Page last updated at 13:06 GMT, Thursday, 3 July 2008 14:06 UK

Do the French do it better?

By Stephanie McGovern
BBC News

Imagine a health service with no waiting lists and a greater access to treatment. For French patients it is a reality. So why not in the UK?

A patient is taken into Hôtel-Dieu hospital in Paris
France spends more on health per head than the UK

Opposite Notre-Dame cathedral in Paris an ambulance pulls up. It is the fourth one to arrive in 10 minutes.

The paramedics dodge the traffic to pull open the back door.

A trolley is pulled out and wheeled into the grand entrance hall of the Hôtel-Dieu hospital.

It is unclear what has happened to the woman who is lying frail on the trolley.

But what we do know is that if she were in the UK and not France, she would have fewer resources available to care for her health.

For every 1,000 people in the UK population, the Organisation of Economic Development (OECD) says that there are 2.4 doctors available.

In France they go one better, having 3.4 doctors for every thousand people.

Beds

The same is true for hospital beds. For acute care beds the French have 3.7 per 1,000 people, whereas the UK falls behind with only 3.1 beds.

Valerie Paris, a health economist at the OECD, says: "In France the access to physicians and hospitals is easier than in the UK. We don't have waiting lists."

There is a catch. In France you have to pay upfront for some appointments with doctors and then claim back the money from a compulsory social insurance scheme.

Experts admit that this could be a problem for some patients.

Some governments did not invest enough in healthcare
Nigel Edwards, of the NHS Confederation

But why do people in the French health care system get more? The answer is they spend more.

If you remove the exchange rate factor, the UK health spending is £1,799 per person per year. That is for both the NHS and private health care.

But in France the figure is £2,250 per person.

This gap is narrowing.

Since it was founded money has been steadily pouring into the NHS.

Back in 1948 the yearly NHS budget was £280m, a mere 3.1% of the UK's national income, the Gross Domestic Product (GDP).

Sharp rise

The investment grew in the five decades that followed. However, it was only recently that it saw a sharp rise.

It now stands at 7.6% of GDP with a budget of £105bn.

Although the share of the economy spent on health care has increased, it is still less than the EU average.

Nigel Edwards, director of policy at the NHS Confederation, thinks that British patients have missed out.

Medics/X-rays (file pic)
UK health spending has been rising

"Some governments did not invest enough in healthcare."

"They had their eye on other priorities and this does probably mean that we've missed out on the investment of doctors, the uptake of new drugs, and new buildings and imaging, which other countries do significantly better at."

There is no doubt that the UK is spending a lot more on health but there is looming question mark over whether the money that has been pumped into the NHS blood stream has been well spent.

The quality and quantity of health care has increased with more patient care, treatments and doctors.

However, it doesn't match the pace of growth of staff numbers and drugs.

According to the Office of National Statistics, the amount of resources going into the NHS, such as equipment and drugs, rose by 29% between 2001 and 2005.

That is after allowing for wage rises and inflation.

But the patient care and treatments - the NHS output - was up just 19%.

Statisticians say that in the last few years there have been signs of improvement with higher health investment producing better results for patients.

But with six decades of catching up to do it could still be some time before patients in the UK can benefit from a health service that rivals the access to treatment that the French have.




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