The picture of health

Until quite recently, and unless you were genuinely very sick, you could often wait over a week to get an appointment with a doctor in the UK. For most people, of course, that meant that they were either recovered from or struck down much worse by their illness, of they'd have to suffer the pain of an ear infection or ingrowing toenail or whatever for ages before it was swiftly and simply rectified. Not really an ideal situation.

The problem was that you don't have to pay anything upfront to see the doctor. So people assume it costs nothing - and they tend to go to the doctors when they might, for example, be better off going to the pharmacist. And every surgery has people that are regularly going to see the doctor essentially because they don't really have anyone else to talk to. Which is sad, but it's not really the best use of time for someone that should really be prescribing the drugs that make people better.

When we lived in Sweden the system was quite similar, but very different. You paid SEK60 (about ?6 or £4.50) to see the doctor. Which isn't a huge amount of money (and is refunded if you can't afford it), but is enough to make sure you think twice. And the effect is remarkable, because you tend to be able to see a doctor the same day.

And in France, it seems the situation is again better. I'm not actually a part of the French system, as I'm covered by health insurance from my employer. But essentially it works in quite a similar way. Doctors here are private. So you go, and you pay for your appointment. There's a fixed fee that the state will reimburse you for, which is what most doctors charge. But if you go to see someone that charges more - like our Canadian doctor who presumably takes advantage of the fact that a lot of her patients are expats on deals like ours - you pay the difference. So everyone is provided with a good level of cover and you have the choice to pay more out of your own pocket if you want to. Which to me seems the best way to manage a healthcare system.

The system means there are loads of appointments, you can see a specialist more or less straight away, and things like test results are available in days instead of weeks - since the labs are private and they're rewarded for their efficiency with more custom as doctors recommend them.

To me, the French system seems ideal - a true Third Way (as Mr Blair would put it). But there is one strange thing about health care in France. I don't know if it's a direct result of the system
or just a thing with the French. But there are a hell of a lot of pharmacies here. If I stand at our front door I can see five. I think I'm within easy walking distance of twenty or so - and there are even half a dozen on the Champs Elysées, which is the most expensive retail space in Europe.

So obviously there is money to be made dispensing drugs here!