>The tale of a toe

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A relaxing Easter break with the family in the Czech Republic? Not a bit of it. The kids are ill and I have a toe injury, which I notice with some horror is badly infected. Time to throw myself on the mercy of the Czech medical service. At the local poliklinika , not totally surprisingly, I am sent away with a flea in my ear – hard faced looking nurse gatekeeping access to the doctor who explains (not totally logically to my hearing) that “We’re private so we don’t know how much to charge and pan doktor is on holiday. Try the hospital”. There’s a big teaching hospital just North of the housing estate where my in-laws live. I have bad memories of it having spent a week hospitalized there about 10 years ago with a mysterious fever, but needs must.

I have, it seems, to go to the Surgical Outpatients Department (chirugická ambulance), which sounds a lot for a dodgy toe, but on the other hand the unforuntate malíček is pretty messy. I end up in an waiting room with 60 people in an impressive (and clean) new annex that wasn’t there a decade ago. Next to the hospital is a building site where a new state archive is apparently being built (partly with EU money if I read the construction boards right). The receptionists are not fazed that I am a UK citizen just passing through and are professional and polite (both to each other and to me), but need to spend 10 minutes phoneing to work out how to process me. They manage it in the end and after about 30 minutes I get to see a doctor, who speaks very decent English – which he is keen to use – and I get examined, treated and told to bathe the foot in an antisceptic solution and come back in two days. He spends almost as long typing up a report in his computer and working out how much I should be charged and how it should all be coded. Then he has to go off to theatre and I have to wait another 30 minutes while someone else sorts it out. I read the History Man, as I can’t face reading in Czech on party systems. They do it, send me off to the hospital’s pokladna, where I pay 264 crowns (about six pounds sterling).

Today when I go in for my check up (seems to be healing but come back next week again) there is a similar pattern. I have to go somewhere else, a sort of “surgicial” Accident and Emergency as it is a Saturday. There are about 20 people waiting, I get seen after about 35 minutes, this time by a young doctor, who is happier listening to my rusty Czech than trying his English, then there are delays as he tries to enter my details into the computer. There are still more delays when I try to pay for the check-up as the usual people are off work, so a middle aged women in a floral dress struggles to process the payment and then has to ring aaround and finally go off and talk to the doctor personally to work it out. She is polite, correct and in the end rather apologetic. Stupidly, we have forgotten the British NHS cards, which might have got us free treatment so someone, not the Czech taxpayer, has to foot the bill for my toe as the Czech Republic has had a European style individual health insurance system since the early 1990s, there is no blanket free treatment at the point of delivery as the UK.

It’s an interesting window in Czech healthcare. Good – and by UK standards – reasonably quick , well qualified and professional medical staff, lots of paperwork, which finally if slowly gets done (rather like the administration of a UK university)and some odd inefficiencies – should a surgeon really be attending to dodgy toe? My mother-in-law acidly remarks that Czechs are simply not this nice and that I have been treated with more consideration because I am English and – this not being Prague – something of a curiosity. There is probably a measure of truth in this. It echoes my experience 10 years ago when I lived here, but at bottom suggests a flawed but decent health service.

Fingers crossed for my toe.

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