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Why are the french crowing?

IT'S the best in the world; France's healthcare system is held up as a model of good practice. But when you look at how the system works, it's not unlike what Mary Harney wants for Ireland. Except for one thing.

"What's important is to make sure that the private sector doesn't behave like a poker player, only interested in the money, and to ensure that they stay focused on the main topic, which is healthcare," says Gabriel Ko.

Dr Ko has worked in Ireland and in France -- he is a biopathologist, formerly the leader of the French junior doctors, and now works for Claymon-Biominis and for the French government.

He admits: "When I saw the salaries of the Irish doctors, I said: 'Oh my God, I should definitely live in Ireland!'" French doctors earn, on average, from €50,000 to €100,000 a year. Not a fortune -- but a solid income.

From the patient's point of view, it's a great system. Everyone over the age of 16 chooses a GP who coordinates any medical treatment the person needs. A visit to the doctor costs €23, and if your doctor sends you to a specialist, that visit will cost you €25, of which 70pc is reimbursed by the Social Security.

There are three 'sectors' of doctors. Sector one includes most GPs. Sector two docs are semi-private and can charge more.

Sector three is tiny -- about 1.5pc of French doctors -- and completely private. This includes a lot of alternative practitioners.

"Sector two means that you will be allowed to charge whatever you want to charge a patient, with a certain measure," says Gabriel. "To give you an idea, in Paris for a gynaecologist in the private sector [sector two], the average charge for consultation would be €60 or €70." Of that €15.10 is reimbursed by Social Security and the rest would more or less be paid by your private health insurance.

You can also choose a specialist not recommended by your GP -- but then you'll have to pay it all out of your own pocket.

Hospital is different, too. "With regards to hospitals, we don't have such a definition of consultants like in Ireland," says Gabriel.

"What we would have is senior doctors, and the majority of the senior doctors are not allowed to ask for more than the hospital would ask of the patient.

"If you're going to the cardiology department or going to the pathology department you would have a consultation or even full hospitalisation, and then you will be charged directly by the hospital. The price is fixed by Social Security.

"Professors or heads of service are allowed to work privately within the hospital -- but this is limited to around two-and-a-half days a week. But at the end of the year the public service look at how much they earned in this private activity," says Gabriel. "Making €1m as a doctor working in the private sector . . . will not be tolerated."

If you're in an accident or taken suddenly ill, you call for help -- but what arrives isn't an ambulance. It's the SAMU (Service d'Aide Medicale Urgente).

This is a specialist team, led by a doctor, which may include nurses and a driver, and is qualified to give emergency treatment on the scene or transfer patients to hospital as needed.

"For the French patient I think the system is quite good," says Gabriel.