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?

Slightly off topic but maybe if interest. Did you know that UK subjects can access ANY EU countries healthcare (private or state) through the 'EU health directive' as long as you would have the same referral under the NHS ? e.g. You need a knee replacement but the wait here is three months.. you can find yourself a private surgeon in say Belgium/France /Scandinavia and go next week. If you go EU directive route you pay up front and claim back, if going state route (called S2) then NHS sends operating hospital payment direct. Prices are often half those of the UK, thus saving NHS money and cutting waiting times.
Google EU health directive. For more info. I found out from my ndn who had hip replaced in Stockholm. English speaking, immaculate hospital. Great service done within 2 weeks of referral.

One reason you don't get GPS and Consultants wanting to work in rural areas is the lack of employment options for their spouse. The companies and larger businesses have closed down or become centralised. Also there won't be 'desirable' schools as no middle class areas to feed them. That sounds snobby but if I was a high flying surgeon I'd prob want more than the comp wot I went to for my DCs.
I don't see how that an be fixed.
Also sqeezing the most out of employees means nurses do 12 hour shifts when they used to do 7-1, 1-8pm etc - much more suited to parents.

If we are going to rethink the NHS then one of the things we need to seriously consider is what we expect the NHS (particularly A&E) to cover. At the moment like the police it is a service of last resort.

A lot of problems which should really be under the remit of social services but arent being dealt with there end up at crisis point being dealt with by NHS or police.

We cant sort the NHS in isolation. Improving mental health and social care services would lift a lot of pressure off acute services.

"Minor ailments would be treated at home with OTC products. Only going to GP if there was no improvement in a few days."

That's how it works here. What's the difference?
In some other European countries, you might go to the doctor, but you'd be considered a terrible time waster if you went to the doctor with a minor problem here.
I think it's often counterproductive. People delay going to the doctor and then the problem is worse and there's no prevention. A colleague of mine burnt her legs in the sun. Of course she didn't want to bother the doctor, but when it got worse other colleagues took her to A&E. She had sepsis and could have died if she hadn't been seen at all.

"One reason you don't get GPS and Consultants wanting to work in rural areas is the lack of employment options for their spouse."

We should pay them more to go to those areas if that's the only way.

We do Gwen. Remote Scottish GP vacancies often offer more in salary to compensate for certain lifestyle/job factors.

Scandinavia. Clean efficient hospitals. You pay a bit but children under 16 free. I have never understood the love for NHS other than that it is free. I dread to think I would ever be seriously ill in Britain and went home to give birth to my children after experiencing a British hospital where the care, management of my labour and maternity ward was.... I still cannot speak about itsad The NHS should start charging and people should stop over using it.

This. I am half Swedish and the care in Scandinavia is so much better than here. I have no intrinsic love for the NHS and think it's madness that we don't pay anything for it. And that we are so opposed to private companies getting involved.

Unless as a country we tackle obesity we are pissing against the wind with the current system. I read that 40% of NHS workload is health risk factors that are modifiable behaviours (eating, drinking, drugs, lack of exercise etc). Is Western Europe doing better than us or are we their future as they to become more unhealthy.

Bruffian do you pay for healthcare in Sweden through taxes? Or are there upfront costs when you need to use it?

We pay a lot of tax! And there are more private companies involved. You do pay but it is capped per year

"think it's madness that we don't pay anything for it."

We do pay for it! Through our taxes in a fair way rather than penalising those who are ill. Whether we pay enough is a different matter...

"Is Western Europe doing better than us or are we their future as they to become more unhealthy."

We have more obesity than almost all other Western European countries - Malta might be the exception.
Whether they will all end up like us, I don't know.

"And there are more private companies involved. "

Only in England, I think, not in the whole of the UK and it's a terrible thing.

Or did you mean that there are private companies involved in Sweden?

Gwen it probably depends where you are. I know a lot of people who still take their DCs to the doctor when all they have is a cold.

There are probably lots of reasons for this:

• lack of local family to reassure them that it is only a cold
• access to free prescription for OTC medication
• making the illness 'official' for time off school for the DC or work for the parents

Nope both times far worse. Usa...will let you die if you cant pay. Beligum...pay an awful lot and mother in law still in severe pain with massive infection caused by their treatment. Sorted out by good out nhs on our return from holiday.

Good old nhs

Employers and schools shouldn't ask for doctor's certificates for absence in this country considering how the NHS works.
In any case, it wouldn't work at my GP's as you wouldn't get an appointment for weeks or months.
For every person in the UK who wastes a doctor's time, there's probably a person who should be going to the doctor but won't because of how bad we're made to feel just for wanting to use the system we pay for.

And then when people do go, the GP has to work as a gatekeeper, minimising their problems and telling them to go away until they can no longer avoid referring them to a specialist - this costs lives if the problem does turn out to be serious.

"Beligum...pay an awful lot and mother in law still in severe pain with massive infection caused by their treatment. "

I'm sorry to hear that, but the Belgian system is very good in general. I believe hospital infections are a problem as they are here, but not as big an issue in the media.

Gwenhwyfar

I realise it is different but lots of people are saying, "here in X..." as if it is like that for every GP in their country.

My GP's surgery has a mix of appointments and open surgeries, for an open surgery you have to turn up before 10.30 and you will be seen by a Dr that morning. I had to visit last week and people were complaining about the wait.

Swedish healthcare is organised by the county councils and most of the county council tax you pay goes towards healthcare. You also have to co-pay at a subsidized rate to access services.

When you go to the doctor you have to cite your personal registration number to show that you have the right to care. If you don't have one or are on holiday they will take a credit card or billing details. They will always treat emergencies but you will not get non-emergency care. For example they will set a broken leg but you are expected to fund your own physio or go home

However - and this is where it gets tricky - because it is a county service and not a national service the amounts that you pay to access services differs as each county decides its own fees and charges

• GP - usually £10-15 per visit
• A&E - £30-40 per visit - they weight it so that people take minor issues to a regular GP and not A&E although there is usually an out of hours GP in A&E
• District nurse/physio/nutritionist etc - £8-12
• Overnight stay in hospital £8-12
• maternity and HV - free
• medical aids such as wheelchairs, toilet seats etc £8-12

Medical treatment costs are capped at MAX £100 per year (1100 SEK) so once you reach this they issue you with a free card for the rest of the year.

Medicines - you pay the actual price with a rolling series of discounts but it is capped at MAX £200 per year - after this you get a free card

Children - in most of Sweden children and teenager up to the age of 20 are treated free but Stockholm and Gotland have chosen to charge 50% of the adult fee for children

Since the 1990s there has been more of a public/private partnership. Some private providers are accredited by the county and you pay the same rate as for public providers. However you get more choice in the big cities.

The system is not prefect. Rural areas have issues of reducing and aging populations. This has resulted in reduced tax income and pressure to close small hospitals and rural GP services.

Interesting to read about other countries. I do think something needs to be done about the NHS and the way it operates.

A small example. A few weeks ago I received a letter through the post inviting me for bowel scope screening. This is a new test that is being offered to people aged 55 and over. I didn't want it, but while the letter invited me to confirm the appointment, it didn't offer a way of turning it down - no form to fill in, no number to call. So I ignored it.

A few weeks later I received another letter saying that I hadn't written or called to confirm the appointment and they wanted to check whether I wanted it. If not, they would cancel. Again, there was a number to call to confirm, but not one to turn it down. So I ignored it again.

This week I received another letter through the post saying because they hadn't heard from me they'd cancelled the appointment. If I still wanted an appointment, this was how I could rearrange.

This is insane, surely? Three letters sent through the post - and that's presumably duplicated across the country to thousands and thousands of people. What an absolute waste of admin time, paper and postage.

Please realise that this is not the case for lots of people in the UK.

But it is also not the case for those in other European countries being talked about in this thread, regarding seeing their GP same day either. In fact, in two posts near the start back to back, someone was saying how easy it is to see a GP in France vs. another one who was saying it was nigh on impossible...and they pay!

This thread is very interesting but one thing has stood out for me is that in every country, people will have different experiences of their healthcare system. That's why any anecdote, good or bad, doesn't really paint a full picture.

Most other European countries pay. At point of use somewhere down the line. That's what the UK should do. A capped amount like Sweden

Hackmum I don't know why it is done that way but bowel screening has very low take-up but good evidence of it being effective in reducing morbidity and mortality so it may be that way of reminding people has been weighed up as achieving higher response than just one letter and more than balanced out by the money it would save in treating bowel cancers later.
I suspect there will be some evidence behind it even if you and I don't know about it