Even Brexit voters go weak at the knees for some French delights

UK quietly outsources some surgeries

Sergei Orlov, a British national, talks to his doctor while recuperating from knee surgery at the Hospital de Calais, in Calais, France. Photograph: José Sarmento Matos/The New York Times

Sergei Orlov, a British national, talks to his doctor while recuperating from knee surgery at the Hospital de Calais, in Calais, France. Photograph: José Sarmento Matos/The New York Times

 

Serge Orlov, a 62-year-old Briton, likes to rail against what he calls the tyranny of the European Union.

Like most supporters of his country’s withdrawal from the bloc, he wants Britain to strike out on its own, a fully sovereign state unshackled from Europe’s pettifogging rules and the Continent’s overweening state.

But faced with excruciating pain and a seemingly endless wait for a knee replacement, Orlov temporarily shelved his euroskepticism to take advantage of a little known National Health Service program and jump to the head of the line – in France.

What used to be a trickle of British patients at the hospital has turned into a steady stream.
What used to be a trickle of British patients at the hospital has turned into a steady stream.

After waiting a year just for the possibility of the knee replacement he badly needed, he turned to Calais Hospital in northern France, where in a matter of 10 days, he found himself on the operating table for the three-hour procedure. He plans to get his second knee replaced in a few weeks. Back home, it took him a year to receive a letter informing him when he might have the operation.

“Waiting, it’s just miserable,” he said, describing how he had been shuttled to five UK hospitals over more than eight months. Waiting rooms are “full of sick people,” he said, adding swiftly, by way of explanation, “I can be a grumpy old git.”

Orlov, who has Russian-Italian ancestry, is among a rapidly growing number of British patients who are crossing the English Channel to seek medical treatments – mostly elective surgeries – in France.

I think it’s hilarious

Given that the Brexit vote was largely won on highly emotive issues surrounding British sovereignty and a misleading promise by politicians that leaving the bloc would free up £350 million a week to fund the NHS, the paradox of Britain seeking aid from France is not lost on the French hospital, nor on Orlov.

“I find something quite ironic about it,” he readily admitted. “I think it’s hilarious, actually.”

After years of austerity, Britain’s lumbering NHS is under enormous strain, with severe shortages of beds and medical staff, all of which is producing waiting times for nonemergency procedures to stretch over months, and sometimes beyond a year.

The situation in Ireland is similar in Ireland, with the number of people awaiting out-patient treatment in public hospitals above the half million mark.

Figures released by the National Treatment Purchase Fund (NTPF) put the figure for pending outpatient treatment in Ireland at 500,800 by the end of February. The number of those awaiting in-patient and day-case treatment for longer than one year stands at 13,500.

In the UK, to cope, the NHS has been quietly outsourcing some surgeries to three hospitals in France for the past year or so. It is a little-known partnership, because the NHS is not eager to advertise the measures it is being forced to take.

But as more people join Orlov in crossing the English Channel – and with a predictable but particularly severe “winter crisis” this year, forcing the cancellation of tens of thousands of elective surgeries – word is spreading.

Orlov was only Calais Hospital’s 15th patient under the program, but it has received 450 inquiries from British patients over six weeks, after fielding fewer than 10 a month previously. With 500 beds and a surgery ward with an occupancy rate of 70 percent, the hospital could treat as many as 200 NHS patients a year, officials said.

It’s shocking what’s going on

Orlov marveled that he had a spacious private room in the French hospital, with a window looking out on some greenery and a television set that offered the BBC. Parking is free, he exclaimed several times. “And the food is pretty good,” he said as an afterthought. “I’ve got to say, I’m not averse to French cooking.”

Hospitals in Britain “are so old they should be museums,” he said. “It’s shocking what’s going on.”

NHS England’s outsourcing deal has technically little to do with Britain’s decision nearly two years ago to leave the European Union. Rather, it has more to do with the myriad ways that countries across Europe are tied together, but that are often ignored in public discussions about Britain’s relationship with Europe.

“Let’s hope the talks don’t speed up too quickly though, I want to get this done first, and ideally the second one,” Orlov added, half seriously, referring to negotiations about the terms of Britain’s departure.

He asked that his surgeon not be told he had voted for Brexit – just yet. “I’m happy to tell him when he’s finished carving me up, but certainly not beforehand,” he whispered. “I do have my second knee.”

(“Oh, la la,” Martin Trelcat, director of Calais Hospital, groaned in mock outrage when he heard he had a Brexit supporter on his hands. “It’s time for a new vote,” he joked.)

Martin Trelcat, director of Calais Hospital.
Martin Trelcat, director of Calais Hospital.

Britain has about 340 available beds per 100,000 inhabitants, compared with an EU. average of 515, according to Eurostat, the European statistics agency. France has 706 beds for every 100,000 people, and Germany 813. Only three countries – Ireland, Denmark and Sweden – have lower rates of available beds than Britain does.

Britain spends almost 8 percent of its gross domestic product on health care, slightly less than France and Germany, and the share is forecast to fall to about 6.8 percent by 2020, according to the Office for Budgetary Responsibility.

Estimates from the King’s Fund, an organization that researches the British health care system, suggest that NHS England funding is at least €4.6 billion below what is needed this year, and that the shortfall will rise to around €24 billion by 2023.

People have been left on trolleys in corridors in scenes of chaos some have likened to “war zones”

But UK health secretary Jeremy Hunt argues that pressures on the NHS are increasing not because of a lack of funding but partly because people are going to emergency rooms when they have bad colds or other minor afflictions.

This winter, people have been left on trolleys in corridors, in scenes of chaos some have likened to “war zones.” Patients in emergency wards sometimes waited up to 12 hours to get treated. The situation generally comes to a head every winter – so much so that the “winter crisis” has almost become an annual tradition. But even Hunt admitted that this year’s was the worst, and the British Red Cross declared the situation a “humanitarian crisis.”

Last Monday (March 12th) there are 714 patients on trolleys or on wards awaiting admission to a hospital bed in Ireland – the highest number ever recorded.

The NHS insists the outsourcing partnership is “purely about patient choice.” Officials declined to comment for this article, despite repeated requests.

Trelcat, the hospital director in Calais, said the most likely explanation is that Britons are more patient than the French. “We don’t understand how you can delay so many operations that make many patients suffer,” he said. “A knee replacement that is delayed for one year – in France, it just can’t happen. It takes a maximum of one month here.”

Calais Hospital representatives said that, in private meetings, NHS officials had told them they wanted to enter a partnership because many of its hospitals were old but had little chance of being refurbished or improved soon.

The entrance to the Calais Hospital features a flier for the NHS, which has been quietly outsourcing some of its surgeries to three hospitals in France.
The entrance to the Calais Hospital features a flier for the NHS, which has been quietly outsourcing some of its surgeries to three hospitals in France.

The delays are a “sign of failure” of the NHS, Britain’s national pride, Trelcat said. The limited publicity about the deal may stem from an “embarrassment that most certainly comes from the fact that our hospitals are so reliable,” he added.

NHS officials who visited Calais Hospital were probably “not aware of the gap between a standard British hospital and a standard French hospital,” he continued.

Orlov proffered his own explanation for the NHS’ reticence to advertise the possibility of treatment abroad. “I don’t know if it’s a breakdown in communication,” he said, “or because the NHS doesn’t like the idea of parting with the hard cash and bringing it to France.”

Either way, he said, “it’s shocking.”

– New York Times

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