I’ve been having some lughole trouble over the last week or so. It happens every two to three years: when I’ve been swimming a lot in the pool, ear wax mixes with the chlorinated water to produce an unpleasant plug, so I get irregular deafness. None of this, of course, will evoke widespread sympathy from those scraping by on a part time job as a single mum, but sooner or later I wind up going to the GP to get the ears syringed. This is something of a hassle because first one needs to lie on one side for a day while softening chemicals loosen things up, and then sit for ages in a waiting room until Mme le Medicin gets busy with the power jet.

What I therefore tend to try (in the hope it’ll clear itself) is doing it myself. This isn’t as difficult as you’d imagine. All you need is a small cooking funnel, and a jet-hose whose pipe has been lying in hot sun for an hour or so. The water held back by the jet’s locking device heats up, you lie on one side, stick the funnel in the affected ear and give it a blast. After about thirty seconds, I usually find that shaking the head is enough to clear things. Then for the next hour or so it feels like everyone is an RSM bellowing at you.

It does, of course, keep on reblocking every few days, until I relent and just go to see Madame wotsername in the village to have it done properly. Her name is double-barrelled and multi-syllabled, so these days my memory isn’t up to it. She been Mme Wotsername for years, and she is smashing: heavy smoker and drinker, petite with a sexy gravelly voice, and a wit to win any bloke’s heart. But mainly she’s a proper doctor, as opposed to the wannabe Alan Sugar-cum-order-takers we have these days in England.

I know perfectly well that the expat boffing on about how much better the French health service is than the NHS is something of a cliché, but that doesn’t make us wrong. The key point is why it works better.

There are a number of factors involved. First up, it isn’t hogtied by archaic Left-wing doctrinaire bollocks about everything being free at the point of purchase. And allied to this, it doesn’t have Right-wing sociopaths chiselling away at its budgets all the time. The French health service (L’Assurance Maladie) is almost apolitical: it is accepted as part of being a civilised culture, and so like all such things (electricity generation, agricultural mix and so forth) it is taken away from grubby politicians and given to the ENA (Ecole Nationale d’Administration) graduates to sort out and run properly. In Britain, we have too much political government; in France, they have more apolitical governance areas which are off-limits to MP egotism. There are many infuriating and badly thought-through systems in France, but this isn’t one of them.

A key foundation of the health system here is the ‘centres of excellence’ idea where they try to ensure an equal spread of surgical and other hospital treatments to a high standard everywhere. The idea that the London teaching hospital professor will be far better than the under-achieving mediocre surgeon in Exeter is almost absent as a thought. You can also top up your automatic citizen rights to free health with private insurance that covers areas that are, quite rightly, not free. The Maladie Assurance does not try to offer everything free, because the ENAs aren’t fluffy socialists. It is not engorged by Sir Humphrey delusions of grandeur: it focuses and it works; but if you want a nose job done, then cough up chummy.

I once suggested to my neighbour Ange that the British and French health systems could learn from each other and have one joint name, for which I suggested Maladie Nationale, at which point his face clouded over and he shook his head. Ange is very straitlaced, but his stepson Lauren laughed his head off: Maladie Nationale in France is the slang term for gonorrhea. We live and learn.

Waste is in turn frowned upon by those working in the service. Take the purchase of medication: you cannot buy cheap generic drugs from pharmacies here, and you cannot get prescription drugs in the supermarkets. Dan Hannan would condemn this as over-regulation, but it is in reality very shrewd. Together, these two things ensure that every village has a pharmacy economically protected and able to make a decent margin in order to survive. It makes it easy for the patient to get the drugs needed sur ordinance by toddling down the street, it makes for close cooperation between the GP and the chemist, but above all it tends to mean that, with a degree of government subsidy involved, the GP will prescribe the best drug (not the cheapest) and be fairly certain the pharmacist will have it in stock.

However, a major reason for the success of L’Assurance Maladie is that the Primary Care sector (GPs) is (a) still an integral part of the commune; and (b) general practitioners here are encouraged to be perpetual learners rather than order-takers. Not having endured thirteen years of New Labour’s insane targeting obsession helps too – as indeed does the absence of a Jeremy Hunt at the top casually throwing tiles off the roof now and again when nobody’s looking. There are no potty time restrictions: the consultation takes as long as it takes. This makes for a longer time spent reading Le Cheval et Des Chasseurs in the waiting room, but Health provision is not entirely about efficiency. The idea that they might be ‘in business’ rarely occurs to French GPs: it is still a calling. Every time I experience it, I am reminded just how much better-run the NHS is than it was in the 1970s, but mainly how the cure has ripped out the patient’s heart.

There are those neoliberals, of course, who will observe, “Ah yes, you little bourgeois Leftie francophile, this is all well and good but France is broke! It can’t afford this service, and so things must change!” That is almost certainly correct, but France is broke because of politically fiscal incontinence and grandiose expenditure ideas from Brussels. Fifi Lagarde may well have f**ked up the French finances during her brief three years in power, but the ENAs run a tight ship when it comes to the Health Service and other ‘social weal’ provision.

Anyway, back to Mme Wotsername. Nobody is entirely sure why, but a couple of years ago she hit the bottle quite hard and was often AWOL. Whether this was a maladie du coeur I know not, but things now seem to be back to normal. Last year I went to her with an odd looking growth on my calf after a few weeks in the sun. In Britain, this would’ve turned into a series of arse-covering tests, but Mme simply said no, it’s not cancer, took a dry-ice spray and zapped it. A few days later it fell off, and has never recurred.

What I think one gets here in primary care is less drama and better diagnosis. My good friend in Seyche had her breast cancer spotted quickly by the GP three months ago, so she had a pdq op in Bordeaux, and equally rapid prognosis from experts – and thus didn’t need any chemo. After a short course of radiotherapy, here we are in July and she’s clear of it.

Communal weal, callings, and an absence of neolithic ideologues ensure together that State Health things do work for the citizen in a personal way. The French AM proves it – just as Iceland’s banking experience proves the EU nutters wrong, the German money-transmission system proves the credit-driven capitalist model wrong, Greece proves Milt Friedman wrong, the USSR’s collapse proved Marx to be wrong….and so on, ad nauseam. Those whose welfare is tied up in an obsession with selfish advantage – incompetent bureaucrats, egomanic MPs, mad bankers, and African dictators – do not learn these lessons – because being deliberately obtuse is more advantageous.