Ailing service Down Under

Yet when I travel abroad, I find that our system bears comparison with the rest of the world, and is much better at looking after everyone than the systems in other countries.

I've just returned from New Zealand, where people are generally very worried about their health provision.

The Kiwis' main problem is that there are only four million people in a country with a land mass bigger than the United Kingdom, and that makes it very difficult for a modern health system to be sustained from tax revenues alone.

So everyone has to be insured, and pay fees (most, but not all of which may be paid back by their insurers) at every step of the way for their medical care.

For example, they pay 20 NZ dollars (about £8) every time they see their doctor, and most get about 80 per cent of the fee back from their insurers. Their age doesn't matter - pensioners have to pay as much as younger people do.

They all have to pay the going rate for their prescriptions, which can be very expensive for many drugs to treat chronic diseases. Often people choose not to take all their drugs because they can't afford them.

Probably worse still, there is a great shortage of doctors in the country areas, and even in the smaller towns, so that hundreds of people have no regular doctor, despite trying to join a practice.

We were in a relatively affluent area on the west coast of the North Island, and were told that there were at least 200 people without any chance of getting on a doctor's list.

The consequence of the doctor shortage there is that hospital waiting lists are even longer than they are here - unless you opt for private treatment. That's costly, and even then it's difficult to find a private hospital doctor to help.

When we were in Wellington the news broke that the last children's cancer specialist in New Zealand, based in the city, had resigned. While the hospital was waiting for a locum to take his place, children were having to be flown to Australia, three-and-a-half hours away, to be seen and treated.

In the meantime, in Britain, our NHS is improving steadily. Waiting lists are down, and we as GPs feel that things are getting easier for our patients. We have an excess of young doctors, and although that has led to difficulties for them in obtaining their first jobs, it bodes very well for the future here.

We should have plenty of medical staff in hospitals and general practice to look after the generations to come.

Better still, we seem to be getting the health message across in a more effective way.

One statistic that impressed me was that cannabis use has fallen in most areas of Britain, largely, it seems, because of concentrated efforts in primary schools to teach pupils about the dangers and pitfalls of drugs, and how to avoid being taken in by the pushers and dealers who try to influence them.

Two more great news items this year came from Ireland and Scotland. Both followed the new laws against smoking in public places.

The Irish reported an amazing 17 per cent drop in new cases of lung cancer only two years after they banned cigarettes in pubs, shops, restaurants, workplaces and other public buildings. This was a far bigger fall, and in a much shorter time, than expected. It indicated that a substantial proportion of the Irish population had opted to stop smoking completely, and that most of the other smokers were smoking less.

The Scottish report came from Aberdeen, where researchers had measured lung function (a direct indicator of damage to the lungs by cigarettes) in barmen and women before and nine months after the ban on smoking in pubs.

The improvement was much greater than expected, and proved beyond doubt the amount of damage that secondary smoking (inhaling other people's cigarette smoke) had been doing. Many of the bar staff had been non-smokers, so that the improvement had to be due to the improved air in which they worked.

Numbers in reports, of course, are difficult to relate to individuals.

For my own part, looking back on 2007, I have been impressed particularly by our emergency services.

Several times during the year I've had the privilege of working with paramedics in emergency ambulances. They are so well-trained, whether the patient has had a heart attack or a road accident, that doctors like myself are almost an irrelevance.

The figures for survival after heart attacks and strokes, and after serious accidents, are rising steadily, thanks to these consummate professionals.

We have a lot to be thankful for, and to look forward to, in 2008. Happy New Year.