14 March 2024
THINGS COME IN THREES
12 March 2024
MOVING TO FRANCE the French health system
Unlike the UK NHS, health care in France is not free.
Certain items are not free in the UK either, such as eye care, dental care and medications, except in circumstances due to one's age or financial situation. Generally, GP appointments, hospital appointments, operations and all free in the UK. They are not free in France, although there are exceptions for people with certain chronic conditions and those with a low income where the cost is effectively free.
(There are those that would argue that the NHS isn't actually free as people have no choice in paying National Insurance all their working lives in order to pay for it. A similar system of Social Charges also exists in France.)
The French health system is essentially one where the government contributes part of the cost and it's up to the individual to pay the difference.
Once we had been in France for ninety days we were entitled to apply for a Carte Vitale. This we did by presenting ourselves at the local office of CPAM, the Social Security service, in Tours. We first went to ask for an appointment to do this. At the appointment we had to present the usual set of documents including proof of identity, residence and income. The Cartes Vitales arrived a few weeks later. In the meantime we paid for all our health needs and could claim the money back from the UK.
The Carte Vitale is an actual credit card sized card which we now present at every appointment or at the pharmacy. With this card the French government pay 70% of the cost of everything (but pass that cost back to the UK for its citizens) and it's up to the individual to pay the remaining 30% or take out an insurance to cover it. This kind of insurance is called Mutuelle Assurance.
(Visitors to France and people on holiday will not have a Carte Vitale and pay the full amount. In return they receive a claim form to send to the DWP for a refund or claim on their own travel insurance.)
A consultation with a GP (Médecin Générale) costs around 25€. With the Carte Vitale 70% of this will be refunded to the individual's bank account by the Government and the rest by the Mutelle Assurance. People are not obliged to have a Carte Vitale and can pay the full cost of everything if they wish but costs can mount up. Medications are surprisingly inexpensive and in fact often cost much less than the basic UK NHS prescription charge.
There are dozens of insurance companies offering Mutuelle Assurance and choosing one can be complicated. The interesting thing is that, unlike the provision of private health insurance in the UK, existing medical conditions are not taken into account. The annual or monthly premium seems to be determined by a person's age and location and no questions about medical history are asked.
One thing we really like about the French system is that having registered with a local GP we can get appointments within a very short time and see the same person each time. This is much better than the situation in our part of the UK where the best we can hope for is a telephone consultation with someone we may never have seen or heard of before and may never again. Getting an appointment face to face with an actual doctor in the UK, never mind one you may already know, can be very difficult.
One quirk of the Mutelle Assurance is that people can opt for the level of cover they wish. It's not cheap and typically will cost a couple our age over £1,500 per year in order to have most things covered. Whether or not this is value for money is a gamble as with all insurance. If you never need to be hospitalised it probably isn't but if you do you can end up with a large bill if you don't have Mutelle.
Another quirk is that health care providers can charge what they wish. Many will have a set of fees that are in line with recommendations so that a person who has a Carte Vitale and Mutuelle will have little or nothing to pay. However, some charge more so that Mutelle Assurance providers will offer a level of cover that is much more than the 30% deficit.
One of the curious things is that the process of referral to a consultant is very different from the UK NHS system. In the UK a GP will say he or she is referring you to the hospital and, although you might have a choice of hospital, an appointment is made for you and arrives via the post. In France it's up to you to find a consultant or hospital and make the appointment for yourself. Most of these appointments can be made using a website called Doctolib where most providers and their fees are listed.
One of the disappointments we have found is that once referred it can take a long time to get an appointment with a consultant or hospital. It seems that the French system is oversubscribed just like the UK one. Many people find it impossible to get registered with a dentist in France, just like in the UK. However, everyone I know who uses the system is full of praise for it and from our experience it does feel very much like a private health system but without the extortionate cost of similar private health care in the UK.
9 March 2024
AN UPSETTING EXPERIENCE
This photo has nothing whatsoever to do with what happened.
It's been a funny old week chez nous. We have dealt with numerous things that range from annoying to downright silly but something happened today that was quite unsettling. Upsetting in fact (for me anyway).
We are on the lookout for some new lights for the kitchen and I went along to the huge barn that sells antiques/vintage stuff in Mairé. My friend Alison came with me.
On the way there we encountered a bit of a kerfuffle on the road on the straight part of the route between Le Grand-Pressigny and Barrou. A car had stopped and a young couple were trying to catch a dog that was running about loose in the road.
I have to say that we see loose dogs here in France much more often than we ever do in the UK. All kinds of dogs from tiny fluffy lap dogs to huge guard dogs. They seem to escape from their homes with amazing regularity. It's unusual for a week to go by without encountering an escaped dog somewhere.
This dog was clearly a hunting dog with the usual brown, black and white colouring. It was circling around in the road and whilst being friendly enough and happy to approach people was not going to be easy to catch.
Numerous cars stopped. It's a long, flat and straight stretch of road between two forested areas and two villages and the one place where drivers can pick up speed and even overtake. Not the best place for a loose dog.
I had a spare lead in the car of the type that just slips over the dog's head but this dog, although friendly enough, was careering around and not willing to be put on a lead. I doubt that hunting dogs ever get to be on a lead, or walked, or socialised. In many ways it was surprising that it was so keen to be near so many humans. At one point five cars had stopped to see if they could help and mainly to slow down the other drivers passing by. Several of the drivers had dog treats that they tried to use to capture the dog but it sniffed then rejected all of them.
Eventually a lady said she would call her husband and he would come and get the dog and take it to the Mairie or the vet, which is apparently the usual thing to do. However, it was now Saturday afternoon so I had no idea if that was actually a possibility. With so many other people around and us being the only non-French speaking people we decided to leave them to it and the dog hopefully in safe hands.
An hour later, on our way back home and with no other vehicles around, the dog was still there. We guessed that the attempts to capture it had failed and people had given up and gone on their way.
What to do, what to do? Being short on ideas we thought why not contact the police. Apart from the fact that the dog itself was in huge danger, there was the potential for a serious accident, especially come nightfall. Even if we managed to catch it we didn't know what we would do with it.
We stopped outside the Gendarmerie at Le Grand-Pressigny. To my amazement it is manned every day and by pressing the button and speaking via an intercom we were allowed into the police station to speak to an actual person. I emphasised, in my best French, that it was a dangerous situation and hopefully it made a difference. The young woman heard our story and said she would tell her colleague to go and investigate.
That made me feel a lot better. Dogs are not always treated very well in France (not always in the UK either) and especially hunting dogs. This poor dog was so cute, so friendly, clearly lost and stressed and deserved to be looked after properly. I sincerely hope that a friendly Gendarme managed to catch it, to take it to safety and that it has food, water and somewhere warm for the night, until its owner can be found.
4 March 2024
A WEEKEND OF TWO HALVES
1 March 2024
MOVING TO FRANCE removals and belongings.
For several years our house in France has had everything we need. When we downsized in the UK in 2014 we moved to a much smaller house and most of the furniture we had was too big so everything came to France. We then brought all the furniture from the little holiday home we had in the village as well!
Brexit.......
One of the difficulties caused by Brexit is that the days of being able to bring more or less anything and everything from the UK to France are now gone. Year after year we would bring bits of furniture, tools, paint, plants and gardening equipment every time we came for a holiday. Since Brexit that is no longer allowed. Generally we are only allowed to bring the kind of personal items appropriate for a holiday and a limited value of other stuff. Anything over and above that is subject to import charges.
This is why many UK companies, especially smaller ones, no longer ship to France. The paperwork required and duty on goods is often prohibitive. Equally, anyone ordering goods from the UK is often obliged to pay a disproportionate amount of duty on goods that previously did not apply.
However.......
Because we are actually making France our permanent residence we have a year from the start date of our visa during which we could bring any of our belongings, just like anyone would who was actually moving house (rather than coming to live in one they have had for years, like us!).
Consequently we had a good look at what we had in the UK that we might benefit from having in France and managed to fill the trailer with a variety of things. A few tools, some hobby and craft stuff, a few pots and pans, bedding, bits of furniture and so on. The tedious part was that we had to make an inventory for every item and give its value. Most of it was stuff we had owned for some time and no longer had receipts for, but the information on the French government website states that a reasonable estimate of the value of used items is acceptable. We spent a lot of time writing a list of everything and its approximate value.
We took the opportunity to being extra pillows and duvets. The issue with bedding is that French beds, pillows and duvets are a slightly different size to those we get in the UK. The equivalent items in France vary by just enough that our existing sheets and duvet sets (that we brought from the UK years ago) do not fit them.
So, in my very last trip with the car I brought a supply of replacement duvets and pillows so that when the old ones are past their best and need changing we won’t have to buy a whole lot of new bed linen as well.
Next time……..grappling with the French health service.