A visit to Germany. Report of a medicine-Gilliland travelling fellowship.
Overall the health system in Britain is better and cheaper than that in Germany. It is a pity that one needs to go away to appreciate how good our system is. The financial problems of the health service in the UK are no different from those in Germany except that the cost of the health system in Germany is much greater. The training of junior doctors is not as good in Germany as in the UK and overspecialisation is introduced too early. There is no supervision or counselling of juniors by hospital or college representatives, no vetting of posts by college representatives, and professional advancement is often in the hands of one consultant. There is evidence of overmanning with widespread unemployment amongst doctors in Germany. Geriatric services in Germany have little to teach the British except for the concept of the importance of care for the elderly which our more acute systems in Britain might have lost. The best German rehabilitation centres are excellent and the lucky patients who are in such units have better treatment and facilities than those in similar centres in Britain. The acute neurological services are most impressive, aggressive and intensive but have no follow-up service for patients. Some practices possibly create more problems than they solve. There is wide interest in research in Germany, with considerable expertise not only in the university but also in community hospitals, and a great desire for cooperation with Britain. There are many interesting observations and comparisons between the Germany and British systems, and each could benefit from incorporating the other's ideas.
Castleden
C M
CM
University of Leicester.
D002561:Cerebrovascular Disorders / Q000628:therapy; D003695:Delivery of Health Care; D005853:Geriatrics; D005858:Germany; D006801:Humans; D012106:Research