Health: Relax, this isn't the National Health Service: Jack Holland was in luck when he had a suspected epileptic fit: he was in Germany at the time

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Like Lotte Hughes (Health, 25 June) I recently had something very similar to an epileptic fit. The descriptions are almost identical: one moment I am placing a glass of water on my bedside table, the next I'm on the floor having severe convulsions before lapsing into unconsciousness, blood pouring from my mouth as I bite off the tip of my tongue.

I remember nothing of this: my first memory is of being stretchered into an ambulance by two burly men while my girlfriend holds my hand. 'You've had a funny turn,' she says with unnatural calm. 'Don't worry, we're just popping along to the hospital'.

The difference is that I am in Germany. Compared with the all-pervasive gloom of the National Health Service, I could be in the sick bay on the Starship Enterprise. On arrival I am wheeled into the sub-intensive care unit and a team of nurses and doctors begin EEG (brain) and ECG (heart) tests, organ function analyses, a range of blood, reflex and co-ordination tests, while I am encouraged to recount every illness I have had since childhood. The doctor in charge apologises that the ultrasound and CT (brain) scans will have to wait till the morning, and assures me that this pre-mortem inquest is routine for someone suspected of having an epileptic fit.

The following morning I wake up in a three-bedroom ward that is better than some hotel rooms I've stayed in. The doctors arrive on their rounds and smile when I ask if I can leave after my scans. Epileptic fit or not, they would not dream of letting me out until they are confident I am fully recovered. Perhaps tomorrow? One week minimum, they say.

In fact, I was in for 11 days - a fairly routine stay for someone suspected of having a fit, I later learnt. This gave me time to explore. Though built at the turn of the century, the 520-bed hospital, St Joseph's Krankenhaus in Tempelhof, Berlin, has none of the decaying misery of most big NHS hospitals of that era. What it does have are state-of-the-art equipment, a gym, a swimming pool, masseurs and beautiful gardens. The rooms are bright and freshly decorated, and never hold more than four patients.

The staff enjoy working conditions unheard of in Britain. Few of the 400 nurses work more than 40 hours a week and all enjoy the six weeks' paid holiday standard to every worker in Germany. On average, each of St Joseph's 100 doctors works around 50 hours per week, never more than 60. Salaries are 30 to 50 per cent higher than those in the NHS. This goes a long way to explain the staff's relaxed and uniformly cheerful attitude. German doctors and nurses have the time to fulfil their roles as carers - roles pretty much extinct in the NHS.

An example of this was Ali, who shared the room with me: he was 70 and suffering from a chronic illness that had resulted in obesity and was complicated by pneumonia. He was also deeply depressed, seldom speaking to me and taciturn even with family visitors. Yet the nurses and doctors would sit and talk with him until they had made him laugh, in an attempt to alleviate his despondency. Later I learnt that, as a matter of course, patients who received few visitors were given greater attention. Perhaps most remarkable of all was the fact that the Germans, not the world's most tactile people, were constantly touching patients, shaking and holding their hands, and clasping shoulders in encouragement. Ali was given a 45-minute massage each day, purely, he told me, to help cheer him up.

A further eye-opener was St Joseph's diagnosis of a problem I have suffered from since 1987, when my GP noticed liver spots on my hands and sent me to a large south London hospital with a nationally famous liver clinic. There I was told that my liver was severely enlarged - the result, they assured me, of too much alcohol. This seemed odd, since I am not a heavy drinker. I was instructed to stop drinking completely for six months, while the consultant continued to administer liver-function tests and, eventually, a biopsy. Every six months or so I go to the clinic, where I am lectured on the dangers of drink.

When I mentioned this to the doctors at St Joseph's the tests were repeated, and, for the first time, my liver was checked using an ultrasound camera. With this they discovered that I had had an infection of the urinary tract which had temporarily damaged my liver and kidneys. The doctors at St Joseph's succeeded in diagnosing my complaint in around five minutes - something their London counterparts had been unable to do in six years.

The cost of all this to me was my signature on an E111 form, which guarantees free (or, occasionally, reduced cost) health care for residents of the European Union while holidaying within the EU. The German health service itself is funded by insurance companies which take the premiums - ranging from 6 to 7.5 per cent of salary - direct from employees' monthly pay cheques; employers pay an equal amount into the scheme. The unemployed or those living on low incomes have their insurance premiums paid by the Arbeitsamt, part of the German department of social security. Higher premiums provide for more elaborate services and facilities. The cheapest basic 'safety-net' level of insurance is provided by a company called AOK: provided you have an E111, you are entitled to the benefits AOK offers.

As for me, two 'deep' brain scans eventually revealed traces of the tiniest of haemorrhages rather than the an epileptic fit. It is unlikely that my local hospital in London would have - or could have - provided me with a fraction of the diligence and care I received in Germany, and I would never have known the true cause of my fit.

I left feeling better than I had done for years, but raging at the fact that were it not for political stupidity and dogma we, too, might have a health service that people in Britain should have - and used to have - as their right.

Jack Holland is co-founder of the Rough Guides, and author of the titles to Berlin, Amsterdam, New York and Holland, Belgium & Luxembourg.

The E111 form is available at post offices.

(Photograph omitted)

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