 Poster: A snowHead
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and the reason GPs do not offer ear syringing any more is because it is no longer an 'essential' service and is now a specialist service. Many still offer it to older patients and pay other providers like Specsavers to provide it, but it is now up to each individual GP practice whether they provide the service or not.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Two things from me.
Firstly, I only have positive things to say about the French health system. They have saved my dads life twice through two separate bouts of serious illness. Their professionalism, urgency and care is the reason why he is still alive today. I'm a firm defender of the NHS but I fear he would have not got what he needed if he was still a British resident.
Secondly, I pay for Benenden Health Care for both the OH and me. I can't afford private health care outright, however Benenden kinda fills that middle ground. I had a persistent ankle issue for many years, to the point where it was affecting my work (being a firefighter, you need to be able to move at the moments notice!). For years, the NHS kept referring me to physio ignoring the fact that I had regular treatment on it via my rugby club physio. 2-3 years I was just going round in circles whilst numerous consultants kept saying it was just muscular, physio will sort the issue. Eventually I signed up for Benenden and started paying the £24 a month. You have to be with them a year before you can claim for anything medical and you need a referral from your NHS Doctor. After booking the earliest appointment (a 3 week wait) and then having to chase them 4 times and another 6 weeks they finally sent Benenden my referral. Within 2 weeks, I'd had a fresh x-ray and MRI on my ankle with the Doctor saying I had a large bone growth which was impinging the movement and nerves. No wonder physio couldn't massage that out! 2 months later (it would have been sooner, but I couldn't take the time off work) I went under the knife and now can happily say all my pain has gone. On the day I went to get my stitches out, I got my NHS initial appointment letter......
No doubt I'd still be waiting for my operation now, a further 13 months down the line.
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You need to Login to know who's really who.
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@Hells Bells, lol - knew somebody on here would be a medic/pro but did caveat it at the outset so sue me!
You kind of missed what I actually said and the question I was asking - if what you say is correct why do Hospitals regularly prescribe much higher doses of drug X when a GP will only prescribe a lower dose? I have first hand experience of this. Why does the label on a bottle of calpol strictly dictate a lower dose to punters when a Hospital doc will administer over twice the amount when a child has been bought into A&E? Please explain why this is the case (other than safety protocols and fear of domestic overdosing) - are GPs / Pharmacies actually restricted to cover their own position? You may have been aware of Euro protocols pre-Brexit . . .have they now changed?
Either way Dr Hans told me my anti-biotic dose was insufficient for my weight / condition - he described it as a 'child's dose' . . .just stating a fact; pls explain why he might of even bothered to say this; to facilitate my provocative nature perhaps? 
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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seems like maybe the Austrians have their priorities right, whereas we are continue to act like pompous victorians
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There is already a cost of living crisis, putting up taxes is likely to cause more problems than it will solve. For those saying they would be happy to pay more for better service that option is already there - private health insurance.
Fwiw I know people that have had fantastic service from the NHS in the last few years. Of course it's not perfect, and you do tend to hear the most negative stories. I have a Brazilian friend who visited, got sick, went to a walk in GP clinic, was seen in less than 15mins and given a prescription for some antibiotics, which were given to her free. Of course she now raves about the amazing NHS. But when your sample size is one random visit it's easy to have a very skewed perception!
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You'll need to Register first of course.
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Dad has recently spent 3 weeks in hospital with various infections, I can't fault the care he received in the Elderly Care ward in our local hospital. He's very much a regular now, as he has Parkinson's Disease, so visits various outpatient departments on a regular basis. Their GP is perhaps the fly in the ointment as they are often quick to dismiss his requests for a home visit if he is unwell, but when he was admitted to hospital, they came out within a couple of hours. District nurses are in and out to check his catheter and potential pressure sores, and there's an occupational therapist that visits regularly with a physiotherapist to make sure he is managing with the mobility aids he has.
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@boarder2020, I think that's a fair assessment and tbf this wasn't intended to be an NHS bashing thread; just more of an 'amazing experience' for something that's dogged me for a long time. Private health insurance is seemingly the only solution for the future in the UK and unless we have a proper revolution it will be impossible to return the system to anywhere near its former glory . . .
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| border2020 wrote: |
| But when your sample size is one random visit it's easy to have a very skewed perception! |
I know it is easy to think that @Belch may have a skewed perspective, obviously they are not going to have a complete picture after one appointment, but the reason none of us who use the service more regularly are arguing about it, is because that was just everyday normal service.
Since we've been here, the two of us have had surgery three times between us. Two of those times were for issues that in the UK neither of us could get a consultation beyond a GP for, and one of them turned out to be a tumor  The other time was something following an accident that is routinely fixed here (indeed I was in surgery a few days later), but I later found out is not repaired by the NHS. They just leave it, untreated. It is not something that would repair itself either, like a broken bone you can cast in place.
The local “no appointment” GP system falls down a bit when more people turn up than slots available, but as you still get seen the same or next day, it's not really a big deal.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Belch I have had exactly the same experience as yourself regarding ones ears in the uk .
Its a uk thing so if traveling get a clean up
Have had the ears done properly the old fashioned way as you describe in at least three other countrys from europe to the southern hemisphere both when infected and/or just blocked .
My experience in the uk is hopeless for your ears ie. exactly as in your experience
You just get sent round the bases and continual reinfection takes place over many months...this is and was the norm in my case.
The NHS is like Herpes in this respect it just keeps on giving !
I have had a small piece of coral in my ear that completely messed me up including my balance ,the coral came from reef surfing .
Yet a old fashioned Canary island doctor fixed it completely in hours he was so careful taking as long as it took.
This was really a operation as the ear felt so swollen it had closed .
In this infected case it required skilled care which I have also seen with french doctors from the West Indies to Canne
As with yourself you see the result in a kidney dish that isnt forgotten .
These doctors in other countrys all had one thing in common which was a personal care ethic both older guys or younger docs often with a sports background seemed fantastic .
So after all that I used my travel insurance to get my ears cleaned in other countrys that actually want to fix the issue at hand .
If your not traveling then you need another uk option which I havent found yet as they just give me ear drops .
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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How does the Austrian system work, @Scarlet? Is it just free at point of delivery and paid for through general taxation, like the NHS?
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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And if we needed anymore evidence to bash the NHS this sums it up totally;
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The NHS is a huge organisation. Yes you will find failings. You will also find many examples of fantastic service and care. I know someone for whom they found a tumor while looking for kidney stones, and he was in surgery less than 2 weeks later. Again some anecdotes are not really representative of what is a huge organisation.
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untreated surgical necessities because its 'policy' based on political or financial dictates
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Well there is a limited pool of money. So at some point you must consider what is feasible. Is an experimental treatment costing £500,000 with a 1% success rate viable? If yes, is it still viable if the person is 90? It's very complicated and a huge question both financially and ethically.
It would be interesting to know exactly what procedure @Scarlet, is talking about. There are many examples where there is some debate about if intervention is necessary and best practice regardless of cost.
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So the GHIC card covers you for any medical treatment in Austria? So only need for insurance is to get you off the slope if injured? Can't quite believe that...? I guess insurance also desired in case of additional stay and repatriation if injuries are so bad....
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You know it makes sense.
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Also, a bit of googling suggests that ear syringing is available privately - it's not clear to me why, with all this pain and difficulty (which does sound absolutely miserable), the OP didn't avail himself of this - it's cheaper than going to Austria.
The topic of "health care rationing" is one I often used in interviews with prospective fast stream civil servants. It's astonishing how many otherwise moderately bright people just say asinine things like "you can't put a price on a human life".
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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@boarder2020, Sensible response and agreed. Obvs the NHS is not all bad; my father died from Bladder Cancer last year and his treatment was tip-top until the last as well as being handled with empathy and efficiency. Prioritisation is the issue IMO - and the layer upon layer upon layer of sticking plasters (ineffective management tiers) to that seem to hinder effective decision making (eg what no matrons / local surgeries etc). No health service is going to get it right 100% of the time irrespective of investment, however applying a little logic (eg the referral Down system) could be a good starting point . . . . .
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Poster: A snowHead
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@riman8, I believe this is correct. When my son was injured in Switzerland in 2014 there was a 'race' for the bloodwagons to arrive (it turned out the winning wagon privateer was related to the local doctor we were exclusively 'delivered' to mmmm) and the broken leg treatment (cast and early return home) was covered / paid for by our insurance.
On the same holiday my sister was rear ended up ze mountain and the offending non-pole clicker skied over her thigh creating a major cut with his edges . . .she was choppered immediately to Interlaken and dealt with at the hospital; EHIC card covered it all - zero outlay
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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@Origen, There is no “Austrian Health Service”. All providers are private companies which vary in effiency and quality. We pay a mandatory health insurance which covers some but not all Services. For employed people this is deducted from the salary, but for self employed people it is self-paid. It is not part of taxation. Many also pay for private insurance additionally to cover more services.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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That's useful, thanks @Mankei. It sounds as though there are no very useful comparisons between the UK and Austrian systems. What is a typical level of mandatory "health insurance"? Does it vary if you have kids? I recall that when Nadenoodlee spoke about the Swiss system her payments were a significant chunk of money each month.
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You need to Login to know who's really who.
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| riman8 wrote: |
| So the GHIC card covers you for any medical treatment in Austria? So only need for insurance is to get you off the slope if injured? Can't quite believe that...? I guess insurance also desired in case of additional stay and repatriation if injuries are so bad.... |
If you are taken to a public hospital the GHIC will cover the cost of treatment to the same limit as locals and you would have to pay the difference. You may be taken to a private clinic where GHIC is not recognised. If you break your leg you would need to pay for extra seats on the flight home. Insurance for all of that
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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| riman8 wrote: |
| So the GHIC card covers you for any medical treatment in Austria? So only need for insurance is to get you off the slope if injured? Can't quite believe that...? I guess insurance also desired in case of additional stay and repatriation if injuries are so bad.... |
What your card does not cover
A UK GHIC (or UK EHIC) does not replace travel and medical insurance or cover services like:
being flown back to the UK (medical repatriation)
treatment in a private medical facility
ski or mountain rescue
We advise that you have a UK GHIC (or UK EHIC) and private travel and medical insurance for the duration of your trip.
and insurance will cover you for unused lift pass days, cutting off / damaging equipment, clothing, etc.
Oh & you need your GHIC on you for treatment. Not left in your purse locked away in a safe in the hotel room... which is what happened with the other half & she had to pay for treatment & claim back via insurance. 
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You'll need to Register first of course.
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| boarder2020 wrote: |
| It would be interesting to know exactly what procedure @Scarlet, is talking about. There are many examples where there is some debate about if intervention is necessary and best practice regardless of cost. |
The one that wouldn't be fixed? Orbital fracture. Apparently it probably wouldn't have been treated in my case, despite me being in quite a lot of pain from having bits of bone lodged in places they weren't supposed to be. There is a risk of damage to the eye/eyesight I believe, though the surgeons here perform the procedure daily (common sports injury) so they get a lot more practice than in the UK. Also a good argument for seeing a local doctor if you are injured on holiday, and not waiting until you get home because it's “easier”.
Regarding private providers, yes, sometimes it is preferable to see a private specialist, sometimes because they are the only ones available. Kassa clinics can be a bit more of a production line. Appointment costs vary – a full eye test with medical checks is about €50, but might be credited against a purchase (glasses are extortionate here because everyone likes their Zeiss lenses), a dental visit with a clean, x-ray and check-up is about €250. However, you can send the receipt to your insurance provider, and you get some of it back, it varies but around 25%-50% rebate.
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The one that wouldn't be fixed? Orbital fracture. Apparently it probably wouldn't have been treated in my case, despite me being in quite a lot of pain from having bits of bone lodged in places they weren't supposed to be.
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Not something I'm familiar with but from the NHS website:
"In most cases swelling and bruising will start to lessen after a week but fractured bones will take longer to heal. Swelling can make it difficult to examine the eye and its movement. Your doctor may decide to reassess you after a week when the swelling has reduced.
If delayed surgery is decided upon it will be for the following reasons:
To remove bony fragments.
To get rid of double vision and free trapped tissue.
To restore the normal shape of the eye socket and eye position.
Surgery is always a compromise between the best access to the fracture and the potential complications of each approach. Exactly what surgery is done depends on the position of the defect, the age of the person and the existence of other related injuries. Your surgeon will discuss what surgical approach is best if you need to have surgery."
So I think it's perhaps an unfair assumption that you wouldn't have got surgery. They clearly do operate to remove bony fragments.
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@boarder2020, Maybe, but the person who told me that is a maxfac surgeon and while they were not my doctor, have seen my x-rays, so I'm inclined to believe them.
I have suffered no negative effects consequently.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Sounds like its a bit patch work and risk taking if you rely on GHIC as there may be a top up cost required v what is covered under the Austrian system (which may differ regionally also?) - particularly in a serious wintersports injury situation and the consequences after (equipment, repatriation etc etc). Perhaps OK for more GP/day surgery type matters. Anyway thanks for the clarity - luckily I have insurance via work anyway which covers the OH and family (OH off to Austria this weekend hence the interest) but always good to know what the local situation is
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@riman8, what is not covered by the Austrian system that concerns you? If you need emergency hospital treatment, the only thing you pay is the overnight bed charge of around €15.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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It sounds as though people in Austria, overall, pay quite a bit more for their health care than many Brits stump up, but it's more affordable than private health insurance in the UK. And private health care is not generally going to cover pre-existing conditions. Or cover some conditions (such as dementia) at all.
What happens in Austria about people with no capacity to pay? And do families look after their "old folk" more than is the case in the UK, where many people in (very expensive) long term care are 100% state funded?
It's hard to compare two such wholly different approaches - especially if Austrians attach greater priority to their health, and are prepared to pay more for it, on a voluntary basis, than in the UK where many folks who could well afford to pay for private ops such as hip replacement will stubbornly suffer for years to get the free treatment to which they feel entitled have paid fourpence halfpenny in tax for 30 years.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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if Austrians attach greater priority to their health, and are prepared to pay more for it, on a voluntary basis,
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From the comments above it doesn't seem like it's voluntary!
It would be interesting to try and quantify how much people prioritise their health. Judging from the average overweight Brit that does no exercise I don't think we as a society really do. But then again I wouldn't consider the average European particularly health obsessed either. A quick Google suggests around 40% of Austrians are overweight and 20% of Austrians smoke daily. Not so impressive imo. There is a certain irony that those that place the highest priority on their health may well be the ones less likely to need so much medical intervention.
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If housing in the UK wasn't so cripplingly expensive, then people would be able to afford to pay a bit more tax after mortgage/rent costs to get towards the quality of public services you find on the continent. The answer to so many problems in the UK is cheaper housing, leaves more money to go towards other stuff.
What are rental/house price-salary multiples in Austria compared to UK?
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You know it makes sense.
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An additional challenge beyond cost, is that people a) are very bad at judging risk, and b) think a good healthcare outcome is one that involves intervention. Combine these two factors, and patients aren't necessarily very good judges of healthcare priorities.
Risk adjusted outcomes often mean that nearly all patients would benefit from procedure X but a small proportion will suffer serious morbidity, and therefore the procedure shouldn't be performed.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Risk adjusted outcomes often mean that nearly all patients would benefit from procedure X but a small proportion will suffer serious morbidity, and therefore the procedure shouldn't be performed.
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I'm no expert but my impression is that NICE are quite good at working all this out, and many - probably most - common procedures carry a significant risk of morbidity. Cataract surgery, for example, which I had yesterday!
It seems from those who are well informed about Austria that whereas all will pay a basic charge, towards basic services, they also can choose more, or less, expensive insurance "top ups" of their own. I'm well aware that many British families can only just afford a roof over their heads and food on the table and that housing is far too expensive. But there are many who DO have a choice, and as in my examples above, put a higher priority on an expensive car, or refurbishment of their houses, and landscaped gardens, than on their health. Lots of us could afford better health care if we gave it priority.
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Poster: A snowHead
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| Origen wrote: |
| Quote: |
Risk adjusted outcomes often mean that nearly all patients would benefit from procedure X but a small proportion will suffer serious morbidity, and therefore the procedure shouldn't be performed.
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I'm no expert but my impression is that NICE are quite good at working all this out, and many - probably most - common procedures carry a significant risk of morbidity. Cataract surgery, for example, which I had yesterday!
It seems from those who are well informed about Austria that whereas all will pay a basic charge, towards basic services, they also can choose more, or less, expensive insurance "top ups" of their own. I'm well aware that many British families can only just afford a roof over their heads and food on the table and that housing is far too expensive. But there are many who DO have a choice, and as in my examples above, put a higher priority on an expensive car, or refurbishment of their houses, and landscaped gardens, than on their health. Lots of us could afford better health care if we gave it priority. |
Agreed - NICE is very hot on this stuff, but not all countries operate in the same manner, and NICE's reach into the private arena isn't as strong. E.g. apparently (at least until recently) some private docs would still prescribe steroids for hay fever. Particularly if you're a top cyclist 
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| snowhound wrote: |
If housing in the UK wasn't so cripplingly expensive, then people would be able to afford to pay a bit more tax after mortgage/rent costs to get towards the quality of public services you find on the continent. The answer to so many problems in the UK is cheaper housing, leaves more money to go towards other stuff.
What are rental/house price-salary multiples in Austria compared to UK? |
Housing isn't cheap here, particularly in the Tirol. We have a "relatively cheap" apartment here, with garden, and we're paying €10 per m2 in rent. In Innsbruck you're probably not getting anything for less than €15 per m2.
If you want to buy something, you're probably looking at needing 20% deposit (certainly that seems the case for non-Austrians).
This site will give you a good idea:
https://www.immobilienscout24.at/
Tax rates here are higher too:
Income (EUR) Tax rate (%)
12,465 and below 0
12,465 to 20,397 20
20,397 to 34,192 30
34,192 to 66,178 40
66,178 to 99,266 48
99,266 to 1,000,000 50
above 1,000,000 55
Although there seems to be all sorts of random things you can claim back tax against. For example I can reduce my monthly taxable income by €128 for commuting to work.
On top of that, you can see where you tax money is going, not sure i've come across a pot hole in the 7 months we've lived here. Virtually every village and town has a communal music facility for whatever local music groups to use to practise.
Public transport is peanuts, I can travel around the entire Tirol unlimited on public transport for €43 a month.
Last edited by Obviously A snowHead isn't a real person on Thu 7-03-24 21:23; edited 1 time in total
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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| Gored wrote: |
| Oh & you need your GHIC on you for treatment. Not left in your purse locked away in a safe in the hotel room... which is what happened with the other half & she had to pay for treatment & claim back via insurance. |
Not quite true for me but agree carrying it all times is the sensible thing to do on ski hols - I cheekily flashed my out of date 2016 EHIC and they spotted the date immediately like I was an underage drinker attempting to get into a nightclub; I've had 2 email comms since confirming that as soon as I receive my new GHIC and scan it all will be resolved - no agg / no threatening bills!
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You need to Login to know who's really who.
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£10 a square metre sounds very cheap to me, compared to UK costs. My 2 bedroom apartment in France was 40 square metres. A 2 bedroom maisonette, in my road, has just gone on the rental market for £1350 a month. Let's say it's 60 square metres (and I suspect it's less, but annoyingly this is not a common metric in the UK) but that's far more. It's nicely located - there would be similar places cheaper, but two bedroom flats seem to be at least £1000 a month. Cheaper in less desirable parts of the country, a lot more in London. My lodger pays £550 a month for one room. Which is less than the going rate. It's a lovely waterside room, he has a free mooring and people pay that for pretty grotty rooms.
I do think the cost of housing is a real problem for a lot of families, even with decent jobs and two parents working. But I also think some people give greater priority to having smart cars than for paying for health interventions!
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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@swskier, Interesting, if you add NI to income tax though, the rates (certainly until until the 48%) don't look too different to ours. VAT 20% as well? They are the big three in terms of tax take in the UK. Do you know the overall tax as % GDP in Austria which is probably the best measure of overall tax take.
I wouldn't mind paying more tax if it seemed like you got something decent back for it. Overall tax/GDP has gone from 33% to 37% in the UK but services have actually declined.
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You'll need to Register first of course.
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@Origen, some people don't want to consult doctors privately on principle. I have one such committed socialist, retired NHS medic friend.
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@Origen, If housing took up 30% of salary rather than (say) 40% (more for many I know), then that is another 10% which would be saved, taxed a bit more or spent, thereby boosting the wider economy. Instead it goes to individual landowners who hit the planning permission jackpot.
+1 though as well for people spending money on flash stuff when they don't need to.
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| swskier wrote: |
Housing isn't cheap here, particularly in the Tirol. We have a "relatively cheap" apartment here, with garden, and we're paying €10 per m2 in rent. In Innsbruck you're probably not getting anything for less than €15 per m2.
If you want to buy something, you're probably looking at needing 20% deposit (certainly that seems the case for non-Austrians). |
True dat, probably more, though in our case it does include the gas heating bill, which is minimal in a triple-glazed modern apartment, so a like for like comparison with the UK is tricky. Buying is not only incredibly expensive, around €10,000 per m2, but the market is small, slow and the return lower than the UK.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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@snowhound, if you're adding NI then you'd have to add the health care costs here as well to give a comparable calculation.
Pensions seem different here too. Employees have to pay 10.25% and employers pay 12.55%. Pension pays 80% of career average earnings for 45 years contributions and is on a sliding scale down to 15 years. I.e 1.78% per year you work. So the smallest pension you'd get is roughly 26.7% of your average wage.
Private pensions through the workplace seem less common, although we have a small contribution which then pays out a lump sum on retirement apparently. Don't know too much about it tbh.
There's also no (as far as I can tell) tax beneficial savings/investment accounts like ISAs over here, so you'd end up paying more capital gains tax on invest/savings.
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@Hurtle, yes, I rather admire the refusal to pay for any private formal health care (which probably goes along with refusal to pay for private education) but many people who refuse to go private are not doing it out of any sense of equity, but because other expenditure is more important to them (the cost of my husband's triple by pass was about £18K (2002, it would be a lot more now) similar to the cost of a kitchen refurb or a new (not luxury) car.
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FAQ
