Experience of the French health system
I have underlying health problems and have been dependent upon the system of healthcare in France since my wife and I arrived in 2002. Some aspects of health care in France are better than the NHS, but my biggest gripe is that we have to pay part of the overall costs.
Payment for healthcare In France
Every procedure and medication carries what is known as a ‘tariff’. This equates to around two-thirds of the costs of the treatments which are met via the CPAM – Caisse Primaire d’Assurance Maladie – for which we have what is known as a ‘Carte Vitale’. That is the part which the French Government claims from the UK to meet my costs.
The remaining third is covered by taking out a mutual insurance policy – a ‘Mutuelle’ – for which we pay €4,604.40 per annum (£3,935.38). That’s my ‘gripe’ but I have to respect that that is the French system, as it applies to everyone needing medical care throughout France. There are cheaper Mutuelles, but they do not always provide the same degree of cover.
There is however an interesting twist – I have recently been diagnosed with diabetes and the CPAM have classified me as ‘ALD’ – Affection de Longue Durée is a major or long-term illness for which the State accepts responsibility for 100% of your health costs. But there is no reduction from the Mutuelle!
The good bits
Now for the best bits. I have no doubt the privatised parts of the French health service work well, without any risks of intervention from US financial interests. My best example is blood tests. I need about 20 blood tests a year. When we lived in Beckenham I used to go to our local “cottage” hospital. A wait of 2-3 hours for the test was not unusual, and at least a further week before the result arrived. Here I go to a privately operated Laboratoire; I’m in and out in no more than 10 minutes; and a couple of hours later I have the results online.
The monthly test I have for my blood clotting problem can, if it is out of balance, require adjustments to the dosage of my anticoagulant and a wait of several days could be critical. There was an example when I needed to use the Emergency Department of our local hospital, and the consultant decided he needed some blood tests. I had to wait for the results to come. I was surprised to discover those tests were carried out by the same privatised Laboratoire where I normally go.
Healthcare for women in France
Every two years my wife is called for a mammogram. She was unhappy with the idea of a strange male technician squeezing her breasts into the scanner. We found a private clinic which specialises in all-female attention. So she has a female doctor and a female technician and is very happy with the treatment.
When you leave they give you the scans and the first diagnosis, and then two weeks later the second diagnosis comes through the post. Both my blood tests and my wife’s mammograms are handled in exactly the same way as all other treatments of the CPAM and the Mutuelle.
Clinic or hospital
Groups of specialists use medical centres for different treatments. I have had both ECGs and Doppler scans by different specialists working in their own surgery from within the same medical centre. This is particularly helpful for getting quick appointments. The same treatments can also be booked in all hospitals, both state and private, and the only difference is that in the private hospitals you sometimes have to make a payment up front at the time of the visit, which you then claim back from the CPAM – some specialists accept the Carte Vitale, some do not.
Since arriving in France I have had two surgical procedures. The first in a private hospital, the Clinique Chenieux, where I had keyhole surgery on a ruptured shoulder tendon. The second was a throat biopsy in the CHU in Limoges.
The quality of treatment was identical apart from the fact that I had to make a small cash payment (€40 for example) for such items as a triage with the Chenieux anaesthetist before surgery.
Praise for treatment in the NHS
There are 32 University Hospitals (CHU) in France, evenly spread across the country in all Regions. This compares to 22 in the UK, six of which are located in London. Both my wife and I experienced life-threatening illnesses before we considered moving to France which received top class treatment from the NHS.
Over a three-year period I suffered two DVTs and cellulitis, all of which needed emergency admission and treatments. My wife had cancer of the cervix which resulted in a complete hysterectomy. We have nothing but praise for the attention we received. In that regard I can genuinely say that both systems have much to be admired.
Always carry your GHIC
Anyone from the UK visiting France on holiday should always carry their EHIC or GHIC card in case there is ever any need to seek urgent medical attention. I have only used my EHIC once, when on a visit to Spain I needed urgent attention to an ulcer on my ankle, and the level of attention and treatment I received was excellent.
Healthcare for would-be residents in France
Those who might consider seeking to become resident in France in future should be ready to sign up to the French health service as an urgent priority if they have any expectation of requiring regular treatment and/or medication. They should sign up to their nearest doctor, then register with the CPAM, but be prepared to wait, since the wheels of French bureaucracy tend to move slowly.
In the future, following Brexit, it will be more difficult to ‘get into the system’ than it was before, simply because future migrants will start as third country nationals but, once in the system, there will be a smooth process from then on.