1. Charlotte Patterson

2. Why compare two healthcare services?
Funding of Healthcare
Accessibility of Healthcare
Outcomes of Healthcare
• Cancer and Heart Disease
• Coordination of Care
• Infection
What I’ve Learnt from this SSC
Conclusions

3. As a tourist...
As a Medical Student or Doctor...
Better informed.
Learn what works, and what doesn’t, and
how we can improve.

4.  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
was $2784.
 Total government expenditure: 79.9% in France,
87.4% in the UK.

5. Expenditure on Health in
France
Public
Money
Private
money
Expenditure on Health in
UK

7. 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
UK.
Same-day GP access always available.

8. In France 34 physicians per 10,000, UK
only 23 per 10,000.
Medical students- same number of
admissions as doctors retiring.

9.  Cancer incidence per 100,000 population was
75.3, compared to just 51.2 in England in
2000
 The 5 year survival rate for cancer in France
1995-2000 was 79.1%, compared to the
English 69.8%
 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

10. Heart attack mortality 30 days after
admission 6.3% in UK and 2% in France.
Better care, or red wine good for the
heart?

11.  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.

12. Very little hand-washing & Elusive alcohol
gel dispensers.
Snacking on croissants in the bureau
medecin
Corridoors smell of croissant, not of
disinfectant.
White coats (infrequently washed) worn by
all Medical staff & Students.
Despite this, MRSA rates are 44% in UK,
just 29% in France.

13. How does France compare to England when dealing
with common ailments such as a cold, backache or
old age?
“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.”

14.  Differences aren’t always immediately
obvious
 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
tea?

15.  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
from: http://apps.who.int/whosis/data/Search.jsp
 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.

16. ... Any Questions?