March, 2013 – Graham Miln

An Unwilling Encore

The week has been a swirl of emotion and activity. Once again I have found myself venturing into the French medical establishment. This time for something a touch more serious than a simple fall.

Those that know me personally will appreciate my attitude as I deal with what needs doing – a quiet focused determination that leaves little time for much else.

I will be fine; that is not my focus here.

A worn corridor in the Tonkin Clinic, Lyon
A worn corridor in the Tonkin Clinic, Lyon

Section R, Hopital Croix Rousse, Lyon
Section R, Hopital Croix Rousse, Lyon

There is something about visiting various medical buildings that lingers. They feel a touch unreal. Doors along corridors that open automatically – highlighting the expected direction of traffic. Staff in white wearing sensible shoes moving quietly around confused members of the public. The smokers standing just outside of the building catching a moment of peace and nicotine while they wait for the next burst of activity.

The French medical system has a positive reputation in the United Kingdom. We hear stories of better service, better facilities, and less cost cutting. Specifics are rarely mentioned, just France is somehow better.

The British forget that in France going to a doctor is likely to involve a payment. They forget that in France individuals are recommended to have top-up insurance; the state does not cover the full cost of treatment. They forget that the system expects more from you.

In the United Kingdom, healthcare is mostly out of your hands. You go to the doctor and the National Health Service (NHS), puts you on a treadmill of care. Appointments are made for you, you go where and when you are told. You learn to expect delays and waiting periods but never a fee, never a personal cost when you need treatment. All those costs have been dealt with through every salary cheque and every pay packet.

In France, we are discovering the expectation on the patient is greater. I am learning to appreciate why and the control it puts in my hands. I am not sure I need the control but it is a point of difference.

Here you are responsible for your medical file. You get copies of all your tests, you see the bulk of the paperwork carrying your name. With every appointment, test, scan, or interaction your file grows. The mountain of paperwork can feel overwhelming but a pattern establishes itself and life goes on.

Much of the French medical system is changing. Swipe cards for medical services have appeared. Doctors are being jostled into a more active role for administering patients’ files. As with the NHS, the French system seems to be in near constant change and reform.

As an outsider venturing for the first time in the serious units of my local massive modern hospital, I am both scared and in awe of the treatment.

It took thirteen months to get my carte vitale. I did not expect it to be so essential so soon.