So there I sat spooning syllabub listlessly into my mouth whilst some conker-coloured convict was gently haranguing me about the qualities of the marvellous Spanish health system and how the NHS could learn a thing or two from our continental neighbours when my thoughts began to drift to a consultation I had had earlier that day.
"Come in."
Enter a lean and tanned man who I see from my screen should be 73 years old but looks at least 10 years younger. He strides across my room in fluid movements, shakes my hand vigorously and proceeds to sit down.
"Well Mr X , what can I do for you?"
"Oh it's only a small matter Doctor. I am close to running out of my pills and need a new prescription. I've got the packets here." He then proceeded to empty out the contents of a Waitrose plastic bag on to my lap.
A perfunctory glance at the packaging immediately alerted me to their country of origin which was confirmed by the following conversation which also confirmed that Mr X was in transit, staying with relatives in the area before moving to a recently purchased property on the borders of our county. In other words he was what we term, a 'temporary resident', in his case repatriating from a country who national sport is demolishing homes. I commiserated.
Now this portrait of robust health was on a hatful of medication including the usual antihypertensive preventative cocktail but also a diverse number of others for which I could see little evidence in the embodiment of a Floridian tennis coach that sat before me. Not only were these expensive formulations but a couple were transdermal formulations of eye-wateringly extravagance. Yet he assured me that he had been taking these drugs for years.
Now this situation was by no means unique. Especially during the summer months we often find expats returning to the homeland to be with their children/grandchildren. They all run out of their medication. They all come in for repeats. I am always shocked both by what they are on and how little regard has been given to the cost by their European physician. And they all harp on about what a great medical service is provided by their hosts. In truth I have never heard anyone ever say- 'oh I am so relieved to be back in the UK under the NHS.'
So how come the health services in our near European neighbours are so highly regarded by their users? How come their doctors seem to have absolutely no regard for the cost of the medication they prescribe so freely? If the patient is paying then why don't they complain? It is simplistic to say that they just spend more on healthcare than we do. OECD charts for 2011 put us pretty much in the middle of per capita spending on healthcare in Europe. Even if other countries do spend more than us then how can they afford to? Why are their doctors allowed to have such little regard for the penny (cent) savings that our own GPs are strong -armed into making to the point where I am agonising more over the cost of a dug than why it is being prescribed? Or going back to my dinner party; why can they order caviar when I have to make do with fish roe?
I would really love to know the answers to these questions since if we can understand these then perhaps we will be able to understand how to fund our NHS without pressing the panic button every decade.
And the gentleman and his shopping list? I printed out the prescription, of course, and then signed it with a heavy hand.