all Kathy, as our parents, friends and siblings pass away.  So are you saying that there has been no improvements in the last 20 years?

 My last experiences in Essex and Yorkshire were that the NHS has come on in leaps and bounds and could not fault the staff or facilities in eother case and that was at Basildon and Barnsley, both were as good as or better than  our local hospital here, people here would rather go to the new one 45kms away than go there.  But  heh,  you keep trumping out your "dirty hospitals uncaring staff,  large open wards dogma"and  "when I was there 20 years ago stuff", the Daily Wail readers will believe it, but those like Dick Smith and RH who live in the UK TODAY know that you are talking past history.  Of course from time to time people have bad experiences, but I can say from my experiences in the last year that the NHS is something the people who work in it should be proud of!!

[Bugsy]

I've copied and pasted this from the other thread as its quite relevent.

All comments on any subject are usually based on personal experiences,

a fact that many seem to forget on this forum. (not just this forum, of

course)

No one should say that anything is all bad (or good)

simply because of their own experience. (well, apart from the labour

government) joke for Ron

I spent a long time in the NHS and am fairly qualified to speak on it.

Today,

generally, its still a superb service at the sharp end but overloaded

and hampered by the top end. The rot set in following the introduction

of trusts in 93/4 when thousands of fifty year managers were removed

and replaced by the new breed of exec and non-exec management. Those

removed were usually people who had worked their way through the

particular department/service and knew the job backwards. The wonderful

expression "You do not need that experience to do the job" was born and

salaries were doubled overnight " You need to pay the money if you want

to attract the right people" being another one.

Does anyone know, for example, that in the UK, there are now more senior managers than there are beds

In

france, I've no (fortunately) personal experience of hospital care, but

have been to see a couple of specialists and the system of a referral

by your doctor followed by an almost instant appointment with the

consultant, is pretty efficient. Whether this is so throughout france,

I have no idea.

Gary.

[Will]

Don't forget that although NHS hospitals have MRSA etc, so do French hospitals.

One can only talk from experience, of course, but we have rather-too-close experience of bodged operations in a French clinic.

[Russethouse]

As I said in the post, only Dorothy will know how happy or not they are with their local hospital, and of course we know that Coops has had excellent care in French hospital. Has Dorothy any experience of the hospital that would be the choice for the op in France ?

Ron, I think KathyC is either still in the UK or has moved fairly recently

[DorothyJ]

[quote user="Russethouse"]

As I said in the post, only Dorothy will know how happy or not they are with their local hospital Has Dorothy any experience of the hospital that would be the choice for the op in France ?

[/quote] Having read all the helpful advice and opinions we are now waiting for Dec 4th. Thankyou all it has been so informative. We live in Poole but the heart op will be at Southampton Hospital of which we have no knowledge. Please dont tell me if you there are poor reports - we have to have confidence in it!! If the op is to be delayed as non-residents I have used a dr in Durtal who is really nice but our nearest hospital is a new one between Sable and La Fleche. Does the system here work on where you live or which Dr you use? As we live in 49 and 72 (boundary through the middle of the house) I'm hoping we have a choice of Dr in 49 and hospital in 72.

[Clair]

In France, your choice of GP is down to you. Most people go to the nearest one to where they live, but it really is down to you.

Once you are in France full-time, you will need to complete a form to let the local health authority who your GP is. This entitles you to a higher rate of reimbursement.

If you want to change your GP, for whatever reason, you simply complete the same form with the details of your new GP.

As far as hospitals are concerned, you can also choose, although most people tend to go to the nearest one for convenience or familiarity. Your GP should be able to advise you.

Broadly speaking, most hospitals are conventionnés, meaning they adhere to a scale of charges set out by the health authorities.

Where charges exceed the scale (hospital specialist usually charge more than the scale), the difference comes out of your purse or out of your top-up insurance if you have one.

More details on hospitals HERE (in French)

[Nickel]

[quote user="Bugbear"]Does anyone know, for example, that in the UK, there are now more senior managers than there are beds


[/quote]

I agree there  is a worrying upward trend in number of managers and a downward spiral in bed numbers- but I am not sure there are as yet more senior managers than beds?

[Bugsy]

It is true,

and here

and here

[Nickel]

Well - I am totally in agreement that there are too many - I also have spent my working life in the NHS but to be accurate then from the data you sourced there are approx 36,000 'managers and senior managers' in the NHS england and approx 130,000 beds.

I think the articles you refer to include all "pen-pushers"presumably administrative staff - who in my mind do a very worthwhile job!!

Whatever the statistics the trend is frightening and some recent articles in the BMJ where some doctors themselves  have been calling for more managers has made me realise I left at the right time !!

 

Edit -  - there are now more managers than consultants !

 

[Quillan]

Looking through what people have posted about hospitals near them and their state it seems to me that if you live in a reasonably affluent area like Berkshire for example then you get a better service. My old hospital was Newham and although modern it was nothing like the Royal Berks. My parents were in Worthing hospital and that was like a different world to me when I visited them there. Poor areas seem to get cr@p hospitals. This of course brings it back to the Post Code and it being a lottery.

[mint]

Same for schools, generally speaking, Quillan. 

Nice, middle class areas usually have better schools than sink estates.

[Will]

[quote user="Quillan"] My parents were in Worthing hospital and that was like a different world to me when I visited them there.

[/quote]

Unfortunately although the actual hospital may be excellent, the authorities cannot leave it alone. There were recent plans to relocate all of West Sussex's hospital care in one place, most likely Chichester (in the extreme SW of the county), though Worthing put up a good case to be the primary hospital. Current plans are to merge Worthing and Chichester hospitals (see here) which will preserve the hospitals themselves though will certainly affect the range of services offered. Those served by the other remaining major hospitals, at Haywards Heath, will lose out badly, as have those of us in the north of the county who have already lost our hospitals, being told we have to use East Surrey (not the best one in the world despite being in an affluent area). These are areas with a high elderly population, many of whom are not particularly mobile (particularly those who need hospitals), as well as one of the major London airports.

It is this mindless messing about, rather than any lack of facilities or inappropriate manager/doctor ratios, that is the least attractive aspect of the NHS in my opinion. It's the responsibility of national and local government rather than individual hospitals.

Nothing to do with France, but it wasn't me who brought it up, miss...

[KathyC]

[quote user="Ron Avery"]

"I've seen a lot of NHS hospitals over the last 20 years"

So have we all Kathy, as our parents, friends and siblings pass away.  So are you saying that there has been no improvements in the last 20 years?

 My last experiences in Essex and Yorkshire were that the NHS has come on in leaps and bounds and could not fault the staff or facilities in eother case and that was at Basildon and Barnsley, both were as good as or better than  our local hospital here, people here would rather go to the new one 45kms away than go there.  But  heh,  you keep trumping out your "dirty hospitals uncaring staff,  large open wards dogma"and  "when I was there 20 years ago stuff", the Daily Wail readers will believe it, but those like Dick Smith and RH who live in the UK TODAY know that you are talking past history.  Of course from time to time people have bad experiences, but I can say from my experiences in the last year that the NHS is something the people who work in it should be proud of!!

[/quote]

I only moved over here a year ago and I have a husband with a chronic health condition so many of my experiences are quite recent. Personally I've seen little improvement in recent years for those who are chronically ill, although I accept that some people may have seen some changes.

And I've never read the Daily Mail in my life!

[Bugsy]

[quote user="Nickel"]

Well - I am totally in agreement that there are too many - I also have spent my working life in the NHS but to be accurate then from the data you sourced there are approx 36,000 'managers and senior managers' in the NHS england and approx 130,000 beds.

[/quote]

"But according to the Department of Health, there are now 261,000 NHS administrative staff. Which is a problem because, as the new Wanless report tells us, there are only 176,000 beds."

[Nickel]

One another thing to bear in mind - depending on the treatment that may be required - not every hospital will have a cardio- thoracic centre, especially with regard to some of the newer procedures/techniques.

I am sure there will be list of hospitals that do - probably Clair will know.

 

[Sunday Driver]

The CHU at Angers (49) has a fully staffed cardio-thoracic centre manned by fourteen surgeons.  The hospital is also regarded as a centre of excellence and attracts top people.

The chef de service of orthopaedics is one of the top bone surgeons in Europe and Mrs Sunday had a knee replacement done by him after our GP gave her a letter of recommendation.  His comment was "I always send my really difficult patients to Philippe....".   No problems with her op - excellent service and aftercare.

Your GP should be able to do the same.

 

[DorothyJ]

Now I wish we had moved ages ago! My husband was diagnosed by a dr here when he went with what turned out to be sciatica. She took his blood pressure, listened to his heart and said he needed to have it checked out back in England. Since then no-one gave any indication that there was anything needed other than monitoring until Nov when the consultant told him that the pressure reading had risen too quickly and an operation was probably necessary. The echogram was in March - how could the hospital take so long to inform us? Anyway, we must look forward and at least once we finally move we can feel assured that the spanking new hospital just up the road will be a good place to go!!! AND there looks to be loads of parking - not something we dont have at the hospitals near us in England.

[Ron Avery]

[quote user="DorothyJ"] We do not want to have treatment in France because we think it is better - we are not particularly unhappy with what is on offer in England.The first thing our french friends said was "dont stay in England, carry on with the move and have it done over here" .[/quote]

 

Dorothy

Harking back to an earlier reply of yours.  I don't think this has been mentioned before, but you need to be careful how you go about getting this operation because AFAIK, as soon as you get your E121 you are off the books of the NHS and then your O/H will have to have the operation in France if there is to be one.  However, that could get refused if you have recently arrived, and you will then be up the swanee without the proverbial.

I am sure that people will tell you that you can just go back to the UK and see your old GP, I know some that still do as their GPs are family friends or their records are still on cards, but if your GP is on the ball, you may find yourself with no options at all.

[Sunday Driver]

Why would you be refused medical treatment in France on the basis that you are recently arrived? 

If you can meet the cost of the treatment, then there's no reason not to receive it. If you are registered under your E121, then the state will contribute towards the bulk of the costs leaving you to cover the remaining ticket moderateur.  If not, then you pay for it all yourself.

The French side of all this is quite straightforward so let's not complicate matters.  As mentioned earlier, the key is the UK consultant's upcoming diagnosis.

 

 

 

[Ron Avery]

[quote user="Sunday Driver"]

Why would you be refused medical treatment in France on the basis that you are recently arrived? 

[/quote]

Has Will got it wrong then SD?

"The principle behind reciprocal European health agreements is to avoid 'health tourism', i.e. visiting a country for the sole reason of taking advantage of its health system. That is different from emergency (or even normal routine) treatment being needed while you are visiting, and also different from arrangements where one country's health system agrees, beforehand, to fund treatment in another country.

So in your case timing is important. If you are resident in France and affiliated to the health system when it is decided that the operation is needed there should be no argument" 

so  E121 in hand or not, doesn't this criteria of diagnosis apply then? 

[Sunday Driver]

No, Will is correct.

The principle behind reciprocal agreements is concerned with the funding of treatment abroad by the patient's 'home' health authority, ie the UK.  The key word is 'visiting' - in other words, it refers to UK residents entitled to NHS cover who are visiting France and expecting the UK to pick up the bill for their treatment. 

As Will says, if Dorothy's husband is registered here under an E-form, then the 'visiting' rule doesn't apply.  He is covered under the French state health insurance scheme - not the UK.

If he's not resident/registered here, and he is just coming here for non-routine/emergency treatment, then unless he has obtained prior approval from the UK Dept of Health and has obtained an E112 certifying that the costs will be met by them, then he'd have to pay cash for that treatment.  As long as he has the means to settle the bill, then the actual treatment won't be refused.

 

[DorothyJ]

I thought i would update all you kind forum members who really helped back in November.

I can only praise the NHS in our area. Dec 4th came and my husband needed an angiogram which happened on the 23rd showing that the valve must be changed. Operation was set for 16th January and today I brought him home. He went into the private hospital in Southampton (where 75% of patients are NHS) on the NHS so was really lucky to have his own room and unlimited visiting for me. The operation was a great success and all the staff were fantastic. Only one downside the food was appalling but that was the least of our worries.

Now we are impatient to get back to France but will have to wait for all the post-op checkups. Now maybe we can get sorted with our French residency.