Why aren't European hospitals facing a 'winter flu crisis' like the NHS?

Europeans who know Britain well are often slightly bemused by our unconditional love of the NHS, even more so when they hear us insist that it is somehow the 'envy of the world'.

Because, to put it brutally, it isn’t.

Of course they recognise that the NHS is a fine system, that delivers great health outcomes in a pretty efficient and cost effective way.

But they don’t envy it, for the simple reason that they have their own health systems which do much the same, sometimes (whisper it if you dare) even slightly better.

And, crucially, they also do it in a way that is funded almost entirely by the tax-payer and is free at the point of delivery.

Most European voters would tolerate nothing less.

So why don’t the French or the Dutch or the Danish or the German health systems live in the same state of 'perma-crisis' as the NHS?

Why is health policy not the perennial number one political issue, dominating the life of every Government whether of left or right?

This is what I went to Germany to find out.

A few years ago, roughly at the turn of the century, the answer was easy - they simply spent a lot more money.

But after the massive increases in health spending ordered by Gordon Brown, this is no longer the case.

The UK now spends around 9.9% of GDP on health, very slightly below the EU average.

Germany spends 11.1% or so, not a massive gap.

The difference, however, in the condition of their health service is huge.

We visited a major teaching hospital in the town of Aachen, where they too have been coping with a winter flu epidemic, and yet no operations have been cancelled, there are still beds to spare and the A&E department is (compared to some in the UK) an oasis of calm.

How do they do this? Sure, the extra money makes a difference, but so does the way they spend that money.

Germany does not believe that health care must be provided centrally with a minister or bureaucrat in Berlin deciding how resources are to be allocated across the country.

Politically Germany is a federal system, and so is its health provision.

Most of the decisions are taken at state level, and there is plenty of competition.

Roughly a third of German hospitals are privately run, a third run by non-profits like charities or churches, and a third (especially the big university hospitals) run by the state.

The Government picks up all the bills - patients only pay €10 per night for an overnight stay up to a maximum of 30 nights per year, with the poorest not even paying that.

Some people do buy private health insurance, which guarantees them a private room and some comforts, but when I asked a doctor whether it allows them to jump queues as it does in the UK he said: "No. Because there are no queues to jump!"

As to funding it all, Germans pay into a compulsory health insurance scheme, which is in effect a hypothecated tax.

Employers and employees both pay, equivalent to around 14% of salary, which people see coming out of their pay checks every month.

This may explain why they demand - and their politicians ensure they get - a high standard of care.

Germany manages to provide 8.1 hospital beds for every thousand of its citizens, compared to 2.6 in the UK.

It employs 4.1 doctors per thousand people compared to 2.8 in the UK, and there’s a similar sized gap in the numbers of nurses.

Little wonder that they don’t run into the capacity problems that so afflict the NHS.

We spent the day in Aachen with Dr Christian Bach, a consultant urologist who has just returned to Germany after six years working for the NHS in London, Bristol and Newcastle.

He is a huge admirer of his old employers, though he thinks that the pressures on it are now so great that if things get much worse, something will have to give.

He was clear that he believes more money needs to be spent in the UK, but also seemed a bit surprised that when we debate health we seem so resistant to studying and learning how others do it.

And that is perhaps the point: for decades we have looked westwards across the Atlantic at the way the Americans organise their health care, and felt a smug satisfaction that we don’t allow the inequalities and excesses of the US system.

But closer to hand, just across the Channel, a number of countries with a similar social system and spending similar amounts of money seem to be managing health care rather well.

Perhaps that’s where we should be looking.