A healthier Europe


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IN LATE November, the European Commission will publish draft proposals for a new Health Services Directive, which will strengthen patient choice regarding seeking treatment abroad if there is undue delay in their home country. A recent report from a Swedish think tank suggests that this would be particularly welcome in Britain.

For the past three years, the Euro Health Consumer Index has impartially compared the value and performance of European healthcare systems across 29 countries, the EU 27 plus Norway and Switzerland, and researched from the point of view of the patient, ranking which country gives the best patient service. The results contain several surprises but make depressing reading for the UK.

Austria, France, Germany, the Netherlands and Switzerland are close together at the top of the table. It could be significant that the healthcare systems in each of these countries are based on social insurance via a number of different organisations, which are in turn organisationally independent of healthcare providers – hence genuine patient choice.

The UK, where virtually all the financing comes from the taxpayer and is funnelled from the centre via the National Health Service, comes in at a dismal 17th place.

Even this poor showing is propped up by a single strong score on availability of information, i.e. patient rights and comparing hospital success rates. On the key measure of waiting times, the UK was nearly the worst and equal to Portugal and Spain. Only two countries were below this and on the general availability of drugs measure the UK is only narrowly beaten into last place by Bulgaria.

Not all the new Member States fared badly. Indeed little Estonia weighed in with better marks than the UK. With a population of only 1.5 million, it has completely changed its system in the past 15 years, moving from a top-down centrally-planned approach to become truly customer-driven. Indeed on a separate “Bang for your Buck” index, which takes into account that costs of healthcare services vary considerably between countries, Estonia actually comes top, with the UK fourth from bottom.

Success is clearly not just a question of flinging money at the problem. The UK currently spends more per head pro rata than most other countries measured, though with less favourable results.

The latest forecast by the Chancellor will increase the amount further to a whopping 110 billion pounds sterling by 2010. However, this will not automatically translate into better delivery for patients unless we move away from a top-down target culture set by politicians, towards the patient-driven, doctor-delivered culture seen elsewhere in the EU.

It is time to learn from other Member States what they do better, and why. Otherwise more UK voters will increasingly seek medical care elsewhere in Europe, though perhaps not in Bulgaria.

Every good wish.

Philip Bushill-Matthews MEP is the Employment and Social Affairs Coordinator for the European People’s Party/European Democrats