Thursday, August 27, 2009

Where I Ruminate on My Experience of the British National Health Service


One of the many inflammatory charges that frequently gets tossed into the current health care reform conversation is how bad nationalized health care systems are.

I have recently read an interview with David Sedaris (very funny, of course) about having kidney stone attacks in New York and Paris and comparing the two experiences (and costs.) And author Sara Paretsky, creator of fictional detective V.I. Warshawski, had a piece in the New York Times Magazine about taking her husband to the emergency room in France with chest pains. Both Sedaris and Paretsky agree that the French hospital experience is bureaucratic, but also effective, and above all, cheap.

I can’t speak to the subject, since I have always been healthy when in France (I suspect it’s all the wine and cheese), but I have been ill while in Britain, and have first-hand (although somewhat dated) experience with the British National Health Service.

My family and I have lived in Britain for extended periods of time on three occasions during sabbaticals. My first one was in Oxford, and my children were almost 5 and almost 7 when we got there. Our doctor was Dr. Shakespeare (I’m not making this up) in Summertown, and he ran a clean efficient surgery that adequately took care of our medical needs for the months we were there. Medications, such as antibiotics for a child’s earache, came from the neighborhood chemist. Both the visit and the prescriptions were free, thanks to the NHS. We were resident aliens, but we received care with no questions asked. Sometimes we had to wait, a situation not unknown in America.

On one of the children’s mid-term holidays, we left Oxford and traveled, along with Martha’s sister Andrea, to the Cornwall coast. We stayed in the charming fishing village of Mousehole (pronounced Mowz-uhl) at a guesthouse called The Lobster Pot.

I awoke one morning with a sore throat and a slight temperature. We were slated to go down the coast to see St. Michaels Mount, a part-time island with a picturesque priory on it that sits just off the coast in the English Channel. I decide to tough it out, but inquired from our host where I might get medical care if I needed it. She told me that there was a medical group in the village of Marazion, on the mainland, just across from the island.

By the time we got to Marazion I was feeling pretty feverish, so I had Martha drop me off at the medical group while the rest of the party went to see the island. I waited for about a half hour for my turn to go to the window. The friendly receptionist asked me my address, and I explained that I lived in Oxford, but was on holiday in Cornwall. “Where are you staying?” she inquired. I told her I was at The Lobster Pot in Mousehole, and she said, “Then you must go to Penzance for care, you are not in our district.” I don’t know if it was the fever or the reference to Penzance, but the conversation did seem to have a Gilbert and Sullivan feel about it.

So, having been denied, I left and walked across the causeway to the Island (you can only do this at low tide) found my family, and spent several hours huddled on a stone bench in a shady spot burning with fever.

In due time we found the doctor’s office in Penzance, waited a reasonable amount of time, and I saw the doctor, who, now that I think about, it looked a lot like Hugh Laurie, the British actor who plays Dr. House, in the TV show House. He asked me where I was from, and I told him Oxford. “Ah,” he said, “the city of dreaming spires.” He looked in my ears and throat, listened to my chest, took my temperature and sent me to the chemist next door to get some antibiotics, which did the trick in a day or two. All at no cost.

So I draw no big conclusions from my tale except to say I always felt welcome as a visitor in Britain, and it always felt like the right thing to do to provide health care for everybody. I’ll let the experts work out the details, but I am really hoping we can do that here.

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