French Surgeons Walk Out - to London

France's ailing health service took a further turn for the worse yesterday when it emerged that up to 3,000 French surgeons will down scalpels and undergo a week's self-imposed exile in London next month in protest at poor pay and working conditions.

The surgeons will board Eurostar trains on August 30 and congregate either in Wembley Conference Centre or the Great Hall, Westminster - the exact venue has not yet been fixed - until September 5 to avoid being "requisitioned" by French local authorities during their strike.

"We're expecting about half the country's 6,000 surgeons to take part and most of the rest will refuse to perform any non-emergency operations for a week," said Philippe Cuq, one of the organisers. "The government is going to have to wake up to this crisis."

Dr Cuq said the sums reimbursed by French social security for surgical interventions had not increased "by a single centime" for more than 15 years, while surgeons' insurance premiums had risen by up to 500% since 2002 alone.

Acording to figures from the Union of French Surgeons, 20% of surgeons in France's public-private health system - those paid excusively by the national health service - now earn no more than the €70,000 a year made by a GP.

The remaining 80%, who charge higher fees because the excess will reimbursed by the private top-up insurance schemes most French employees benefit from, make some €120,000 a year: often only half as much as other specialists such as radiologists or dermatologists.

"Graduating students are no longer entering the profession," said Jacques Meurette, the union's president. "There are too many constraints, too many risks, not enough rewards given the demands of the job and conditions in other branches of medicine. In a decade, France have a shortfall of between 1,500 and 2,000 surgeons."

The surgeons are leaving the country to avoid being obliged to work by their local authorities, as French labour law allows. The choice of London as their destination is both practical and symbolic.

Dr Cuq said only a capital city could realistically accommodate the surgeons' meetings, debates and demonstrations. "And in Britain we are appreciated, we are valued," he said. "The NHS used to send British patients to be operated on in France. Now it is actively recruiting French surgeons for short stints in Britain - up to 150 of us now work there regularly."

The strikers would like to see the fees for individual operations doubled. The government is not prepared - and certainly cannot afford - to go that far, but it has offered to make some €45m available to help the surgeons pay their sky-rocketing insurance bills.

The French parliament yesterday approved a long-awaited government plan to reform the country's near-bankrupt health service, which was ranked the best in the world four years ago but is currently losing €23,000 a minute and is forecast to end 2004 €13bn in the red.

The plans, heavily criticised by healthcare unions, doctors and the opposition Socialist party as wholly inadequate for the scale of the problem, aim to save some €15bn by 2007 by boosting revenues and cutting expenditure.

Among ideas to raise an extra €5bn in health service income, all patients will be charged €1 per consultation, pensioners who can afford it will have to pay substantially more than they currently do, and healthcare levies on companies will be raised.

At the same time the health minister, Philippe Douste-Blazy, wants to save €10bn by tackling waste, over-consumption and abuse in the uniquely generous 60-year-old system. Only cheaper generic versions of big brand-name drugs will be reimbursed, fraudulent sick leave will be eliminated, and a computerised personal medical record will be introduced to prevent the popular and expensive Gallic practice of "treatment shopping".

The surgeons complain that their particular crisis has been ignored. "We have been warning of this situation for 35 years now," said Jean-Gabriel Brun in a letter to members of the French Surgeons and Specialists Union.