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U.K., Land of ‘Brexit,’ Quietly Outsources Some Surgeries to France

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 pounds, or about $ 490 million, a week to fund the N.H.S, the paradox of Britain seeking aid from France is not lost on the French hospital, nor on Mr. Orlov.

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

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The entrance to the Calais Hospital features a flier for the National Health Service, which has been quietly outsourcing some of its surgeries to three hospitals in France. Credit José Sarmento Matos for The New York Times

After years of austerity, Britain’s lumbering National Health Service 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.

To cope, the N.H.S has been quietly outsourcing some surgeries to three hospitals in France for the last year or so. It is a little-known partnership, because the N.H.S. is not eager to advertise the measures it is being forced to take.

But as more people join Mr. 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.

Mr. 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 N.H.S patients a year, officials said.

Mr. 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.”

N.H.S. England’s outsourcing deal has technically little to do with Britain’s decision nearly two years ago to leave the European Union, a process known as Brexit. 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.

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“We don’t understand how you can delay so many operations that make many patients suffer,” Martin Trelcat, director of Calais Hospital, said of Britain. Credit José Sarmento Matos for The New York Times

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

He asked that his surgeon not be told that 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, the 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.)

Britain has about 340 available beds per 100,000 inhabitants, compared with a European Union 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 — Denmark, Ireland 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 N.H.S. England funding is at least $ 5.6 billion below what is needed this year, and that the shortfall will rise to around $ 30 billion by 2023.

But Health Secretary Jeremy Hunt argues that pressures on the N.H.S 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.

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What used to be a trickle of British patients at the hospital has turned into a steady stream. Credit José Sarmento Matos for The New York Times

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 Mr. Hunt admitted that this year’s was the worst, and the British Red Cross declared the situation a “humanitarian crisis.”

Mr. Trelcat, the hospital director, said that 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.”

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

But Calais Hospital representatives said that in private meetings, N.H.S 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 delays are a “sign of failure” of the N.H.S, Britain’s national pride, Mr. 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.

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

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

Either way, he said, “it’s shocking.”

Source: NYT > World

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