3 AUGUST 2002, Page 22

FRENCH BREAK

James Hughes-Onslow found that it was almost a

pleasure to spend five days in a French hospital after breaking his ankle on holiday

WHAT is the most worrying news that a French doctor can give a British patient languishing in hospital in France? Just tell him or her that they're well enough to be sent home for treatment under the NHS.

This is no joke. British holidaymakers are now so alarmed and depressed by deteriorating conditions in the NHS that, when taken ill in France, they choose to stay as long as possible in French hospitals rather than be flown home, even when this option is available to them under their insurance cover.

French doctors are constantly surprised by this, given that NHS treatment is supposed to be free on demand, whereas their own hospitals involve mountains of paperwork, receipts and insurance claims. They notice that whereas patients from Germany, Italy and especially America like to return to their home comforts, the Brits seem to regard this as a death sentence. Sometimes they are accompanied by their families, at great inconvenience to all concerned, and in many cases they return for subsequent treatment to the hospitals where they have had operations, rather than allow British doctors to make a hash of it.

The greatest fear a British patient has is that, once he has been sent back to the squalor of the NHS, he may pick up a secondary infection. I had a modest insight into the workings of French hospitals recently when I broke an ankle outside a swimming pool in the Alpine resort of Vaujany and spent five days in hospital in Grenoble. As a patient equipped only with schoolboy French, one is not especially well placed to make a detailed assessment of the French health system. How do you judge the skill of a surgeon when you are unconscious on an operating slab? How do you know if the cleaning and paperwork are being done properly when your leg is in plaster and you are attached to a bed with drains and drips? Some things are obvious, however. You can see when doctors and nurses are working together in harmony rather than strutting around the wards like characters in a Carry On Doctor film obsessed with an old-fashioned pecking order. It's a curiously British phenomenon, where consultants seem to have equal contempt for nurses and patients. French doctors give patients straight answers without patronising them or playing to a gallery of medical students.

In France all the staff wear the same white overalls. It could be a nurse, an anaesthetist or cleaner at your bedside, and they all work as a team to help you through. Nurses seem happy to help clean the bathroom, to find a plug for the basin or a bulb for the bedside light. It's not too infra dig to help someone else with their work. Who knows, maybe the cleaners stand in for the surgeons from time to time. If so, they do an excellent job.

The wards are clean, and in Grenoble this was made easier because each ward had two beds and a bathroom. There wasn't the feeling of communal squalor that 1 have encountered in British hospitals — in the last three months I have had 17 appointments in four London hospitals for a variety of ailments. Perhaps above all, the food is as good as in a moderate French restaurant. They have a healthy variety of fruit and salads, cheese and seafood on the menu.

From my elementary conversations with French doctors, they seem generally to be no better paid than their British counterparts. And, contrary to the assertions of Messrs Blair, Brown and Milburn, the improved service seems to have very little to do with money and everything to do with attitude. In Grenoble, of course, they are specialists in mending broken bones, the results of skiing and mountaineering accidents. A young man in the next ward, an accountant from Edinburgh, had two badly broken legs, a broken arm, six broken ribs and four cracked vertebrae. His mother had flown out to be with him and was not looking forward to his return to Scotland. He told me his recurring morphine-induced dream was that he was on a television quiz show, that he was constantly under the spotlight but never seemed to win any prizes.

My own drug-crazed fantasy was that I was in a modern, efficient British hospital that had been cured of its dreadful malaise by Mr Blair's magnificent government. According to my dream, the trick had been not to pump extra funds into the NHS but to starve it of cash, forcing bureaucratic fat cats, paper-pushers and self-important consultants to find work elsewhere. But sadly I awoke to find it was not true.

An English woman whose husband had suffered terrible head injuries in a mountain fall, leaving scarcely any bones in his skull and face unbroken, said her worst nightmare was that he might be flown to the hospital in Somerset where her motherin-law had recently been taken with ulcerative colitis. There were open urine bowls made of cardboard with rudimentary pencilled labels in the bathroom, and every time her mother-in-law, who was partially sighted, went to the lavatory she accidentally kicked one. She picked up two urinary infections, in addition to her original troubles, in three weeks. There was a constant change-over of nursing staff, so that there was no one to give her continuous care. She was more worried about her motherin-law with her unnecessary infections than her husband whose skull had been skilfully reconstructed with metal plates by French surgeons.

The hospital in Grenoble has a maison familiale, a kind of guest-house for the relatives of patients. The food was good, the rooms were clean and morale was high, considering the dreadful chapter of accidents that had befallen their loved ones. There were few complaints. It's a singular advantage of being a patient in a foreign hospital that your family is killing time hanging around the hospital looking for trouble. Nothing goes unnoticed when you have such a team of experts in attendance. Yet few could find fault with the treatment in Grenoble. I doubt that it would be the same story in any NHS establishment.

James Hughes-Onslow is a reporter for the London Evening Standard.