Anyone have experience of health care systems in other European countries that works better than NHS

[DeidreInaQuandry]

For decades we've been told the NHS is in crisis/at breaking point etc

I often read on MN about how wonderful health care is in Germany, France, Scandinavia. So what are they doing differently/more efficiently and could we adopt it?

I had routine breast exam at 45! As standard, and will every 2 years from now on!
Hospital referrals within days.

Spain is very good, they do early tests for everything. Family friend has a serious illness that was diagnosed in Spain from a cough, had it been here they wouldn't have tested until a number of other symptoms appeared. Early treatment has meant a full recovery from something that most people here would have died of

main difference is money, we just dont spend as much per head, so we get less which means longer waits/rationing

www.kingsfund.org.uk/blog/2016/01/how-does-nhs-spending-compare-health-spending-internationally

What about elderly care,dementia care,care at home?This is and mental health are the biggest stressors in the NHS,how are these dealt with?

Someone further up said, what about those who can't afford it? I've got a story for that.

Staying in rural South Africa. Mostly adults few children. Quite isolated place.

Small child (6? 7?) gets a sore throat. He then got a secondary infection which was very scary and his throat swelled up so badly he woke up in the night struggling to breathe. Went from going to bed with a normal cold to a life and death situation about 3am.

Nearest hospital is about 2 hours drive but their are local ambulance crews a lot closer.

Ambulance turns up within half an hour and gives him adrenaline to keep him going but refuse to do more ( even giving him oxygen) until his mother finds his health insurance documentation. Which took about 15 minutes of frantic scrabbling. Child was given oxygen on the journey and antibiotics at the hospital. Aside from a few weeks of nightmares he was OK.

We spend less per person than anywhere else in Europe. we get what we pay for and while a lot of people say " the nhs wasn't designed to do so much" they all seem to have a different opinion on what it shouldn't be doing. If we want a better NHS we need to pay for it. Simple as.

I have experience of the German system. Compulsory health insurance for all, - you can opt for private insurance if you want, but I think you have to be earning above a certain threshold to do so.

Once you have opted for private, you cannot opt back in to public insurance unless your income drops back under the threshold; however you can remain with public insurance even if your income goes over the threshold.

Employers are obliged to pay a certain amount, and the employees contributions go out of their monthly salary. Children are included on their parents' policy, and spouses earning under a set (very low) threshold will also be included. However it is pretty terrible for the self employed. They have to cover their premiums all by themselves, as obviously have no employer to make contributions, and it can be very expensive.

The healthcare provided is fantastic, and extremely efficient.

NHS is not funded or managed well.

A lot of waste of resources, time, paperwork, demarcation, unions, you name it.

The clipboard man/woman has all the power, earns the most, but still cannot get things to work efficiently.

But once in the system, it is great. No question about that.

There are so many threads on here about should I, will I go to A+E. Honestly why all the angst about going? I just don't get that. Really what is the problem with calling the OOH doctor, calling your GP, going to A+E.?

Can someone possibly explain. Thanks.

We spend less per person than virtually anywhere. People vastly underestimate how good the service we get is for the money actually spent.

Austria. I have insurance through my husband at the moment, as do our children. Free. When I work again I will have my own insurance through my work, deducted from my pay automatically. How much dependd on how much you earn and the unemployed, those on maternity/refugee status etc and children are free. Care is amazing on the whole. Most doctors are self employed and claim direct from the insurance but you can go private and claim part of the cost back too. I have a smear test every 6 months-year because I go to the gynaecologist for check ups and sje does them as a routine. By the time the NHS sent me a letter saying I am entitled to my first smear, I'd already had about 6 here. Same for all other prevention methods. The only difference is you pay for contraception here and a few other things that would be free over there. I much prefer this system and would probably get private insurance in the UK to match standard care here.

To those who have private healthcare insurance provided by their employer, could I ask what happens when you retire?

Just wondered if it is continued. That is when it is needed most to be fair and realistic about it.

Caveat... I may not have understood the system fully. If so, apologies.

I live in The Netherlands and it feels overly bureaucratic here. It's a semi private system here and insurance is compulsory (you're fined if you don't have it and want treatment) and premiums are paid to insurance companies. Premiums aren't income dependent but if you are on a low income you are subsidised by way of a (toeslag) credit from the tax office. I pay 105 Euro's for me and DD (Basic Policy) and there is a compulsory (determined by the government) 385 Euro own risk element. Fortunately, I haven't needed to use the service much but whenever I do the buracracy is painfull. DD was hit by a car two years ago, police and ambulance called but thankfully no broken bones or concussion. The treatment was great but I was hounded by my insurance company to provide details of the driver so they could make a claim against his insurers, I ignored them because I was busy caring for a very shaky eight year old. However, later friends told me stories of being billed for ambulance services.

GP appointments are free but you do have wait and in my surgery, you will get sucked into an Orwellian style system trying to secure one. Despite the quite understandable disquiet about cuts, DD saw a child Phycologist for years which was paid for by my insurance company and the Phycologist took care of the paperwork, so I didn't have to lift a finger.

Primary healthcare isn't something that is talked about a lot, social care on the other hand, is discussed endlessly with not much being resolved.

I recently had my gall bladder out here in Germany, went in on the Saturday with god awful pains and was in surgery on the Wednesday.

They did a full MOT on me, the hospital and DRs and nurses were all fabulous. They even came to me for a bit of English practice

More medicine doesn't necessarily mean better outcomes.

Poster above comments that she had smears in Austria before reaching the NHS screening age. Smears aren't done routinely before 25 as it doesn't save lives and leads to unnecessary surgery. The cervix undergoes temporary changes at that age which almost always revert back to normal without any treatment, however if a routine smear is performed the woman can be referred for unnecessary surgery to treat a pre-cancer that never was. Sadly the surgery can potentially increase miscarriage rates. Yes there will be a very small number of women who have cervical cancer with no symptoms below 25, but overall studies show that routine screening below that age does more harm than good.

The NHS is generally pretty good at working out when particular tests/ treatments are worth doing. Sadly it often doesn't have the money to follow through on this.

With a private system I'm worried that doctors have an incentive to over investigate/ over treat to earn more. Not inevitable but does affect decision making.

France was very good but I would also say that most of these countries are healthier than the U.K.

NHS still tops most league tables. Certainly other countries pay more for worse outcomes.

In France where I am you can get GP appointments same day. Never had problems getting appointments at hospital etc for other types of treatment, no wait.

However, it is not free. I have a Mutuelle through work which I pay €19 per month for. When I recently broke my leg, I had to fork out approx €800 in doctor, hospital and physio fees, of which only half ended up being reimbursed.

The system is incredibly complicated, with the state supposedly reimbursing 70% and mutuelles topping up the rest. Except the tarifs the state sets for its reimbursement bear no relation to the price you actually pay. The state thought I should be getting physio at a rate of €14 per session, whereas in reality the cheapest I could find was €30. So they reimbursed 70% of €14, and the mutuelle 30% of €14...leaving me significantly out of pocket at the end of it all!

Am also in Switzerland. Medical care is amazing, but my goodness, we do pay for it! Our health insurance is almost as much as our rent. My kids glasses are several hundred pounds each. I am scared about dentists bills, a friend was quoted £11,000 for her sons corrective braces/treatment ( or covered by insurance).

That said, my eldest has autism, his therapies/specialist appointments and school assistance is picked up by the equivalent of the state, which is amazing.

But, overall, the care is absolutely brilliant, so I don't really mind paying for it. I get very cross when my parents (in the UK) are ill but can't see a doctor for a week as there are no appointments!

In Spain there is a much more proactive approach to medicine. When you are ill they do blood tests to rule things out earlier rather than the wait and see approach of the NHS. Screening is much better, had smear tests, all kinds of gynae screening including breast ultrasound as routine. Major employers also offer health checks to employees. The hospitals check how people have entitlement to health care. They are streets ahead in transplants. Women are more routinely offered epidurals for childbirth. In my experience it was easier to see a specialist. I could always get a GP appointment for the next day and the opening hours of surgery were great.
I think a lot of this is down to how things are run and much better management of the available resources.

More medicine doesn't necessarily mean better outcomes.

This.

The problem in the UK is not just that the NHS is underfunded and not perfect but also that a significant number of patients have no awareness or consideration of costs as we don't pay anything at the point of care so they waste prescription medication, DNA appointments and expect attention and prescriptions for things that they could manage themselves with a little commonsense and a trip to the local pharmacy

Another person with experience of healthcare in Switzerland. Only hospital I have ever been in where a nurse came round at night and offered to rub aromatherapy cream on to my back to help me sleep! And the hospital was so quiet that you would have sworn that you were the only patient in it. On the other hand, we did have longish waits in A&E when they were busy (ski area with lots of injured skiiers that weekend!) and I had to do similar chasing up of tests and paperwork prior to being admitted for an op as I have had to do in the UK. We sometimes had to wait a while to see the equivalent of a GP but once you were in her office, she gave you her undivided attention for as long as she wanted to, and there was a much more holistic approach to health. You could also have a check-up with a gynaecologist (with a surgery looking like something out of beauty parlour) annually, and it was easier generally to see a specialist. My children's health care and milestone check-ups were with a paediatrician which was reassuring although possibly not always necessary. My children weren't born there but accounts of the fantastic post-natal care available as the norm in Switzerland were light years away from my experience in the UK.

It was expensive and the more you could afford to pay, the more choice you had. However, - and I think this is a big however - the rate of income tax payable was much lower than in the UK, so the extra cost was less than it might seem at first sight.

Receiving invoices for all the care you received - even though you only paid a small percentage with the rest being met by the insurance company was a real eye-opener and perhaps it would be good for people in the UK to realise just how much their care is actually costing.

There was a safety net for people who were unemployed as the local commune would cover the cost of premiums for the basic level of cover.

I really value the free-at-the-point-of-delivery health care we have in the UK but I do wonder if we are too tunnel-visioned in terms of thinking that the current NHS is the only way to do things.

Not Europe, but I think Canada's socialized medical care is very good. Ambulances in my city arrive on average apparently in under 10 minutes. Drs visits are free (I have to wait about 1-2 weeks to see my gp but can see one at a walk-in on the same day), hospitals are free. We pay for prescriptions, glasses and cosmetic surgery. Low income kids get free dental and eyewear. Our health outcomes are good. We get mammograms free every two years, ditto Pap tests. My dr will have me go and get free blood work done when I am poorly & he deems it necessary. I've had quite a few surgeries, some emergency some not - all done quickly w good outcomes.

Post-natal they turf you out of hospital pretty quickly and there's no follow up unless you take the baby in. If you wish the baby to be checked and weighed etc, it's all free.

The problem in the UK is not just that the NHS is underfunded and not perfect but also that a significant number of patients have no awareness or consideration of costs as we don't pay anything at the point of care so they waste prescription medication, DNA appointments and expect attention and prescriptions for things that they could manage themselves with a little commonsense and a trip to the local pharmacy

The people are the problem rhetoric is something we hear in Australia, but I'm becoming less convinced that it actually is. For example a lot of people here are required to visit a GP for pretty much any work absence which means you can end up at the doctor when your child has a slight sniffle and cant go to daycare or school for a carers leave certificate. That is a massive waste of resources. We have a mix of private and universal healthcare here. I don't think we have done the private aspect very well,

Travelling round Asia

£40 to see doctor at walk in clinic

Examined, letter written (incase I needed to see another doctor on travels) and medecine provided

A few days later ear infection cured

OK if you have the cash to pay