Faithful readers will know of my journey through the French health care system. I have not shared these histories because anyone should be particularly interested in my aches and pains, or to complain. If I wanted to moan about a health system on the verge of a nervous breakdown I would return to Britain. No, I drone on because it’s worth repeating the astonishing discovery that it is actually possible to have a health system that isn’t crap. And I have made some other discoveries along the way.
In previous episodes, I have covered the remarkable behaviour of French GPs, who actually answer the phone – and will see you the same day if necessary or tomorrow if less immediately urgent. I have told of the remarkable private emergency room in Pézenas where I took my wife after she broke a bone in her foot. She was seen by a triage nurse in six minutes, was in radiology in 20, and discharged in one hour. Although private, it’s covered by the Sécu social security system and is the same price as a public hospital. The bill was €19. Lab work? Just show up at the medical laboratory in every French town. Results come the same day over an app.
Then there was my adventure at Béziers Hospital, which made me wait two entire days for a temporal biopsy in search of terrifying giant cells that can make you blind. They didn’t find any. Clean hospital? Check. Amazing space-age operating theatre? Check. Kind nurses? Check. Free parking? Check.
Not everything is perfect in the French system. An ageing population and new treatments have stressed the Sécu budget to breaking point. The deficit is expected to reach €25 billion this year. Not that this is ever visible to most patients. Health spending per capita in France is nevertheless similar to that in Britain, albeit delivering more bang for the buck.
I have been amused to watch the new British government promise a digital health service, revolutionising administration and cutting waiting lists. We’ve had that for years. Everything involving health care in France is done with the Carte Vitale card, which you use to show entitlement to treatment. You present this at every health care intervention in France, even at the pharmacy. The Sécu picks up the bill, with a small co-payment from the patient. A visit to the GP costs €8. My operation in Béziers was €59. I pay more to take my dog to the vet.
So now we come to my latest adventure. I’ve had a bit of a rash on my chest and calves, and my GP had a peep at the spots but wasn’t sure what she was looking at. ‘Bizarre,’ she pronounced – not a word you want to hear from a medic. So she made an appointment for me with a dermatologist in nearby Clermont-Hérault. The notification of the appointment came through on the Doctolib app on my phone, with a link to a map showing me how to get there. The clinic was very busy, so I had to wait a whole week.
I presented myself at the dermatology clinic, showed my Carte Vitale, waited an almost outrageous ten minutes, then the doctor, Marie, put her head around the door and it was show time.
Others in my ageing boomer cohort will recognise the phenomenon that as we, er, mature, everyone around us doing serious jobs looks younger. Police superintendents, the prime minister – you get the picture. And so it is in medicine. My consultant was young enough to be my daughter, in her mid-30s at most.
‘Bizarre,’ she pronounced – not a word you want to hear from a medic
In her office, I explained my not enormously interesting medical history and the story of my rash. She asked questions and took notes. ‘Right,’ she said, pointing to a screened changing area. ‘Go there and take your clothes off.’ Meaning all of them. I had half expected this, but there was a slight twist. In Britain, I recall, they normally give you one of those paper gowns to preserve a modicum of patient modesty while the medic examines the body parts in question.
So I went behind the screen, stripped to my skin and looked for the robe. There wasn’t one. It’s apparently a cost they forgo at the dermatology clinic, along with diversity officers. So I stood there naked when the doctor appeared, looked me up and down with clinical detachment and invited me to lie down on the examination table. She then proceeded to examine every square centimetre of my body. And I mean every one. I lay starkers on the table, not a handkerchief to preserve whatever dignity I have remaining, affecting a studied nonchalance – what the French call mine de rien – and stared at the ceiling.
After several minutes of examining me from basement to attic, she seemed slightly disappointed that she had found nothing especially interesting. ‘It doesn’t look as bad as the photos your GP sent me.’ She sent me away with a prescription for various lotions and potions and told me to come back in a month. The bill was €16.
She was kind and gentle but not especially chatty. I wanted to ask her what it was like, having a job with a parade of naked people before her all day, but thought the question might be interpreted as pervy, so I bit my tongue. Other than my normal plaudits for the French health system, I am not sure what lessons might be drawn from this experience, except that in France, you don’t need to wear clean underwear to the doctor’s – because you won’t be wearing any.
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