Wednesday, 4 July 2012

The european union at work; getting healthcare in France

Following my previous three posts (What if I die before I get old?) my husband Dave now takes up the story of our struggle with health system bureaucracies.

At then end of 3 months of chemo the lumps (secondaries) in Jill's stomach had gone down, so we had two choices -
- whether to have another 3 months chemo
- if so, whether to have it in England or France
Difficult decision; commit to staying in the damp drizzle of a cotswold spring or the sun and vin rouge of the Languedoc.
So after her March celebration in Chippy we phoned the medecine generale (Gp) in Bizanet and asked how we'd get chemo treatment there.
'Simple; just come and see me, I refer you to a specialist, he'll see you in a couple of days, off you go'.  'Pardon; a couple of days - you mean a couple of weeks, surely?'  'Mais non'.
I'd looked at the NHS website which confirmed all EU citizens (that's us) can choose to obtain their healthcare in any EU country, talked about 'possible' reimbursement and directing us to to the CPAM (social security) office in france.  It didn't look too difficult.
The local Dr Azemar referred us speedily to the Narbonne polyclinique which delivered chemo.  They assured us that cancer treatment was paid for '100%' by the state provided you had a social security number.  So down the CPAM office we go - 'your main residence is England but you have a house here - you have proof of ownership? then we can give you a social number'.  Easy; we bring that back next day with passport and other id.  'Ah, now you need an S2'  'What?'  'le S deux!'
Nobody mentioned that.  I ring the international health team in Newcastle and after spending a couple of half hours listening to music someone finally answers. 'Yes, every EU citizen has the right to access healthcare where ever they are.  If it's an emergency use the EHIC card; if it's an existing illness (like cancer) you need an S2'  'We'll have one of those please'  'But you're already in France?  Oh no. Very strict procedure for S2.  Your UK consultant has to agree the treatment you would have had here, write to your local health commissioner who writes back to us, and if we agree we send it to your UK address.'  'Can't you send it to us in France; that's where we are.'  'Of course not; you're registered with the NHS in UK'.
We call our friendly Chippy GP, who seems uncertain who the local health commissioner is in our brave new super choice world, but she finds out who to call a lot quicker than I did and the S2 gets emailed to us in just a week.
When we return to CPAM the woman whose office we huffed out of last time calls a rugby player look alike who doesn't like our assertion that we've been asked for different things each time we visit, that the french ss 'marche bien' and you mess with bureaucracy at your peril.  He ticks off every bit of paper, we think we're there, and he says 'you have a bank account in France?'  'mais oui' says I.  'In your name? not your wife's? the treatment is for your wife, so there must be an account in her name into which we can pay reimbursements.'  'Can't you just use mine?'  'Monsieur! You think we have a revolution for liberty, equality, fraternity so you english types can come here and trouser your wife's money off our state?'  This was of course conveyed not in words but a minute, yet distinct, raising of the right eyebrow.  'Right.  We'll go and open a bank account then.'
By now we're a little anxious because we've booked chemo to start and would really like everything in place.  Into the Credit Agricole branch where I opened my account in 10 minutes a few years back 'Banks much more careful now - crisis, you know.  You must have a rendezvous to open an account and bring all these bits of paper'  'Ok, but it's urgent'  'How about a week next Friday'  'No, URGENT urgent'  'Ah.  Monday morning then'.  So after a pleasant half hour with Gael; 'I like England - work as barman in Birmingham' we finally become signed up recipients to the french health system - and I have to say, once you've got the paperwork, the medical lot do things quickly and efficiently - but that's another story  .   .

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