Getting a doctor's appointment

Antonia it isn’t just what the patient pays directly though in France, money is paid from general taxation as well isn’t it towards the health care system? What the NHS needs is more money that could easily be raised through general taxation but of course that’s huge political issue. Re your pre-diabetes, I may have sounded a bit dismissive but there really is absolutely no evidence base that supports more than annual checks for prediabetes. The French health care system does not always spend its money in the best interests of patients - over treating, over testing and over prescribing carry their own risks.

maryelixa54 of course you have a valid point that money is paid by taxation for the French healthcare system. I suppose my concern about the pre diabetes is that it is a progressive illness, and that my sugar levels could increase significantly in a 12 month period. I test regularly with the finger prick strips though and I would probably notice any change. It's hard to know if the French system over treats and prescribes. It could be that because people pay, they want value for money and expect lots of attention. You may also be right about the yearly check. Possibly the 3 monthly tests make me more stressed out about it all. Isn't it hard to know!!

Good advice there from cornergran. You need to find out how things work in your area. I've got to say I find it confusing myself sometimes, knowing which service to use and who to see. When I rang for a rare appointment a couple of weeks ago though, I was offered either one of the GPs or a senior practice nurse, both the same day. They have a daily "sit and wait" clinic for those who can't make any timed appointment they can offer. All clinics - diabetes, asthma, babies, etc - are nurse led now, and once you're signed up you're seen regularly. I used a fantastic walk in clinic where my DD lives when I had a broken bone, because the two nearer to us get bad online reviews, and I actually like the way pharmacies are used more for advice these days, it saves the trip to the surgery. And I'm sure you can choose any local practice, if they have space. Like your doctor, I'm a bit bemused about your request to see a heart specialist too if you haven't got a heart problem (perhaps I've misunderstood?).

The evidence base takes into account the rate of progression of T2 diabetes. The annual check is for higher risk - for lower levels it’s 3/5 years. You might find reading the NICE guidelines reassuring - I’ll post the link

maggiemaybe the visit to the heart specialist was a once yearly appointment in France, offered to any diabetes or pre diabetes patient.

www.nice.org.uk/guidance/PH38/chapter/Recommendations#risk-assessment

That's interesting, Antonia. A good friend of mine has Type 1 diabetes and has all sorts of medical checks on a regular basis, but I can't remember her mentioning a heart specialist. Others might know if it's something that happens here.

There’s no routine heart specialist referrals for people with T1 diabetes. I think that the approach is mainly trying to lower the factors that increase the risks so routine prescription of statins for cholesterol and medication to lower blood pressure ( people with diabetes have lower targets)

maryeliza54 thank you for the useful link.

Antonia, The thing to remember is that medicine is an art not a science and that there are cultural differences in the way different medical systems work and how different systems treat the same illness.

In the UK in recent years NICE (National Institute for Health and Care Excellence) has been looking at the treatments for all kinds of conditions to see what works and what doesn't and many checks and procedures have been found unnecessary or ineffective across a range of illnesses and are no longer recommended.

I have a foot in both camps, we live in England but for nearly 30 years have had a holiday home in France and have experience of both systems. I feel that the French system is rather like the American system with doctors ordering all kinds of tests and visits to specialists that are not really necessary because it ups there income and keeps their patients coming to them.

If you have pre-diabetes and it is stable, why would you need to be seen more than once a year? As for the heart specialist: if you have a heart problem of course you should be referred, but you do not mention, whether you have any heart condition, if not why would you need to to see one?

There have been concerns for years about the cost of the French health system to the French tax payer, despite patients having insurance and many articles in papers I have read about trying to reduce the costs by having a supervisory group like NICE to decide what treatments have good evidence and what do not so that patients get far fewer referrals. I think M.Macron has reform of the French health system on his list.

The NHS is not perfect, but it doesn't follow that if you are getting less treatment in the UK for any health problems you have compared with France, that the UK system is worse, it could be that you were being over treated in France.

I have been with the same GP Practice for 40+ years. Firstly I moved 7 miles distant but stayed with them. Then I moved to my current home which is 13 miles from the Practice. I stay because my medication is complicated and works, and I don't want to run the risk of a new GP Practice deciding to make changes on my (opiod) medication.

I can go on-line and book an appointment with my doctor of choice but that may be in a couple of weeks.

I can ring at 8.30am join the telephone queuing system and ask for an appt for that day but won't be able to choose the GP and the places may all have gone.
I can also request a telephone appointment for that day and can choose from the GPs on duty.

Alternatively I can arrive at the surgery without appointment and before 9.30am. I will see a GP if I wait my turn. Last time I did this it was 1.5 hours wait. I simply took my Kindle and enjoyed the time to read without disturbance

All practices offer same day appointments for emergencies. If it is not an emergency then it should not be a problem to wait. Is there some urgency about your problem? If so there are also walk-in centres.

When you see the doc you can make a further appointment if needed.

Once you get used to the system I am sure you will find your way round it and get on top of phone consultations, online appointment booking etc.

Well, I must be the only woman on the planet who transitioned smoothly from the French system to the UK one. After 16 years with CPAM I returned to the Uk and within a month I was back in the NHS. I would also say the French system is not the dream many believe.
Our first medicien general was on the verge of retirement, nice though he was, but he really went through the motions of 2 -monthly appointments just to renew blood pressure meds. Next MG was a lovely lady, but still had to see her every 2 months, but she was forever sending us for blood tests, scans or physio for any ache or pain DH reported! None of these requested I might add. As someone who avoids all health -based appointments it drove me round the bend.
My theory is that as French health care is partially funded by private insurance the whole system is a money making operation. For example each consultation costs 23 euros up front with reimbursement later. Hence the 2 month appointments for prescription renewal.
My new UK GP leaves it to me to decide if I need an appointment. I'm a 'big growed up girl'so I'm more than happy with that.
The NHS isn't perfect, but the neither is the French system although theoretically the idea of partially private health insurance is IMHO much better. The UK would do well to dismantle the present system and consider the alternative.

I think the NHS is awful....it is in decline and you have to fight for everything. This country is reactive not proactive.
I would much prefer a French system. If I have anything urgent I have to pay for it as waiting for appointments with GPS, nhs consultants is generally ridiculously long. How do you know if something is urgent or not? Sometimes you cannot know if the pain you have is serious or not....the whole system is flawed .

Can't fault our surgery in North Wales, can get an appointment on the day you ring, with the Doctor you want unless they are off and they are excellent at booking blood tests and other routine things in advance.

If you've just joined a new practice, you should be given a new patient medical and you will be able to discuss any problems at the time.

My husband has had an ECG as part of his diabetes treatment. It was done in the GP surgery. Is this what was offered in the French hospital?

I think there is something to be said for both sides. Where Doctors are free to earn a bit more they will order more tests than are needed, that is the same in Germany sometimes. But German doctors are also free to say enough is enough concerning how many patients they have and then a doctor need not be over worked. Nurses are not allowed to prescribe anything in Germany, so you automatically see the doctor him/herself
We lived again in the UK 20 years ago and decided to return to Germany exactly because we were getting near retirement and thought the German medical system would be better for us. That was a decision we have not regretted. It was the right thing to do.
An urgent case gets to see the doctor immediately and the rest have to wait a couple of days. Specialists can take a month or two if not urgent.

We have to wait for a GP appointment if we wish to see a particular doctor and it is non-urgent. However, an urgent appointment can usually be seen that day, or, if phoning late in the day, the next day.
Hospital appointments are regular and I am seen promptly (sometimes out again before DH has managed to park the car!).

There is a way of getting an appointment it is a question of finding out how they system works where you are. Talk to the receptionist, and be especially nice! Here you need to phone at 8 am to get seen the same day. Of course you have to have nothing else to do, I don't know how people at work cope. There is also a walk-in centre where you get to see a nurse and they have been quite good. TBH. But the NHS is in dire straights.

Nigh on impossible to get a same day appointment here - even booking in advance is difficult however I did receive excellent care when something was wrong last year and the doctor even rang me later that night to check how I was. As has already been said money is the problem and there is no way the NHS is going to get better without it. I do know that France has one of the highest taxation systems in Europe and that is due mainly to healthcare - it's good to know it works - we might have to turn to a similar system when ours collapses under the strain!

It is a post code lottery.
This morning our surgery was fully booked after 10 mins. I was getting low on tablets.
I used the GPs call back service. I had been told to check in with my GP that some new tablets were working and if there were any side effects.

A very short phone call with the Duty GP and a few questions about how I was doing on them and as all was Ok he was then able to issue me another prescription.
That would certainly have saved a consultation.

To add a positive note, I can usually get an appointment within a day or two and can book on line or phone. However I do know that this is rare these days.

My DS has had a knee injury for a week and rang for a GP appointment today at 8am as it was no better. No appointments for two weeks! Usually from 8am you are in an everlasting queue, in my case once for over half an hour. If you redial you go further down the queue. Some excellent GPs have left the surgery over the last year and do not seem to have been replaced. I can't blame them, seeing the pressure they are under.

Hospital appointments are as bad, often being cancelled by text at the last minute, sometimes even before I knew I even had an appointment! Today I received a text saying I had an appointment on Tuesday at 9am. This was the first I knew about it and is not in my local hospital. At that time of day it will take me well over an hour to drive the 8 miles to get there, not to mention extra time for impossible parking.

In the past the specialist used to have a clinic at my local hospital one day a week. It used to take me 10 minutes drive, maybe half an hour wait and 10 minutes home. The specialist team of maybe 4/5 people driving 8 miles instead of hundreds of patients! It's not rocket science!!

It is possible I will not be back to pick up DGC from school at 3pm after this one so I will have to have someone on standby!

Very much depends on where you live and on how good the practice is. Afraid to say it is going to get very much worse: not enough staff, not enough money, services being privatised. Until we have a government which cares for its people, nothing will change. (Not saying that has to be a left leaning one). I should go back to France if I were you!!!