Caroline Dann worked as a speech therapist in London for 23 years – scientifically sound, at eye level with the doctors. Then she returned to Germany and was irritated by the hierarchical health system.
CVs don’t have to be straightforward, biographies have breaks – that’s what makes them so exciting. In the series “And now?” People tell of turning points in their lives, of moments in which they made decisions and made something new. This time: Caroline Dann, 46, is returning to Germany – where she has never worked. She has longed for the UK healthcare system ever since.
“I lived in the UK for 23 years . When I left the island in 2016, many thought it was because of Brexit. The British decision annoyed me at the time, but the trigger was different: my twins were born in 2013, and a little later my relationship broke up. Suddenly I was a single parent, with the expensive London rents, no daycare facilities and far from my grandparents. I persevered for a while and employed a nanny, but there was almost nothing left of the salary.
So I first went back to my parents’ house in a village near Bitterfeld that I left when I was 19. It was good for my children and it made a lot of things easier for me too.
On the other hand, it was a new beginning in a country I knew little. After all, I went to England as an au pair right after graduating from high school. I had never worked in Germany before.
I was not familiar with many expressions, for example that anything can be “crazy”, but also Anglicisms that I had never heard of in England: for example that you are “flashed” about something or that you get a coffee “to go” . Typical German idioms hardly occurred to me at first, but the English ones were always at the front of my mind .
I thought it was great that my children could now also go to daycare, as the German welfare state is so much more extensive. What bothered me, on the other hand, was the professional change. I worked as a speech therapist in London for 16 years and previously studied the subject there. This work is so much better structured and organized in the UK – I miss that very much.
Yes, it is true, the British National Health Service (NHS), which organizes all medical care with general practitioners, specialists, therapists and hospitals, has a bad reputation. Many areas are rather poorly equipped and bureaucratic, complaining about it is part of British folklore. On the other hand, the claim to provide all citizens with comprehensive health care from tax revenues is sympathetic.
Much more teamwork for the patient
The way I got to know it in my work in the Ealing district of London, the approach is very systematic and efficient. There I practiced in a health center, where you work closely with doctors and other therapists on a daily basis. Patients are cared for across the boundaries of the specialist disciplines. The connection to the medical faculties of the University of London is close. New technical findings are immediately implemented in practice, their evaluation is strictly based on study results. You get a lot out of it for the patient, and it’s technically interesting.
In the therapeutic areas in particular, there is hardly anything like this in Germany, so my impression. After moving, I soon started working as a speech therapist and had to realize: In Germany, doctors and speech therapists rarely exchange ideas on an equal footing; rather, as a speech therapist, I am governed by medical prescriptions. A lot of potential is wasted in the process, because speech therapists are experts in a field in which the prescribing doctors have no specialist knowledge.
You can always be lucky with a doctor who relies on cooperation – but the structures don’t support that. If you are unlucky, you are a medical assistant under time pressure. The hierarchical gap, which I also observe with colleagues, affects many therapists.
In London, as a specialist in hearing impairments, I worked closely with parents, teachers, educators, therapists, social workers, audiologists and doctors. Our files were electronically networked, we could see who treated our patients and when. This works nationwide, so that theoretically no child is overlooked – especially important when there are indications of child abuse.
Remedial teachers make use of all the adjusting screws
As a speech therapist in Germany, I really miss cooperation with other disciplines. And there is no time for reflection, hypothesis formation, evaluation and planning of therapies – in Great Britain things are more scientifically founded. The time that is needed for this is not included in the treatment budget by the German health insurance companies.
For many of our patients, however, it is not enough to just work a little on their faulty pronunciation; it is often in a much larger context. I’ve been looking for ways to work more holistically for a long time. That is why I am currently doing a distance learning course to become a curative teacher.
As a curative educator, you help people with disabilities to cope with everyday life by really making use of all the adjusting screws. This includes therapy discussions as well as exercise therapy or the equipment of the workplace or the apartment. It’s a concept that fits my professional ideals. The course takes four years, and I want to finish it in 2023.
In the meantime, I work as a speech therapist and office hours assistant in a pediatrician practice. The doctors there are very open-minded and work well with therapists. Thanks to part-time, I can devote a day and a half to my studies every week.
When I finish, I want to work with disabled and at risk children and their families. There are many possibilities – in the pediatrician practice, in a social pediatric center, in an early intervention center, in the free youth welfare service – or a bit of all that. If it goes well, it will be something like the UK Health Service