Last week in a Blogpost on the sad case of Charlie Gard I said I was going to write some comparisons between the health systems on offer in the UK and Spain so here goes…

Apologies. This is a longer than usual post but please stay with it as I believe it is an important one.

This is based on…

My personal experience is limited in both countries – thankfully. From a personal health point of view I have been a national health service outpatient and a private patient. Nothing major but enough to be able to compare the two countries.

Naturally I have also observed the Spanish system through my young son for his regular medical check-ups, inoculations plus the odd illness and subsequent hospital visits. The usual child’s scenario

The Public Sector…

I don’t want to detail all my hospital visits on the NHS but suffice to say when I was doing more sport I had several injuries that required visits to the nightmare that is the Accident & Emergency (A&E) departments of hospitals in various towns. I also know what it is like trying to get an appointment to see General Practitioner (GP). Over recent years I have made similar visits to hospitals or doctors clinics in Spain.

While the NHS in the UK is completely overburdened – at breaking point –  the Spanish public health system, generally known as the Sistema Nacional de Salud (SNS), seems comparatively underused. The appointment booking process is much easier and waiting times are far less than in the UK’s NHS. Even the waiting times in the A&E departments are far less than the infamously overstretched NHS equivalent.

The Private Systems…

In my brief experience of the “private” system in the UK I had several appointments and a scan. The course of treatment also included 10 physiotherapy sessions The cost of my annual premium shot up considerably the following year.

There are so many types of policy I cannot possibly speak with experience on all of them but generally, in order to book an appointment to see a specialist in the UK, requires your GP to make a referral. As I am sure everyone in the UK knows it can take weeks to get an appointment with a GP. This means that there is an inherent delay built into these private policies. This is true for most private policies in the UK – maybe all; I really don’t know. If you know please tell me.

The two systems are not run completely separately in the UK. Doctors, consultants and other specialists spend part of their valuable time between both systems – no doubt with a reasonable amount of travelling time between the two in some cases.

When I was a child this kind of thing was always referred to as “robbing Peter to pay Paul”. Shared resource in the health sector does not work and is one of the key failures for both private and public sector health care in the UK. Both private and public systems suffer as a consequence.

In Spain there is some sharing of consultants/specialists but it is not as widespread. Plus the private hospitals have their own dedicated staff. If you use the private sector you can feel (more or less) safe in the knowledge that you are not using resource shared with the public sector (and vice versa).

There is no A&E for private health care in the UK. If you need to go to A&E then you face a lengthy period of time in the waiting room. Four hours plus is commonplace. That was certainly my experience on the several visits I have had to A&E in UK hospitals, going back over a 20 year period.

In Spain the private health system runs in parallel and completely separate. The health companies have their own clinics and hospitals which includes the equivalent of an A&E service. The waiting times are almost zero when compared to A&E in the UK. Bliss.

I know from experience that on the odd occasion Dani has woken with a fever or shown signs of a rash, within minutes of arriving at the private hospital he has been seen by a doctor.

You can book your own appointment to see a doctor – effectively the equivalent of a British GP. You can book an appointment to see a specialist directly, without going via your own doctor (GP).

Cost comparison…

In the UK a few years ago I was paying over 60 pounds per month for a system that does not include A&E treatment.

In Spain, I would pay about €65 (Euros) as an individual but can get it as cheap as €35 through an employer’s scheme– that’s less than half what it was costing me in the UK. As if that is not good enough the premiums have not increased., despite me having used the system several times.

In Spain you can get fairly comprehensive cover for less than half the price of an average package in the UK. Not only that, you actually get a good, dedicated service with hardly any waiting time, any time of day.

I don’t know for certain how they manage to do it but they certainly seem to offer a much better service in Spain. This is true for both the public and private sectors.

Here is one simple theory.

How? Why?

In the UK the NHS is a national disgrace and needs completely rebuilding in my opinion. Yet the private health service is also incomplete and not fit for purpose. I believe that Spain has a much better health service. Let me try to explain why.

It’s basically a numbers game. In Spain, so many people have private health insurance. This could be as part of their salary package or they will pay for it themselves. The fact that so many people in Spain are using the private health systems means that the numbers using the public system are greatly reduced. This allows the Spanish SNS to cope far better than the overburdened British NHS can ever dream of doing. I realise that many people have similar deals in the workplace in the UK but those schemes are nothing like the Spanish private health system as explained above.

The appointments process is not only more efficient in Spain – for both public and private systems – but there is far less waiting time when you arrive at the clinic/hospital. Again, this applies to both private and public services.

The Spanish private health system is what private medical insurance should be; and that is probably why it is so widely used in Spain. The biggest argument against private health care in the UK is that the NHS invariably suffers. The Spanish systems prove that this does not have to be the way.

Puzzling…

One thing puzzles me however. What is going on in the world of Radiology? What is it about that occupation? I have had x-rays in both countries and even in Spain the wait times are grossly out of proportion to all the other services. If anyone reading either works in radiology or knows someone who does, please let me know why this is.

Original Expectations….

I said when I started this blog that Dani might expect the best of both worlds. In this case I believe he has the best two options simply by being in Spain.