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Health Service in Great Britain ❖ 273
the Russian Medical Workers' Union last year. The Russian doctors visited
the Health Centre in Hampshire and some hospitals in London, Liverpool
and Aberdeen. Now they are having a talk with their British colleagues on
the health care system in Great Britain.
Dr. Sharova, head of the Russian delegation: Dear colleagues. During
our stay in Great Britain we visited many medical institutions. The doctors
kindly acquainted us with their work. We were told that the National Health
Service Act was passed through Parliament in 1946 and in 1948 this Act
received the Royal Assent and was brought into operation. And what about
Scotland and Ireland?
Dr. McDonald: Similar services operate in England, Wales, Scotland and
Northern Ireland. Further administrative changes were introduced by a
number of other Health Service Acts. f'Z)r. Kelly:I'd like to say that most
medical treatment in our country is free, but charges are made for drugs,
spectacles and dental care. Free emergency medical treatment is given to
any visitor from abroad who becomes ill while staying in our country. But
thpse who come to England specifically for treatment must pay for it.
1
Dr. Nikitina: The National Health Service provides free medical care both
in hospital and in the out-patient clinicVSo you have no private patients in
Great Britain, have you?
Dr. Sharland:Not quite so. People may use the NHS or they may go to
doctors as private patients. In big cities there are some private hospitals
which people may use. Many people who have enough money still prefer to
be private patients because they think that they can in that way establish a
closer relationship with the doctor or because they do not want to be put in
a large room with other patients.
Dr. McDonald: I'd like to add that a patient in our country can choose
between NHS or private treatment at any time. Moreover he can take some
of his medical care through the NHS, and some privately. If a patient is
dissatisfied with his NHS family doctor or dentist, he may change to another
one. In fact, 97 per cent of the population use the NHS. \
Dr. Kruglov:What is the role of the family doctor in the Health Service
system?
Dr. Kelly: The role of the family doctor (General Practitioner) is very
important. Not all patients need highly specialized attention and the GP
does invaluable work by filtering off 90 per cent or so of the total medical
work^
Dr. Sharova: You told us that if a patient is dissatisfied with his family
doctor he may change to another one. And what about the doctors? Does
this freedom of choice apply to them?
274 ❖ Learning To Discuss Medicine £
Dr. McDonald: Yes. This freedom of choice applies to doctors and
dentists too. They can choose whether they want to join the NHS or not,
and whether they will have NHS patients or private ones. In fact, the
majority work in the NHS.
Dr Kruglov: We visited the St. Thomas' and St. Bartholomew's Hospitals
in London and noticed that they are small hospitals with about 200 beds.
They are housed in inconvenient buildings. Can such small hospitals
provide a full range of medical service?
\Dr. McDonald: You see, we do have modern hospitals but half of the
buildings are over 100 years old. 70 per cent of our hospitals are small, with
only about 200 beds. Such hospitals are not economical and cannot provide
a full range of service, which requires a district hospital of 800 beds or
more. Now we have more than 150 health centres in the U.K. The first
Scottish health centre was opened in Edinburgh in 1953. These health
centres are an integral part of a unified comprehensive health service.
Health centres provide all the special diagnostic and therapeutic services
which family doctors may need, such as electrocardiography, X-ray,
physiotherapy and good administrative and medical records systems.
Family doctors work in close cooperation with the hospital doctors. Health
centres are the basis of primary care, jr
Dr. Nikitina: Are there consultant services in such health centres?
Dr. Sharland:There are centres which provide consultant services in
general medicine and surgery, ear-nose-throat diseases, obstetrics and
gynaecology, ophthalmology, psychiatry and orthopaedics. All consultations
in the centre are by appointment only. The patient is given a definite time at
which to attend. This is recorded on a card for him. Each doctor decides for
himself how many patients he can examine in one hour. We believe that the
patient is the most important person in the health centre and that we should
direct all our energy towards helping him as much as possible.
Health Service in Great Britain ❖ 275
Dr. Sharova: Dear colleagues, thank you ever so much for the warm
reception, for this interesting discussion and for the opportunity to get
acquainted with the health service system in your country.
Active Words and Word Combinations
National Health Service, the NHS drugлекарство, лекарственный
система здравоохранения в
Великобритании
spectaclesочки
препарат dentalсаге
стоматологическая помощь
topreferпредпочитать
GP
9
general
practitionerврачобщейпра
ктики
toapplyкасаться, относиться,
быть применимым
whether they want зд.хотятлиони
unifiedcomprehensivehealth
serviceединая система
оказания всесторонней
медицинской помощи
administrativeandmedicalrecordss
ystemsсистема управления и
медицинской регистрации
inconvenientнеудобный, без
удобств
full range (of medical service)
полный спектр
(медицинской помощи)
therapeuticлечебный
tohaveaccessиметь доступ
appointmentзд. назначение,
предварительная
договоренность
byappointmentпо
предварительной записи,
договоренности
Упражнение 6. Прочтите вопросы, которые были затронуты в беседе
английских
и
русских
врачей.
Ответьтенаэтивопросы,
используятекст.
1. When was the National Health Service Act brought into operation?
2. Are ther£ private patients in Great Britain? 3. Why do many people
who have enough money prefer to be private patients? 4. What is the role
of the family doctor in the National Health Service system? 5. What is the
role of health centres in the health service system in Great Britain? 6. Are
there consultant services in health centres?
Упражнение 7.Подтвердитеследующиесуждения. Используйте в
ваших высказываниях следующие словосочетания:
276 ❖ Learning To Discuss Medicine £
Yes, I agree that...; Yes, as far as know ...; It is true that... .
1. The general practitioner services include the family doctor service,
the dental service, the pharmaceutical service, and the ophthalmic
service. 2.The GPs do very important work, which consists in filtering off
90 per cent of the total medical workload. 3. Health centres are
institutions where various medical services, both preventive and curative,
are brought together. 4. The patients are the most important people in the
health centre and the doctors should direct all their energy towards
helping them as much as possible.
Упражнение 8. Приведенные в случайном порядке высказывания
взяты из беседы врача и его пациента:
а) запишите эту беседу, поставив высказывания в логической
последовательности б) прочитайте свой диалог и скажите, в помощи
хирурга или терапевта нуждается больной.
Dr. Young:Good morning, Mr. Hollister./ Are you still taking your
digitalis?/1 believe you have hardening of arteries
(облитерацияартерий) with heart involvement (поражениесердца)./
How are you getting along? / Now your heart is not able to perform the
work it is supposed to./ Regarding your treatment, I think you should
continue to take one tablet of digitalis daily and stay on a salt free diet./
You need to do this indefinitely, otherwise (иначе) you'll get into trouble./
What seems to be the problem?/Three weeks from today. Good-bye now
and be careful ./ Do you put any salt in your food?
Mr. Hollister: I've not been feeling well for the last week./Well, Doctor,
I've been not taking digitalis for the last week./ Doctor, could you tell me
what my problem is?/When shall I come back?/ I've had some shortness
of breath, and as you can see, my legs are swollen now./ Bye. See you in
three weeks then./ I find it hard to eat completely without salt./
Упражнение 9. Прочитайте текст беседы врача и пациента еще раз.
Скажите, какие утверждения соответствуют содержанию беседы.
Health Service in Great Britain ❖ 277
1. а) Больной жаловался на одышку и отечность ног. б) У больного
не было жалоб на одышку. 2. а) Больной принимал по одной
таблетке дигиталиса в течение недели, б) Больной не принимал
дигиталис в течение недели. 3. а) Больной чувствовал себя хорошо,
б) У больного была сердечная недостаточность. 4. а) Врач
посоветовал больному придерживаться бессолевой диеты, б)
Больной соблюдал бессолевую диету.
Упражнение 10. Вы ведете прием. Составьте беседу врача и
больного с подозрением на стенокардию. Используйтеданныеслова,
словосочетанияифразы.
Where does it hurt?, Can you describe the pain?, What makes it
worse?, complaints, to complain of, to have troubles with the heart, to
have pain in the heart, the character of the pain, dull pain, sharp pain, to
have pain on physical exertion, arterial pressure, angina pectoris, cardiac
failure
Упражнение 11. Прослушайте (прочитайте) диалог. Какой анамнез со-
бирает врач? Перечислите основные вопросы, которые были заданы,
больному.
1
Dr. Harper: Have you ever been sick before?
j
Patient James Ross: Yes, sir. I have had scarlet fever and pneumonia.
Dr. H.:Have you ever had measles? Chicken-pox? Whooping cough?
Patient: Yes, sir. I had all the childhood diseases.
Dr. H.:How about adult illnesses, have you ever had ТВ, jaundice, heart
or kidney trouble?
Patient: No, I have only had the ones I just told you.
Dr. H.:Have you ever been operated on? Have you ever had any
operations?
Patient'Yes, several. I've had my appendix out. And I've also had my
tonsils operated on.
Dr. H.: Did you ever break any bones?