This works out as a 22% deficit in funding in the UK.
Does it show?
The French ordered MRIs, EEGs, extensive courses of physiotherapy... Handed out wide assortment of drugs. Private side rooms, max two people, and latest equipment (things never seen in UK...) Is it because French? Or beacuse better?
Does this relative decadence make a difference? Euro index of countries 2009 showed England as 14th and France as 7th.
79.9% in France 87.4% in UK
Assess healthcare based on: patient rights and access to information, use of eTechnology, waiting lists for treatment, health outcomes, range of services provided and pharmaceuticals.
Must be doing something right...
Evident as soon as in France- signs lining streets for private specialist clinics. Different atmosphere in urgences. Most patients seen within about 15 minutes. Pehaps cos medical students see patients? Our experience- seeing GP the same day.
Cancer and Heart disease two of biggest killers in France and in UK. Suggests that although the French have higher incidence of cancer, they are better at dealing with it.
Particularly disadvantageous for elderly who need efficient care plans. Much more than 40% diabetics in the UK have a regular eye examination.
In my experience, only one social worker seen regularly on the wards (neuro)- v involved, attending staff meetings and ward rounds.
Likely to be because majority of patients in side rooms, not due to croissant eating. Also, observed French hospitals v v clean.
From Stephen Clarkes novel “Talk to the Frog: The ten comandments of living in France”
Didn’t realise there were so many differences before doing the research. Don’t always realise when in hospital environment, eg. Carte vitale etc.
May seem to be less hygenic but doing better than UK in MRSA battle.
Article in the telegraph- looked up data, was all out of date eg. France best in world, England v low down. (3rd from the bottom)
Compare and Contrast Healthcare delivery in France and the UK
Why compare two healthcare services?
Funding of Healthcare
Accessibility of Healthcare
Outcomes of Healthcare
• Cancer and Heart Disease
• Coordination of Care
What I’ve Learnt from this SSC
As a tourist...
As a Medical Student or Doctor...
Learn what works, and what doesn’t, and
how we can improve.
French healthcare is funded by a mixture of public
and private money.
Pay up-front, then Health insurance reimburses at
least 70% of all health costs.
Those of low income are entitled to Couverture
Maladie Universelle (C.M.U)- 100% of costs are
covered, no up-front charges.
In 2006, France spent $3554 per capita on health,
in contrast to the UK where per capita expenditure
Total government expenditure: 79.9% in France,
87.4% in the UK.
Expenditure on Health in
Expenditure on Health in
Inarguably better in France
French have the right to choose their
doctor, and go directly to a specialist
(although may not be reimbursed)
Waiting lists virtually non-existent.
90% major/non-acute operations carried
out in France within 90 days, just 65% in
Same-day GP access always available.
In France 34 physicians per 10,000, UK
only 23 per 10,000.
Medical students- same number of
admissions as doctors retiring.
Cancer incidence per 100,000 population was
75.3, compared to just 51.2 in England in
The 5 year survival rate for cancer in France
1995-2000 was 79.1%, compared to the
Lack of treatment availability?
Lack of screening?
• 75% vs 70% PAP
• 78% vs 75% Mammography
• 15 per 100,000 vs 8 per 100,000 PSA
Heart attack mortality 30 days after
admission 6.3% in UK and 2% in France.
Better care, or red wine good for the
Lack of coordination in France, as healthcare
provided by isolated individuals.
Leads to over-prescription, waste, and
inadequate care plans.
A study by one of the leading health
insurance companies in France: Just 40% of
diabetics have a regular eye examination.
Recent plans to combat lack of social care:
employ social workers on the wards.
Very little hand-washing & Elusive alcohol
Snacking on croissants in the bureau
Corridoors smell of croissant, not of
White coats (infrequently washed) worn by
all Medical staff & Students.
Despite this, MRSA rates are 44% in UK,
just 29% in France.
How does France compare to England when dealing
with common ailments such as a cold, backache or
“OLD AGE: France: Visit several doctors (all of them refundable), have a
nice chat, get prescriptions for hormone replacement pills, the latest anti-
rheumatism and anti-arthritis drugs, sleeping tablets, food supplements and
two weeks at a spa (all of them refundable). Go to the electricity, gas and
water companies to confirm with them that it is illegal to switch off your
supply even if you never pay the bill. Inform your landolord that it is illegal
to evict you or increase your rent, even if your lease is up and the
market value of the property means that it would not be
Excessive to double your rent.
England: Put on all your woollies, and have a nice cup of tea.
Or move to France.”
Differences aren’t always immediately
Appearances can be deceiving!
Papers don’t always tell the truth about
hospitals..even the Telegraph!
The French healthcare system is very, very
good & lucky to have been a student there.
Perhaps in the future English hospitals will
smell of Fresh Croissants, and in French
outpatient clinics they’ll be drinking cups of
Sandier, S. et al (2004) Healthcare systems in Transition: France. WHO publications,
ISSN 1020-9077 Vol. 6 No. 2.
L’assurance Maladie (2010) Le parcours de soins coordonnés. [online] Accessed 12th
April 2010. Available from: http://www.ameli.fr/index.php
Clarke, S. (2006) Talk to the Snail: Ten Commandments for Understanding the
French. 2nd edition. Black Swan publications, 2007. Pg 82.
WHO (2006) Detailed Database Search. [online] Accessed 12th April 2010. Available
Health Consumer Powerhouse (2009) Euro Health Consumer Index, 2009 Report.
[online] Accessed 12th April 2010. Available from: http://www.healthpowerhouse.com/
Autier, P. et al (2007) Cancer Survival Rates should be viewed with Caution. The
Lancet Oncology, 8, 12. Pg 1050-1052.
Woods, J. (2010) We are the Losers in a tale of Two Hospitals. Daily Telegraph,
Monday 29th March 2010. Pg 24-45.
BBC News (2007) End for Traditional Doctor’s Coat. [online] Accessed 12th April 2010.
Available from http://news.bbc.co.uk/2/hi/health/6998195.stm.
Treakle, A.L et al. (2009) Bacterial Contamination of Health Workers’ White Coats.
American Journal of Infection Control. 37, 2. Pg 101-105.
Pearson, A. (2009) Historical and changing epidemiology of Healthcare associated
Infections. Journal of Hospital Infection. 73, 4. Pg 296-304.