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.