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?

Ivor: "I suspect there will be some evidence behind it even if you and I don't know about it."

I doubt it, to be honest. I mean, I appreciate there is evidence for the benefits of bowel cancer screening but I doubt there is evidence for the three-letter approach. I think it's just an example of NHS ineptitude - and it may even just be our trust doing it that way.

Another not dissimilar example. A family member has had to have a few hospital appointments over the past couple of years. Typically she'll receive a letter in the post giving her the date of the appointment. Two weeks later, she'll receive two letters in the same post, one cancelling the appointment, and another giving her a new date. That's insane, isn't it?

Currently live in Belgium. Health care v efficient, even if they tend to over medicate.

Disagree about too many staff. There is an efficient booking in and billing process, much more organised than the scrum at the local NHS hospital I've used in the past. They are also proactive with diabetes eye care, foot care etc.

Another one here to love the system in Switzerland. Yes it's expensive, mine is currently chf 400 per month but I have a low excess as I knew we would be having fertility treatment here. The treatment has been excellent, all extra tests available same day, choice of treatments etc. The only down sides have been that they wouldn't start any fertility treatment until DPs divorce was finalised (they had been separated 5 years by the time we needed it), no IVF is included at all (but three lots of IUI covered in full) and now we need genetic testing the doctor has to request special permission from the insurance company because I am over 35, if they don't agree to it, we pay at chf 1500 per person. Having said that, the taxes are very very low, so in total I'm still better off financially than in the UK. When I had to be in overnight for medical management of a miscarriage I was admitted quickly and in surgery within an hour and recovered in a two-person ward, which is apparently standard in the hospital I was in.

The german system is excellent

I'm currently in Sweden. It's not free at point of care for most things; you pay roughly 15-30 quid per visit. Anything maternity related is free and kids go free. Dental is crazy expensive. You're charged per night in hospital and pay a fee for drugs.
Once youve reached a set limit you get a 'free card' for the rest of the year. I had my own room when I gave birth- nothing flash or fancy but privacy and joined up care. I can't imagine having to be stuck on a ward for postnatal :(

Oh and we pay absolutely shitloads of tax. But to be honest it's well spent.

I really think a token fee at the point of use is a good thing. Also here you need to be in the system to access care. No ID number, no dice, with a few emergency exceptions. I e noticed that the care here seems more efficient - everything is linked to that ID number and things just seem to connect better. It's not perfect - there are several week waits to see a GP in my area but it's better than the UK in the main.

Currently live in Belgium. Health care v efficient, even if they tend to over medicate.

Belgium annoyed me as I was paying quite a lot for health insurance but GP 's were over capacity, poor quality and not helpful at all. Hospitals tended to be older with older equipment too.

See. Not one country has the perfect system for everyone. Two separate posts from different people experiencing the healthcare system in Belgium....

My parents moved to Spain and, though hospital and GP care was great, we found there was NO elderly social care or long term nursing care whatsoever. The family is expected to provide all long term care.

The result was that when my DF developed Parkinson's and dementia all care was left to my elderly DM who has severe arthritis. Not even help with getting him in and out of bed unless she paid privately. Only private care homes available with all fees paid by patient.

Things got very bad and my poor DM couldn't cope, almost had a breakdown. We were forced to fly my DF back to the UK and get him into the adult services system in my home LA where he was admitted to a nursing home. Thank god for the NHS, if left to the Spanish system both my parents would be dead now.

I had a (very) long awaited Neurology appointment last week. A week before, I had a helpful text reminder, plus how to cancel/re-arrange, with a note at the end that a missed appointment would cost the NHS £160.

So if I had missed it for no good reason, in my opinion I should have been billed for that amount otherwise I am abusing the system. Are there systems in place to do this? If not, why not?

I am assured that would happen in days in France, Germany, Spain.

Because we have allowed it to become a world health service and not a national health service

So true isadoradancing123 so true

"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! "

Yes, but even if someone has problems seeing one GP in France, you have to bear in mind that they might be able to go to any GP they like whereas here you're restricted to a certain catchment area so if your surgery is busy you're in trouble.

"Belgium annoyed me as I was paying quite a lot for health insurance but GP 's were over capacity, poor quality and not helpful at all. Hospitals tended to be older with older equipment too.

See. Not one country has the perfect system for everyone. Two separate posts from different people experiencing the healthcare system in Belgium...."

I'd like to know more about GPs being supposedly 'over capacity' in Belgium because this is the first I've heard of it and I used to live in Brussels. There's no shortage of doctors in Belgium as far as I understand. There can be waits for specialists, but I've never heard of a problem with GPs and, in fact, if you heard someone complain it would be something like having to wait until the next day.

"Also here you need to be in the system to access care. No ID number, no dice, with a few emergency exceptions."

Same in the UK, you need your NHS number.

"Are there systems in place to do this? If not, why not? "

It would cost more to administer than it would probably raise.

I moved from London to rural Sweden nearly three years ago. I always felt I was treated well by my London GP and I had.twins in a London hospital. It's a shame a lot of people are quite negative about it.

The local Swedish system seems very efficient. In two and a half years I have been called for two mammograms, one smear and had a hospital visit for cell abnormalities. I do have a personal number and pay 15.00 pounds each for the above. GP visits are around 30.00. My 8 year old had very itchy skin and the DR wrote her a prescription. 30 quid for a cream we had showed him (and didn't need a replacement) plus a packet of clarityn. Not too impressed by that one.

There are no free prescriptions for the elderly here either. There is a cap of about 300 quid. But my 79 MIL own house, pensions, savings etc., has to pay which I don't think is unreasonable but my mother in the UK thinks is despicable. There are exceptions but I think the bar is a lot lower over here.

Before I left London I had a job booking people's appointments to see a consultant. The patient's had been referred by their GPs. It was a highly sought after appointment and some had to wait up to six weeks for clinics. I was stunned at the amount of 'no shows' and this was after we had called made.the appointment in person. Then called, or left a message or as a last resort send a reminder the week before. Charging for missed appointments should be Introduced.

"there was a number to call to confirm, but not one to turn it down. So I ignored it again."

Why didn't you try the one to confirm rather than the one to turn it down?
Also, why don't you want free, medical screening when it's offered to you? You don't have to take it, of course, but I don't see why you'd refuse it.

Ireland- there is a two tier system public and private. Everyone is entitled to treatment under the public system which is funded through taxation but some may have to pay a flat fee for certain services depending on income, age and illness or disability. A non referred visit to A&E costs about €100 and GP visits cost about €50 and prescriptions must be paid for. There are caps on the maximum amount people can be charged for hospital stays but many people have health insurance.
Those on low incomes or with certain conditions may qualify for a medical card which entitles you to free GP visits and hospital treatment and other services.

I would be in favour of some sort of charging system for GP visits or hospital referrals particularly for repeated no shows. It's so infuriating to think that there are so many time wasters when others struggle to get an appointment.

I also think there is serious time wasting and inefficiencies within the NHS. The communication between GPs, hospitals, consultants and patients is slow and ineffective. Often something that could be resolved quickly with a call or email takes weeks and escalates into something more serious as a result.

Same in the UK, you need your NHS number.

No you don't. You will be treated even if you don't have one for a lot of issues hence the huge health tourism bill (which is the NHS' fault for not chasing up yes but not really the same as you are claiming outright), rather than, we won't touch you if you don't have an NHS number.

And just because you don't have experience of something Gwenhyfar, doesn't mean it doesn't happen. I was quoting other posters from Belgium but I can honestly say, here in the U.K., in London, I can see a GP same day. I know of friends who use GP surgeries less than a mile away who can't. Therefore I can't say 'everyone can see a GP same day in the UK' but neither is it true for other posters to say you never can.

The Swedish cap on drug spending is 2200 SEK (currently £195).

My Swedish health authority (in a ski area) now makes you buy your own crutches as nobody ever returns them so you pay £10 - but they are yours forever.

When I first moved here I noticed how much time I got for a GP appointment. The UK Surrey GP that I had come from had 5 minute appointments (and constantly ran late) whereas the Swedish GP usually had 3-4 patients per hour. Some things are dealt with instantly - for example a pin-prick blood test to see if you need antibiotics done there and then.

Although you have to pay approx £10 per day to be in hospital in Sweden they provide most of the things you need such as towels and nice hospital gowns (soft jersey material that button down the front). They also provided strange clothes if you wanted - track suits and flip-flops many used them to save on the washing but I always preferred by own. Also wards have a patient kitchen area and fridge so you can always get a drink or make a sandwich day or night. Maternity also provided all the things for the baby such as nappies, maternity pads and even baby clothes (as long as you didn't mind babywear stamped property of the health authority)

nappies, maternity pads and even baby clothes (as long as you didn't mind babywear stamped property of the health authority)
Ok, not nappies but I was given maternity pads to start off with, initial babygro, hat and large towel (blanket) in my NHS hospital less than two years ago. I'd love for those Scandinavian boxes to be offered and hope the trial in Scotland goes well!

The Swedish personal number is you registration with the tax authorities - everyone has to have one. The "full" personal number gives full access to public services.You use it for everything - healthcare, work, education, housing, student finance, uni exams etc. There is also a second type called a coordination number which is given to short term or temporary residents so for example you can register with a doctor but does not give the right to subsidised healthcare or free uni etc

Gwenhwyfar: ""there was a number to call to confirm, but not one to turn it down. So I ignored it again."

Why didn't you try the one to confirm rather than the one to turn it down?
Also, why don't you want free, medical screening when it's offered to you? You don't have to take it, of course, but I don't see why you'd refuse it."

Well, call me literal-minded, but it was the one to confirm. I didn't want to annoy them by calling the number when there was no need. I couldn't have anticipated at that point that they would keep sending me letters.

Why don't I want medical screening? Well, that's my business, really, but in short: it's a slightly unpleasant and invasive test and I'm pretty sure I have nothing wrong with my bowels. It seems like a waste of NHS resources - and my time - to undergo an unnecessary test.

I do attend my cervical screening appointments and mammogram appointments if that makes you feel better.

Kitty I can see a GP the same day, or the next in Belgium, (we are just outside Brussels) if I use anyone at the practice, but it might be a week to see my preferred GP.

That is not possible at the practice I used in Cornwall.

The Belgian hospitals I attend are both teaching hospitals, so up to date with scanners etc.

I had to have cardio tests earlier in the year. The GP gave me the number of the clinic ( founded by a group of GPs), I rang, got an appointment, and was seen within 4 days.

Gywn ;

"
I'd like to know more about GPs being supposedly 'over capacity' in Belgium because this is the first I've heard of it and I used to live in Brussels. There's no shortage of doctors in Belgium as far as I understand. There can be waits for specialists, but I've never heard of a problem with GPs and, in fact, if you heard someone complain it would be something like having to wait until the next day."

This was between 2010-2014 and in flanders. I worked in Brussels and ended up switching to a GP there as I had better luck with appointments and being seen. The GP in my town and surrounding area was a right kerfuffle to get into and on the off chance that I managed an appointment, I'd be joining the back of a very long queue and the "open spreekuur".

Again, regions and areas are all different. I'm sure that's the same for every country but that was my experience.

I'm in Flanders Emmy (3080 postcode) and have no problems at all.

Are there systems in place to do this? If not, why not?

It would cost more to administer than it would probably raise

I hate this sort of argument against charging- as with anything with no penalties, more people will do it, think of any road with speed cameras, there must be a reason people come from overseas to the UK for medical care when better is available in Sweden, the USA and Sweden!!!!!