Posted by / Category Cultural Differences, London, Stereotypes /

This post is written in collaboration with Qare, a French telemedicine service in London, and is the start of a new series on the differences between the French healthcare and the NHS.

If, like me, you’re used to the French health system, moving to London will be a steep learning curve. First of all, it can be hard to find a French-speaking doctor. This is where Qare also can help: they set up virtual consultations with doctors -in French, and can refer you to a French doctor in London if need be. I wish I had known about this service when we moved. When you are on your own with a sick kid, things can become very stressful and it’s easy to panic (been there, done it). In France, your physician always listens to you. You’re always given a prescription, a routine examination, and taken seriously. Your symptoms will never be minimised, and if your doctor has the slightest doubt, you’ll be referred for a scan, an X-ray or a blood test. Needless to say, things are slightly different this side of the Channel. The weird thing is that, come to think of it, the health budget is similar in France and in the UK (OK, a bit higher in France, but not massively higher), and life expectancy is, again, very close. So why does it feel so different? I have no idea. But this much I know: for me, it was a whole new experience. Here is why. Let me know if I missed anything. And if you are planning to move here, be prepared! Don’t tell me you have not been warned.

Telemedicine is on the rise and can be the response to French expats’ concern. Picture: consultation with Qare

 

 

 

TOP 1

Over here, the first hurdle, after being registered, is to successfully achieve an appointment. What looks easy in theory is a game of patience and resilience. The line is always busy, and the receptionist will do her utmost to encourage you not to get an appointment, because you’re not sick, are you? In France, I have always managed to get an appointment within 48 hours. After many times calling your practice on speed dial and being hung up on a few times, you might be given a slot, usually two or three days after you need it. Don’t believe it’s the last of the hurdles you’ll have to overcome. It’s just the start.

 

TOP 2

Once you get to see your GP (that’s what they call their doctor over here. It stands for General Practitioner), which usually happens after a long wait in the waiting room, you need to convince him or her that you need help. Most of the time, you’ll be told to come back in forty-eight hours to see if you/your kid feel better, and maybe to take some Nurofen in the meantime. Helpful advice (yes, even we French do sarcasm sometimes). He/she will not examine you at all, because he/she will type on the computer during the whole consultation without looking up. Do not listen to your GP. As a French woman, I had to learn to keep on complaining until he/she gives up. In France, you usually end up with a prescription longer than your arm without having to say anything. I told you, things are different over here. You have to fight to be taken seriously. Devise your strategy accordingly.

 

 

TOP 3

We French also have specific ailments, such as heavy legs or a heavy shoulder, that don’t seem to exist on this side of the Channel but are regarded as significant in France. I am not suggesting that we French are a nation of hypochondriacs but we do take our health very seriously. Come to think of it, have you ever heard a British person complain that they are suffering from “heavy legs”? I haven’t. What about you? Let me know.

 

 

TOP 4

Another surprise was to find that, in London, you need to book one appointment for each symptom. This means that, in theory, if both your ears and your throat hurt, you need two appointments. I wonder whether you have to book the whole day to get a full examination?

When I didn’t know I was pregnant and was feeling nauseous, I went to see my GP. He spent half of the ten-minute session telling me off because my back was hurting a bit, and I should therefore have made two appointments instead of one. That’s when I puked on his desk and collapsed. It got his attention. Over here, it’s all about making your point as clearly as possible. I am pleased to report that I did.

 

TOP 5

I have to break it to you: the British don’t do suppositories. So why are suppositories so popular in my home country? This is the one subject that we French are quite relaxed about, whereas the British conversely get very hot under the collar whenever suppositories are mentioned. In fact, we French will quite happily use suppositories for any ailment. I was told countless times by my French pharmacist that they work much quicker than tablets. This is because they go straight into the bloodstream, and I was also explained that they are better for the system, because less chemicals are added to the active ingredients. As a result, French doctors love to prescribe them.

My family doctor used to find them very valuable for babies and older people, because they bypassed the stomach. I am sure he was right. He often prescribed them to adults too. I was told that GPs are happy to prescribe them over here, but often it’s the patients who aren’t keen. The worst thing, apparently, is the patient who complains the tablets the doctor gave them were so big they could hardly swallow them.

 

TOP 6

Don’t be sick outside of working hours. Seriously: don’t you dare. Obviously forget about being sick over the weekend or during the holiday period. Your GP practice will be closed anyway, and your best bet is to spend the day at a hospital emergency department. There is such a thing as a hotline in case of a problem, but it’s hard to actually speak to someone, and, once you do, you will clearly understand that you have caught them in the middle of their cup of tea. The advice I was given in the middle of the night for my daughter who was burning up with fever was to give her an ice lolly.

In France, with some luck, they would have sent a doctor to my place and deliver the medication within two hours. At. My. Door.

 

TOP 7

Over here, I was explained that my ethnicity or sexual orientation dont matter, except for statistical purposes. In France, such things are considered to be private. You NEVER EVER mention them, let alone fill a questionnaire with your name on it for your GP practice, for whatever purpose it might be (apparently it’s for statistics). To make matters even worse, my GP practice makes me fill a questionnaire on my religion/sexual orientation and ethnicity every couple of years or so (you never know, things might have changed, right?). In short, over here, be prepared to replay to questions like:

Please state whether you are:
1.     A heterosexual male
2.     A heterosexual female
3.     A homosexual male
4.     A homosexual female
5.     A bisexual male
6.     A bisexual female
7.     Male to female transgender
8.     Female to male transgender
9.     Other (please specify)

It’s not personal, it’s for statistics. Relax, dear. Yes, even if you are French.

 

TOP 8

In France you usually have to pay for each consultation, and you get reimbursed. That’s simply how the system works. Over here you don’t pay anything if you go through the NHS. A private consultation with a GP will cost €23 in France. In London, it can be anything up to £120, and it usually isn’t reimbursed by health insurances. And don’t get me started on the cost of dentists: it’s two to three times more than in my home country. A rip-off.

 

TOP 9

I first heard about waiting lists for non-urgent operations in London. I didn’t even know it existed. That’s what being brought up in France does for you. Silly French me.

 

TOP 10

Over here, you can buy some medication in a supermarket, while you are grocery shopping. This still amazes me. No need to go to a pharmacy to buy vitamins, aspirin or ibuprofen. Amazing, right? In France, you have a family doctor and a family pharmacist. They know you inside out. What can I say? I miss them. I was pampered by the French system and didn’t even appreciate it.

 

In short, let’s tell it as it is: it looks like the British put up with a lot more than we French do. Which is why, I believe, French expats need to be extra-careful when they move, especially if they suffer from a chronic condition that requires specific care. It’s all about finding what works for you.

  • disqus_72GXGq6drQ

    I hope this is written in French somewhere!
    I would be terrified of being ill in a foreign country where my language skills do not match that of the local medical service. You soon learn how good your French, English, German etc is when ill abroad. I suspect something similar happens even to English speakers in America…

    • Believe me, it’s terrifying. I will always remember when my daughter required medical attention during the night. I felt let down. As in, really let down.

  • James Casserly

    The NHS must work slightly differently in different regions, as nobody here has ever been told to make a separate appointment for each symptom. That has to be the most ridiculous and frivolous waste of time for the practice. Sounds like they are trying to bill the government more.

    • There is a sign in my GP practice that says ‘ one symptom per consultation’. I really don’t understand the reasoning behind it. I totally agree with you, it doesn’t make sense. Some symptoms can be correlated.

  • Wendy

    But don’t you think the amount of drugs given in France is horribly wasteful?

    • You are right, it is wasteful. But the french are used to it, which is a shame!

  • Debbie Thomsett

    You are, of course, entitled to your opinion and maybe you have been unlucky in your dealings with the NHS. Having recently returned to the UK after living in France for ten years, I have to disagree with some of your points. Why would you be disapointed by a lack of prescription? Surely this is good. In my experience, visiting a doctor in France results in a huge prescription, a bag full of unecessary medicines, lots of which is wasted!
    You may have to wait for an appointment here but it’s not one appointment per symptom, it’s one per problem. Earache and sore threat are related problems. Ear ache and a sore toe are not. You need two appointments because the doctor has a limited time per appointment because he/she will have many more patients on his list than a French GP. If patients keep asking about unrelated problems, the appointment will overrun and the everyone else has to wait longer….another of your points.
    I could go on but risk boring everyone. Please get your facts straight, some of your observations are at least misleading if not untrue!!

    • Thanks for taking the time to comment Debbie. This blog is just about my experience of the NHS from the perspective of a French mother/woman. Nothing more, nothing less. The reported facts are just what they are, i.e. what happened to me.
      I think you are right, getting a huge prescription isn’t necessarily a good thing. That said, having a prescription made me feel like I had been taken seriously (rightly or wrongly). And I can assure you that I got sternly told off when I mentioned my back pain. How am I supposed to know whether my symptoms are related to the same problem? (In this instance, they were -pregnancy). In short, it was (and still is) a steep learning curve. That said, don’t get me wrong: I am not saying that one system is better than the other, I am just saying that it felt very different because I am biased: I am French-born and used ti the French way.

  • Bill Telford

    What a really misleading and very untrue article! If you are so passionate as to put an article together, get your facts right before it goes to print. I too have lived in France and it is simple fact that it is not the best healthcare in the world. Having an illness which requires hospital treatment can end in multiple miles having to be travelled to see one department and then another department. Stand outside a pharmacie over there and you will see people coming out with carrier bags full of medication which I was told by a French neighbour is normal but stupid. How wasteful is that? As for a GP appointment, in many communes you have to go and sit in the surgery as there is no appointment system. Go for the 2pm surgery time and you had to arrive at 1pm to find a chair you could sit on! And they always always saw reps first which was infuriating. I’ve arrived at 1pm to get back home going on to 5pm. The NHS can trounce it!

    • Thank you for taking the time to comment, Bill. This blog is not about how much better the French system is, it’s about my experiences of the NHS as a French mother, that’s all. Both system (French & British) are world-class and I am HUGELY grateful for having a health system at all. If you are a regular reader, you will know that I don’t do bashing anyway and that I believe that this world badly needs more kindness. I am simply trying to build bridges and explain how the NHS made me feel. That said, everything I wrote is true (it’s happened to me!), and the two systems, despite being in the same league (i.e. amongst the best), feel very different. I suppose it’s just two different philosophies, and I am biased because I am French-born.

  • Vivienne Gilfillan

    This is quite an inaccurate blog!! It is clearly your personal experience and depends on the area! Although my doctors are closed weekends I have a hospital on my door step open 7 days a week 7am- 9 pm and it’s a walk in centre, you can walk in and get an appointment! Plus we have NHS mobile stations set up all over the place!!!! Suppositories what are you going on about??? I’ve regularly got suppositories in the past and even for my 4 year old son last week! I could disputed every point you’ve made , it’s laughable! but I think your article is extremely flawed , as you fail to mention how ( in my opinion ) behind france is in regards to special needs! It was the reason for us returning back to the U.K. It was shocking how they dismissed the possibility of my son being autistic because he had eye contact and because he had emotions and was affectionate! It was suggested that the problem was with me the mother!! It was shocking ! I can not fault my personal experiences in French hospitals, I was generally impressed but was totally let down with my son and for the lack of knowledge on Autism & ADHD etc. I have also been personally lucky with the NHS here but I can not fault the help we’ve had on the NHS for our son, within 6 months returning we had a diagnosis, speech therapy, OT, ehcp, numerous treatments and tests and a placement at special needs school not to mention the financial support all on the NHS. ALL FREE!!!!! surely when you make a a blog your judgment on NHS you should include the much bigger picture! Suppositories Really?? How about SEN ….. no comparison !!!

    • Thank you for taking the time to comment Vivienne. I am sure you are right, it depends on the area, but I can assure you that I don’t have a hospital on my door step and getting an appointment at my local practice is a nightmare, although today I received a text saying that I will soon be able to do in on Internet (I can’t wait!). As for suppositories, my various practices never prescribed them. They recommended ‘glow in the dark’ Calpol, which really surprised me. This is a light hearted post explaining what my experiences of the NHS were as a French woman/mother, that’s all. I am not saying that the NHS is better than the French system (or the other way round), I am just talking about how different the experiences can be (and I am of course biased, because I am French-born and spent most of my life in France). In short, both systems are world-class, but are very different.

      As for autism, I am not a doctor and can only offer you my deepest sympathies for what you have been through in my home country. The way autistic kids are looked after in France has indeed been highlighted as inadequate (see here: http://www.euronews.com/2016/03/30/children-losing-out-as-france-lags-rest-of-europe-on-autism-vision). That said, as an example, the treatment of cancer in my home country is, I believe, second to none :there are no waiting lists! Both systems have their strengths and weaknesses, and this post was, again, an humorous attempt to explain how I felt about it.

  • Oui In France

    I always enjoy your posts, Muriel. Love your sense of humor and commentary. Sharing with the Oui In France FB community. 😉

    • Thank you very much for this comment! I am glad that you get my (bad?) sense of humour (ahem…not everybody does -just saying!). Feel free to re-post, etc, and have a great day!

  • Tracy Thurling

    As a Brit living in France for many years, I think your comparison is spot on and very funny. My elderly parents living in rural UK have had impeccable service from the NHS and my French born children and I have also had excellent service in rural France. Both are great systems, both have their downsides but they are oh so different. Just like us all!

    • Thank you so much for this comment Tracy! I am glad that you understand where I am coming from. It’s a steep learning curve. In fact, I am still learning. If you want to write a post on your experiences of the French system as a Brit, I will happily publish it here! Have a great day!

  • Charlie James

    Firstly Muriel, all receptionists will ask you if you feel you need to see your GP urgently & if you say you do they will give you an on the day appointment. 2. If you have to wait before your app’t it’s because your GP is helping someone who needs their attention. Also if you have more than 1 symptom you can book a double appointment at the time of contact. 3. Saying you have heavy legs or rheumatism isn’t a condition it’s a feeling you have and you can’t expect your GP to make that a diagnosis, but they will try to get to the right answer from you. 4. Most females would suspect a pregnancy and puking over the GP’s surgery just makes the doctor over run and keep everyone else waiting longer than you. 5. GP’s will prescribe suppositories and medi patches if requested. 6. There is an out of hours surgery at nearly all local hospitals or you can go to accident & emergency where you will be triaged and seen on the severity of your symptoms, but be aware if you go because you have a cold virus be prepared for a very long wait while more seriously ill people are being attended to. 7. You are under NO obligation to enter any details about your gender, religion, ethnicity etc. 8. The NHS is not a rip off and we have been well served by it for many years but now it’s under great stress for a variety of reasons. A private dentist is expensive (I know this) but NHS treatment is reasonable and you can pay extra for more superior materials for a crown etc. 9. Waiting lists for surgery are legislated by G’ment and from the date your GP writes or refers you to a hospital consultant is 18 weeks to any surgery you may require. This does not include maternity and cancer patients. 10 Drugs purchased at the supermarket are also regulated. There is a limit to how much paracetamol you can buy anywhere and Calpol, benylin can only be purchased from the pharmacist after she/he has ascertained that you are 1 responsible and 2 it’s right for your symptoms. Unlike many pharmacies in Europe you are unable to buy steroid creams or antibiotics in UK pharmacies (GP Prescription only).
    I do know a number of French people and it often amuses me that they appear to be hypochondriac but perhaps more sensitive than the Brits. GP’s in UK are trying to move away from issuing too many scripts unless they’re vital, obviously BP meds are important and statins but less so too much antibiotic and less anti depressants. However gym visits can be prescribed and acupuncture, hydro therapy, so the future is bright and remember the NHS really does pull out all the stops when they’re needed.

  • Julie

    The difference between the French and British health systems is the NHS
    deals with far more traffic than the French system. You only have to go
    to Urgencies to prove that compared to A & E but I think the
    nursing staff and doctors do a marvelous job in the NHS considering the
    constant pressure they work under. And as for buying drugs in a
    supermarket I miss that terribly in France. The cost of things like
    paracetamol are exorbitant that is why I always stock up when I am back
    in the UK. Sixteen doliprane equates to nearly €4. The same in the UK
    varies between 54p – 90p …..no comparison. It would be a quicker to go
    to the supermarket to get things like paracetamol because you
    invariably have to stand round for ages in the pharmacy while the French
    person in front of you contemplates how they are going to carry their
    numerous bags of drugs home. I remember speaking to a Parisian once who
    pointed out to me that all French people are hypochondriacs. The NHS is
    far more prudent and cautious about dishing out drugs The French
    system is not perfect and the NHS has its problems too. It is a pity we
    cannot combine the good aspects of the NHS and the good aspects of the
    French system, we would them have a near perfect
    health system on both sides of the Channel. My husband had excellent care in Poitiers Hospital. The nursing staff were wonderful. He also had excellent care in Sandwell Hospital in the Midlands. .As for dental costs in
    France I have just had a crown done in the UK as it was far cheaper than
    having it done in France, and a friend of mine has just had some dental work
    done in the UK for £600. She was quoted €1400 in France, but I have been told that dental costs differ from region to region.

    • I think that you have summed it up really well Julie: both systems are different, and wouldn’t it be great to combine the best practices of both? If only…
      I hadn’t realised that paracetamol was so expensive in France, and €1400 for a crown seems extortionate -my French dentist was a lot cheaper! Getting used to different systems is part of the charm of living abroad, I suppose. In any event, don’t get me wrong: at least we have a health system and I am grateful for this. Thanks for taking the time to share your experiences. x

  • Hassan Shirwani

    It’s ridiculous that the GP practice requires one symptom per consultation. I have heard some practices do require this. Thankfully my GP in Surrey doen’t. Well done for highlighting this Muriel. It should be given more promenence and outlawed.

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