Sun, Sand and Surgery | Germany| News and in-depth reporting from Berlin and beyond | DW | 26.03.2002
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Sun, Sand and Surgery

British patients fed up with waiting for a free hospital bed are travelling abroad for treatment, after last year's European Court of Justice ruling, enabling hospital treatment in foreign countries.


Free hospital beds are rare in Britain

It is a country increasingly popular for abundant wildlife, sun worshipping and safaris. But now South Africa is becoming a favourite destination for British patients fleeing the British health system in search for treatment.

And South Africa is just the start. Every week, dozens of British patients travel to South Africa, or - closer to home – the European continent, for treatment abroad.

British cancer patients, fed up with poor cancer services in Britain, are attracted by low treatment costs in South Africa due to the value of the South African rand, and the prospect of relaxation in a warm climate afterwards. Patients with knee ailments are flying to France for knee transplants. And pregnant women are shuttled to the German capital for delivery.

Waiting for help

The most crucial reason why patients in Britain are taking to the skies for treatment is – time.

Around one million British people are waiting for a hospital bed. Patients are carted all over the country in the hope of finding a free bed.

At least 10,000 British patients are said to die each year due to delays and poor treatment.

A study earlier this month showed cancer services in Britain to be so poor that lung cancer patients are half as likely to survive than those on the continent. Therefore, patients are looking for help beyond British boundaries.

This was made possible last year, when the European Court of Justice ruled that governments must provide treatment abroad if it coud not ensure timely treatment within national boundaries.

This year, the first of 200 patients to be sent to France and Germany were sent to the continent for knee operations at the taxpayer’s expense. Health care trips to South Africa are paid for by the patient, but are expected to be added to the list of NHS treatment locations due to the low value of the South African rand, bringing low costs despite good treatment.

Trying to keep up

The British tax-financed National Health System, founded in 1948, was once a model for national welfare systems in Europe.

In the past decade, medical development has advanced in great strides - open heart surgery, hip and knee replacements and keyhole surgery have meanwhile become medical routine. The NHS, however, with its ancient structures and constant lack of finance simply can not keep up with this phenomenal growth in medical development.

Other European countries are not faced with the same difficulties as Great Britain simply because they spend more on health care. Germany spends well over one tenth of its national income on health, Britain 6.7 per cent. Inside the EU, only Spain, Ireland, Greece and Portugal spend less. As a result, the NHS is constantly underfunded and short-staffed.

However the NHS’ difficulties are not just a matter of budgets. Levels of spending and waiting times are set by the central government – local health authorities then decide what to fund. The result is a system slowed down by bureaucracy at its best – at the expense of the patient.

Britain’s feeble health system has led to calls for a compulsory health insurance system, of the sort in Germany and France. Insurance-based systems prove more efficient than tax-based ones due to higher competition between insurance companies and a higher overall budget. But it also means less control over costs. Indeed, the German system is at current under severe criticism within the country, accused for being inefficient and costly.

However, for British patients health care in Germany is still a dream. The British daily "Sun" investigated Berlin Virchow’s Clinic and called it spotless, praising its abundance in doctors and nurses. The paper went on hospital "reasearch" for a woman who was awaiting quadruplets, and couldn’t get a hospital bed in her home country. The "Sun" – suing its own methods - threatened that the newborn babies would return home with German names, if a bed was not found.

Pressure on the British government to treat more patients has led to a drive for more efficiency. However, measured in terms of costs per unit of output, British hospitals – treating the maximum number of patients with the minimum number of hospital beds – are probably some of the most efficient in the world.

As Germany and France are looking for ways to reduce costs, the irony is that Germany and France are looking across the canal, for inspiration.

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