Castleden C M
University of Leicester.
J R Coll Physicians Lond. 1994 Sep-Oct;28(5):434-8.
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.
总体而言，英国的医疗体系比德国的更好且更便宜。遗憾的是，人们需要走出国门才能体会到我们的体系有多好。英国医疗服务的财政问题与德国并无二致，只是德国医疗体系的成本要高得多。德国初级医生的培训不如英国，过早引入了过度专业化。医院或学院代表没有对初级医生进行监督或辅导，学院代表没有对职位进行审核，职业晋升往往掌握在一位顾问手中。有证据表明德国医生人浮于事，同时存在广泛的失业现象。德国的老年护理服务除了重视对老年人护理这一观念外，没什么能教给英国的，而英国更完善的体系可能已经忽视了这一点。德国最好的康复中心非常出色，有幸入住这些机构的患者比英国类似中心的患者能得到更好的治疗和设施。急性神经科服务令人印象深刻、积极且深入，但没有为患者提供后续服务。有些做法可能制造的问题比解决的还多。德国对研究有着广泛的兴趣，不仅在大学，在社区医院也有相当多的专业知识，并且非常渴望与英国合作。德国和英国的医疗体系之间有许多有趣的观察和比较，双方都能从借鉴对方的理念中受益。
