I love French bureaucracy

I was hugely relieved when I left the CPAM offices on Thursday morning with a French social security number. This means that all the health care I arranged earlier in the week will be paid for and if I have any hiccups with my health – however serious – all I have to worry about is getting better again.

We were both impressed by the efficiency of the French system. It is different from in the UK, so could be confusing, but does have similar values to the NHS in that the number one priority seems to be the patient getting the care they need.

Some of this efficiency comes down to there being plenty of civil servants staffing the various offices. Each time we’ve needed something sorted out, it has been done there and then on the phone or by hand-written letter.

The new French president is a great admirer of how the British have cut back their ‘inefficient’ state bureaucracy over the past 25 years. However, efficiency for me is getting the right help or advice when I need it – something the UK system struggles to deliver via centralised call-centres or overseas secretarial services.

There is also a strong commitment to giving all people with long-term health conditions 100% free care which is actually better than the UK where we have to pay for our prescriptions as well as dental and basic eye care.

So, I now have a provisional social security number and that will be transformed into a Carte Vitale over the next few weeks. I’ll need to take some photos and my passport back to the office after I receive a letter from them. I’ll also need to go back to CPAM to get a French EHIC card, it being done face-to-face here rather than by post.

Having left CPAM, we spent a couple of days relaxing, visiting the city’s botanical gardens and then taking a day-trip to the seaside on Friday. Although we were both tired – physically and emotionally – after a busy week, it was important to start having a holiday.

We’re now having a very restful weekend to recharge our batteries and to plan a more normal week. There is also the end of the Tour de France which, I guess, helps us to close the first chapter of our time in France.

Liberté, Egalité, Fraternité

By far the most worrying aspect of coming to France for a year was the uncertainty around getting my health looked after. I was unable to get any straight answers from the UK authorities and French guidelines seemed clouded by M. Sarkozy’s political bluster.

In the end, my decision was to come here, tell the UK authorities that I wanted to transfer my health care cover to France and present myself to the French health care system and see what happened.

Yesterday I was guided through applying for a French health care card (Carte Vitale), registered with a general practitioner and arranged an appointment with a gastroenterologist.

Today I saw the gastroenterologist, had a very thorough 45 minute consultation and booked an appointment to receive my first Remicade infusion (it’s definitely Remicade rather than Infliximab here) on 14 August at the University Hospital.

So in just over 24 hours I have all the medical support that I had in the UK. It is so unfortunate that all the messages I got from the UK authorities suggested the process would be difficult and “may take months”.

Had the process actually taken months there would be no way someone like me, with ‘severe’ Crohn’s, could even think of living in another EU country – unless some insurance company could be found to provide cover and then a premium of perhaps £10,000 or more could by paid.

There may, of course, still be hiccups with the Carte Vitale. I shall find out on Thursday. However, I get the impression that the civil servant we saw on Monday will help me through the process because he understood the important of me receiving the health care I need in order for me to live as healthy and fulfilling life as possible.

Perhaps it is something about the French ideals of Liberté, Egalité, Fraternité that filter through the French state and give me a sense of having been treated as a human being. Yes, there are also mountains of paperwork and a different type of bureaucracy to understand and navigate through, but I really don’t mind that.

I am going to write up exactly how I have negotiated this forbidding hurdle and post it somewhere on this site – maybe it will help other people who want to try something similar to this year in France but are put off by scaremongering.

One final thing. When I asked the gastroenterologist what I should do if I needed urgent medical attention, he said I should get to the 24 hour emergency department at the clinic and the staff would call him. He said he lived very close and it should only take him a few minutes, a little longer if it was at night and he was asleep.

Finding a doctor

The health system works quite differently in France, as we found out today. After waiting for ten days for the UK civil service to send me an E121 form I was now able to approach the French health service (CPAM) to register with them.

We turned up at the CPAM regional office in Caen around 10am, explained what we wanted at reception and received a number – 42 – which was called shortly after.

We were dealt with in a friendly but thorough fashion by a civil servant who spoke a little English which he used to put me at ease and spoke mainly in French with Becky.

It took a short while for us to explain why I needed to register with the French health system rather than use the European Health Insurance Card (EHIC) – because I have a long-term health condition that requires regular assessment and treatment by a gastroenterology team.

This was all understood and accepted. We were given a form with which to register with a GP or généraliste and the details of how the payment and refund system works were explained to us.

I was then asked to return on Thursday with the completed généraliste form, my birth certificate, bank details and my E121. After this the registration process will be completed and I will be issued with a French health insurance card or Carte Vitale.

We left by 11am and after a bit of shopping, lunch and a rest, we headed out to make an appointment with a local généraliste. We asked about local doctors at a pharmacy and were directed to a practice nearby with three doctors. We were asked to wait and saw a doctor after about 20 minutes.

The doctor was fantastic and understood all about Crohn’s disease, Infliximab infusions and the need to keep an eye on my general health. He didn’t speak any English, but our communication was very clear.

I left with a repeat prescription to take to the pharmacy and a blood test form to take to the local lab. He also hand-wrote me a referral for a gastroenterologist at a local clinic and suggested we run it up to the clinic and make an appointment there and then. Doing it all by post could mean we get caught up in the August holidays when everything shuts down for a month.

We walked the 300 yards to the clinic – more of a small hospital, complete with A&E – and made an appointment with the gastroenterologist for tomorrow morning. Okay, not everything is sorted out, but I am still stunned by what we did today and how helpful and understanding everyone was.

We're going on a slipper hunt

When you’re packing for a trip like this there are inevitably some things you decide to leave behind. Coming to a place like France, you assume that the shops are full of similar stuff to the UK. Like slippers, for example.

I would struggle to survive without a pair of slippers to wear around the house. When we were packing, I had a new pair and a nearly-new pair to choose from, but as we were bringing only what we could carry, neither of them got packed.

I wasn’t too bothered about what sort of slippers I found in France, although I would prefer some sort of moccasins or something with a little bit of simple style – I do love the Simpsons, but I would draw the line at pair of Homer slippers.

After ten days of keeping an eye out for slippers, I went on a very thorough slipper hunt today. I’m not sure if French people understand the concept of slippers in the same way as we do in the UK. There were leather sandals at €50, flip-flops and Crocs™. Galleries Lafayette had a pair on sale that were a long way the wrong side of my Homer Simpson line-in-the-sand.

We tried a Chinese supermarket where the owner understood what we were getting at, but his small supply of canvass shoes were only in women’s sizes. So we arrived home without slippers.

I now have a number of options. One is to ship in slippers from the UK. The other is to utilise options that exist in France like Kung Fu slippers or espadrilles. I haven’t seen any martial arts shops in Caen and this could be another fruitless search. However, I did see some espadrilles somewhere in the past ten days. The only problem is that I can’t remember where.

Rest is the best medicine

There is always the temptation when I’m holiday to think that my health problems haven’t come with me. Often my symptoms are less of a problem, but they are still there.

We’ve had a busy ten days since we got here and very busy and hectic time before we departed. I have taken care of what I’ve been eating and we had a good rest last weekend. Yet I am really tired and that’s often an omen for my bowel symptoms to flare-up.

Being so busy, excited and stressed has meant that I haven’t been sleeping too well and have been missing out on my 30-60 minute lie-down that I should have each afternoon. So it is time to reinstate proper rest and look after my body.

Resting in the afternoon should really not be a problem – most things shut down for at least a couple of hours for lunch and there is the Tour de France to watch at the moment. Also, when the summer finally arrives it is going to be hot in the afternoons.

The last few days I have watched the Tour de France. I have turned on the TV with about 100kms of the stage to go, laid down on the bed and usually woken up as the riders go through 10kms. As they have been flat stages, it has been the finish where the main excitement happens and they have been really exciting finishes.

So for the next week I can plan my rest around the cycling and hopefully by then it will have become an established pattern in my day.

Le camion théâtre

We have swapped our lives in the UK for something new and exciting in France. Yet, moving away from our families and friends has left a gap in our lives and probably theirs too. Of course we are hoping for plenty of visitors, but, for the moment, the telephone is our way of filling that gap.

Both of us have spent a lot of time on the phone since our ‘Numericable’ cable package was activated on Tuesday. It is a brilliant package with unlimited phone calls to fixed lines in France, Europe and North America. This means we can keep in touch with family and friends by phone as well as by email, text and instant messaging.

Now we have been here over a week, we will inevitably start to drop into some kind of routine. Shopping needs to be done, clothes need to be washed and the apartment tidied and cleaned.

Today was my first trip to the launderette. I can’t remember the last time I had to wash my clothes in a launderette, but it could be nearly twenty years ago. I’m blaming that for my total bewilderment and inability to follow instructions, because the French was actually quite easy to understand.

I have a student who spoke some English to thank for pointing me in the right direction and I now feel that I am perfectly capable of doing the laundry for the next year. It was really expensive though - €7.80 to wash and dry one load of clothes.

Living costs are different to those in the UK and we will need to look at what we are spending and how to budget sensibly. We don’t yet know how much income we’ll have over the next year, but we have been saving up every since we started planning the trip four years ago, so we can afford to do everything we want to do, within reason.

There are so many interesting free events on over the summer in Caen. Earlier we watched a play by a travelling theatre company who drive all around the north west of France and perform their plays from the back of their truck – camion théâtre.

Their style of performance is very traditional with comedy, slapstick, satire, tragedy and a good moral to their stories. It’s a style that is still common in towns and villages across Europe, but much less so in the UK with the exception of Mummer’s plays which you still sometimes catch around Christmas in southern England.

I have to admit that I understood very little of the hour-long performance, although I did get one good joke that Becky missed and I understood the moral of their final play – if you go to the swimming pool, stay in the shallow end.

Avoiding supermarkets

The pledge to avoid supermarkets is a good one. I would like to add online shops and ticketing too.

I had planned to buy a season ticket for the local football team to give me something to do most Saturday evenings. The team – SM Caen – have spent a year back in the top flight and play good football, although their young starlet Yoan Gouffran has just been sold to Bordeaux.

I could have tried my luck buying a ticket online, but instead I got a bus to the stadium and had my longest conversation yet in French. Sadly, all the season tickets where I wanted to be were sold out – but there are plenty of tickets sold the Monday before each match, so I will do that. Perhaps it is better, so I can try out different sections of the stadium and also take people along with me.

We had also planned to buy ourselves some Calvados – the local apple brandy – and buy some good wine to drink. We could have done both in supermarkets, but we didn’t. At the local Calvados shop the propriétaire explained (in French) all about the different types of the drink, which we got to taste in quite generous quantities.

Of course we bought a bottle. We chose an ‘old’ Calvados, Dupont ‘Hors d’Age’, which is perfect for a digestive after a meal, a little luxury I’ve always found useful for my Crohn’s (no, really…).

Following our Calvados tasting, we popped into a small independent wine merchant quite near our home. Again, the caviste was most helpful and gave up talking in English as soon as he realised that we could understand his French. We were steered away from the €70 bottles and recommended a stunning biodynamic Bordeaux for €6.70.

When the propriétaire found out that we were in town for a year he invited us to his regular Saturday wine tasting sessions which are free and last all day apparently. I suspect we will be there regularly and probably come home with bottle of wine or two. I can then have a little sleep and head off to the football – not a bad plan for a Saturday.

Monoprix madness

Reaching the end of our first week was a little disconcerting. I was struck by how much more I need to do to feel at home. Of course my French isn’t up to much yet and it is frustrating not being able to communicate very well, but what brought on my feeling of unease was a trip to the supermarket.

Back in the UK, nothing is more relaxing than having a walk round Waitrose and buying a few bits and pieces. I know the shop really well, know where everything is and hardly need to engage my brain. If I’m feeling little poorly, but want to get out for half an hour it’s a good place to go.

It’s probably a sad indictment on me or on our consumer society that a walk to the beach is slightly nearer, but that I choose to go to a supermarket to relax…

Anyway, my favourite supermarket in France is Monoprix. I guess it’s a bit like an old-style Co-op maybe edging towards Waitrose. When we’ve stayed in Paris, Toulouse or Caen it’s been the place I’ve gone to buy provisions and Becky’s mum absolutely loves their smoked duck.

I have been to the Monoprix in Caen a few times. It’s quite big and has a clothing section, a toiletry section and an excellent stationary section as well as food and household goods. Sadly, I have a thing about stationary shops too, so Caen’s Monoprix should be heaven for me.

However, this was the location for my first bout of culture shock. Actually it was more like a bout of existential angst straight from the pages of Sartre’s Nausea. Perhaps it’s just a Normandy thing.

Here I was in a supermarket and I didn’t know where everything was or, indeed, what everything was. Worse, I couldn’t ask anyone anything and expect to understand their answer. And worst still, I wanted to buy a bottle of Normandy cider but all I could find was a three-pack of litre bottles on offer – buy one get one free (can’t remember the French for that) – but there was no way I could carry six litres of cider home.

I was a supermarket nightmare and I ended up feeling all clammy and the fluorescent lights looked a bit weird.

But I got over it, and I actually had a conversation with another customer in a boulangerie while I was waiting for my croissants to be wrapped.

So, my lesson is – don’t go to supermarkets. They are too big, impersonal and only reinforce your isolation. I now realise that going into small shops and to the market might mean I have a very clumsy conversation, but the personal interaction will be far more important to helping me feel at home. And we’ll eat better food.

Le 14 juillet

Yesterday (July 14) was a public holiday in France, celebrating the fall of the Bastille and the start of the French revolution in 1789. Like a Sunday, Caen was quiet and its inhabitants had a very leisurely day.

We decided to go to the local shopping centre and buy all the things we need to make our apartment more homely – like an ironing-board cover and a potato-peeler – but not breaking the bank. Shopping centres are usually heaving on UK bank holidays, but this one was virtually empty.

Mission accomplished, we returned home, unpacked our shopping, had a rest and prepared ourselves for an evening of festivities in a local square and a huge fireworks display at the racecourse nearby.

Spending the evening the Place Saint-Saveur was delightful. The square has been pedestrianised for the summer with a stage built at one end of the square.

Last night there was folk music and people were being taught various folk dances. All ages were getting involved and having fun. Around the square, hundreds more were eating and drinking in the various bars and restaurants.

There were two exhibitions the council-run gallery at the end of the square. One was a really interesting display of photographs and press cuttings documenting the student and workers’ upheavals of 1968 in Caen.

We didn’t catch the other – a video work by a local artist, but we can see that another evening when we go back to listen to music, watch a film or enjoy some street theatre.

We realised that we don’t go out much in the evenings in the UK. If we do, we spend the evening with friends, but avoid going out in the town centre because it is too hectic. I think it will be different in Caen.

It was still light at 10.30pm when we all moved off to see the fireworks. It was only a 10 minute walk to the Prairie – a vast open space with a horse-racing track, a park and an exhibition centre (but no little house).

We had assumed that fireworks weren’t being sold in the shops because we hadn’t heard any over the past few days. However, that wasn’t true. People were letting off fireworks and flares from about 10 o’clock at the Prairie, I guess as a disorganised ‘warm up’ for the main event.

The official firework display started just after it got dark enough – around ten past eleven. The display was magnificent. There must have been a few tens of thousands of people there at the Prairie and we all headed for home at a quarter to midnight.

There were traffic jams and hundreds of young people cycling home on the council ‘Veol’ scheme bicycles. Everyone was very good humoured. Certainly most people will have been drinking during the day, but no-one was ‘drunk’ as we would recognise it in the UK. It was just a great festival atmosphere and our first July 14.

A day of rest

Sundays are traditionally days of rest across Europe and in France they remain so. Today, hardly a car went past and there was no sign of life on our street until after midday. No-one was spotted washing their car or carrying-out DIY.

This is the third Sunday I’ve spent in Caen over the past year, and what the caennias seem to do is visit the market in the morning and then have a leisurely lunch at home.

The market is huge – the biggest in the region – and is based around the port in the centre of the town. The stalls are similar to those at our local Friday market, but just more of them. There are also more stalls with cooked food – roast chickens, paella, couscous, tartiflette and Asian and African dishes.

We had pencilled-in going to the market yesterday, but decided on another restful day at home – we had enough food to cook, although Becky went to the boulangerie for bread.

I’m sure we will discover other typical Sunday pastimes, like going to the cinema, the beach or a museum. However, it’s nice to feel under no social pressure to go out and be busy on a Sunday.

The only sound to break the Sunday silence are the local bells. One set is definitely from the famous church of St Etienne at the end of our road. The Abbatiale Saint-Etienne is where Guillaume-le-Conquérant (or William I of England) was buried and we definitely need to pay a visit.

We’re not quite sure where the other set of bells are – there are several other churches nearby – but both ring on the hour from 8am to 8pm and Saint-Etienne each half hour. We really noticed them to begin with, but now they are becoming just normal background noise – a good sign that we’re settling in.

Le week-end

The plan for this first weekend was to have a rest. We knew we would be tired after the journey, but it was important to start the ball rolling on bank accounts and telephones before the weekend (Monday is a public holiday).

During the next year, we both expect to have times that we don’t leave the apartment due to ill-health or because of the fatigue related to our health conditions. So this was a good opportunity to test out our new home.

Our apartment isn’t that big compared with where we live in the UK and our bedroom, living room and study are all combined into one room. Fortunately it is a large, bright and airy room. The kitchen is small, but does have a table to eat or to work at.

With the front door shut there is enough room in the hallway for another comfortable place to sit and read or listen to music. And the bathroom – a place I am likely to spending some time – is roomy, warm and quite pleasant as bathrooms go.

There is even a tiny courtyard out the back, overlooked by dozens of other flats, but a place to get some fresh air and sunshine if we don’t feel well enough to go out.

Today we read, slept, watched TV and used our laptops. I popped out to buy a newspaper and some food which took about 10 minutes - a shorter trip than back in the UK.

Probably the highlight of the day was watching a stage of the Tour de France. I usually follow Le Tour avidly, but have missed out on the first seven days due to our busy week moving to France.

It was easy to catch up on the race, thanks to the local paper which has two or three pages on Le Tour each day. Today’s stage was full of drama with rain and a determined four-man break-away. Eventually Mark Cavendish from the Isle of Man won a magnificent sprint - much to the delight of the spectators and the French media team.

So, a comfortable day resting and the apartment passed the test with flying colours – but I do feel a little exhausted after watching a 170 Kms cycle race.

Market Day in Caen

The market was fantastic - as one would expect of a French market that dates back to the 1300s. I’ve been to markets in France before, but that was as a holiday-maker and was only sight-seeing.

Going to a market as a resident is a different experience altogether - I was planning meals for the next week and I was also thinking about what might be good to eat in the future and looking at some vegetables, fish and animal parts and realising that I need to look at some recipes and cook books to find out how to eat them.

Back in the UK I have learned to be kind to my guts but, at the same time, not let my Crohn’s ruin my culinary pleasures entirely. I know what food is safe, what is hazardous and what I can expect if I eat something that doesn’t quite agree with me.

Moving to France means a whole new exploration of these categories. There is no way that I’m going to stick to what I eat in the UK – not with what I saw in the market today. But neither am I going to be entirely reckless, that would just be stupid.

So I have Julia Child’s iconic ‘Mastering the Art of French Cooking’ to help me through some of the cooking techniques of France. Soups and sauces are great for my small bowel strictures – as is drinking plenty of wine with my meals.

The fish on sale in France is far more bountiful and diverse than in the UK and I intend to make the most of it. A popular diet book for Colitis and Crohn’s by James Scala suggests that people with IBD should eat only the flesh of animals that swim or fly – so fish would be a good choice.

However, even on the dozen fish stalls at the market, there was a bewildering variety of fish, some I recognised, but others I will have to write down and look up in the dictionary. Then I can look them up in Rick Stein’s excellent little ‘English Seafood Cookery’ and find out how to prepare and cook them.

So what did we come home with today? We bought apricots and a melon, tomatoes and courgettes, onions, fresh garlic and potatoes. And we bought a vase in the bric-a-brac section and some flowers to go in it. Not much, but we do have another 50-odd weeks to sample other delights.

Plans become reality

We’ve had an exciting couple of days. Plans that have taken several years to concoct are now being turned into reality.

I have gradually formed images in my mind about how our life might develop here - especially after three fact-finding trips to Caen and visiting our apartment and new neighbourhood a couple of months ago.

My partner, Becky, has been receiving email bulletins about the town since we visited in April and I have been following the local football team for the past year. All this is good preparation and helps give a context to the world we dropped into less than 48 hours ago.

Because we have prepared our trip, we are very aware that we are here to live, not just on a long holiday. So opening a bank account yesterday and organising a telephone, internet and TV package today are really exciting and meaningful – they are not holiday activities.

There are also small but important details we have thought about - like how we keep in contact with our 32-month-old niece so she remembers who we are! We decided on sending her a postcard each week (supplemented by phone calls and visits) and today we bought her a lovely postcard of a Normandy cow.

A certain degree of planning is important for us because we both have long-term health conditions. We need the basics of life to run as smoothly as possible so we can be spontaneous and grasp opportunities as they present themselves. Planning also means that if our conditions play up we are able to rest, recover and get treatment if we need to.

So, given that we do both have serious health problems, it is frustrating that issues around benefits and health care entitlement are taking longer to resolve than they could. I am promised a call from the UK Department of Work and Pensions overseas office in Newcastle, but I have to say that our dealings with the DWP so far have been less than satisfactory. But more on that another time – we have our first market day to prepare for tomorrow.

Crossing the Channel

Our adventure has begun. After months of preparation, we arrived in France at 7.30 this morning.

We caught the overnight ferry, so went to sleep just as we left Portsmouth and woke up shortly before we arrived at Ouistreham.

Neither of us slept particularly well but we have managed to catch up during the day, in between paying our rent, buying insurance for the flat and opening a bank account. These first few tasks in France all went smoothly.

We were very sensible with our travel arrangements, getting a taxi from our home to the ferry terminal. Given that we had two heavy suitcases and a guitar, we didn’t want to be hopping on and off of trains or buses.

We asked the ferry company (Brittany Ferries) for disabled assistance as Becky walks with a stick. Although we had to wait around a little, we had our own mini-bus and could move at our own pace. The staff were really friendly and couldn’t have been more helpful.

After breakfast at the Ouistreham ferry terminal, we were picked up by our new landlord and driven into Caen and our new home.

At the end of our first day I am struck by how at home I feel. France isn’t unfamiliar and neither is Caen – I’ve been here three times before today. I suppose it does feel a little bit like being on holiday, but I am well aware that I’m here for a year and that our tasks over the next week or so are not the sort of things you do on holiday.

The weather is the same – sun and showers – and we can pick up a number of UK radio stations, including BBC Southern Counties Radio with news about Brighton and Crowborough.

There will, of course, be thousands of little differences between life in the UK and life in Caen. Rubbish collections are one thing we need to find out about and understand. Then there is the very important issue of health care, which is becoming a somewhat epic saga...