COMMENT

Despite the war, you can still see a doctor when you need. No wonder refugees go back for treatment

MARIA CHAPLIA. 10 March 2023 •

Last May, after a stay in a suboptimal German hotel, I contracted a nasty skin infection. After countless futile attempts to get through to the NHS to be seen by a dermatologist, I was told that it would be months before I would be given an appointment.

So far, so familiar, you might think. But if you have read and struggled to believe stories about Ukrainians living in the UK returning to their native country for medical treatment, let me tell you that I am one of them. Having given up on the NHS, I flew to Poland and crossed the border. Later that day, amid air raid sirens, I visited a hospital. By the evening, I had the relevant medicines to get me back on the mend.

After living in the UK for over two years, I can see that Ukrainians are spoiled in terms of access to healthcare compared to Britons, despite the billions that are lavished on the NHS. Growing up in a small town in western Ukraine – to which it is still possible to return despite the fighting in the east – I never had to wait more than two days to be seen by a specialist doctor.

When you fall unwell in Ukraine, you are usually advised to get seen by a doctor right away. Within a day or two, you have different tests done, such as a lung X-ray and blood sampling, and then you are prescribed treatment. The doctor would usually give you their phone number so that you can text or call them to discuss your progress. Following recovery, the doctor would normally recommend having blood tests again to make sure that the illness is completely gone. On the NHS, by contrast, ibuprofen seems to be the panacea to all of life’s ills.

Covid and a full-scale war have inevitably taken their toll on the Ukrainian healthcare system. But its fundamental features are good. Introduced in 2018, it is based on the principle that “money follows the patient”. In essence, that means that Ukrainians can choose their doctor – unlike in the UK, where you choose a surgery – and they can switch to a different one if they are unsatisfied.

So doctors in Ukraine are incentivised to perform their best: the more patients they have on their records, the higher their salaries are. My Ukrainian doctor, for example, is a family friend. She has successfully treated me and my parents for many years, so we keep going back to her.

Ukraine has an extensive network of private hospitals and clinics where you could get a walk-in MRI or X-ray scan for £80 at most. Many of those clinics have handy mobile apps, which allow you to choose a specialist doctor and book an appointment on the go.

In May last year, I paid £5 for a private dermatologist appointment, during which a nurse took a sample of my rash to establish the cause of the problem (I had the results back in half an hour). On average, the price of a private doctor’s appointment in Ukraine varies between £10 and £40. Given that monthly average salaries are still comparatively low, not many Ukrainians can afford to go private. However, it definitely helps that the choice is there, and the options are many.

When planning a trip back home from the UK, I’ve noticed that Ukrainians will often try to see as many doctors as possible. A few months ago, I met another Ukrainian woman who lived in London and was travelling back to get checked by Ukrainian doctors. Having suffered from severe stomach pain for weeks on end, she didn’t want to take her chances with long NHS waiting lists.

A quick search through Facebook groups shows that Ukrainians can be frightened about getting sick in the UK for fear of not being able to receive treatment. Considering that most who came to the UK after the invasion are mothers and children, lack of quick access to doctors only contributes to the anxiety. Ukrainian doctors have made themselves available online 24/7 for refugees scattered across the world.

Of course, Ukrainian healthcare is not perfect. The remnants of the Soviet past, reinforced through corruption and cronyism, are still present in the country. However, as my Ukrainian doctor friend Olha Fokaf has pointed out, if the Ukrainian system is able in the future to develop without external shocks such as war, it could become a huge success story. Maybe the UK could learn from the Ukrainian healthcare experience one day.

---

Maria Chaplia is a Ukrainian research manager living in the UK