The Dialogues of Civilizations course in London offers students a front row seat to hearing from practitioners and former lawmakers about the National Health Service.
LONDON — For years, clinical professor Maureen Watkins had taught what the textbook said when it came to explaining the U.K. health model to her students on the administrative health care course.
But she decided that, in order to test the theory, there really was no better way to understand and teach it than to become immersed in the country itself.
So the board-certified clinical specialist in orthopedic physical therapy decided to set up a Dialogues of Civilizations course in London. “Health care and culture in the United Kingdom,” now in its second year, gives Northeastern University students enrolled in the U.S. the opportunity to live and study in the U.K. capital for five weeks over the summer in order to understand the way health care and medicine have evolved.
“I’ve been teaching that administrative health care course now for several years,” explains Watkins, “and so when we start to talk about health care in other countries, we always say that the U.K. has a really great NHS system, because that’s what the book says.
“And I thought, why don’t we go dig a little bit deeper? Let’s see what we can find out and really do a better, deeper dive into the heritage. I chose the NHS because it is one of the oldest universal health care systems in the world and London because it has access to understanding its history.”
The students, through classroom learning, guest talks and cultural visits, are given the chance to compare how a nationalized health provision, in the form of Britain’s National Health Service, fares in contrast to the insurance-led offerings found in the U.S.
From visiting the Houses of Parliament in London, to day-tripping to Canterbury, which is steeped in English religious history, to spending time at the Surgeons’ Hall Museums in Edinburgh, Scotland, Watkins says the out-of-class experience that forms part of the course enriches the students’ learning.
“They can see the relationship of politics, medicine, societal norms and how wealth and poverty play a role in it,” continues Watkins. “And they can see those stories over and over again at all these sites that we’re going to. I think the fact that they’re here and not just hearing it from me but hearing it at a variety of sites, it ties all those pieces together.
“We went to Canterbury and had a tour there, and we heard how people would go there on pilgrimages to try to heal themselves. It is about understanding how this relationship with health care has been there since the beginning. I think they have really learned that health care is not just health care — there are all these interplays, with politics and policy playing a huge role.”
Isabel Desai, a major in health science and business administration, said the ability to mix classroom learning with experiences at museums and other cultural locations had brought the teaching alive.
“I think it’s been a great balance of classroom activities and being able to explore,” the 18-year-old from New Jersey said. “It is not just about your standard classroom learning but also cool cultural experiences as well that help put things in perspective. It brings it all to life much more than a textbook ever could.”
The students heard from guests who had different perspectives on Britain’s health care system, with former lawmaker and health minister Steve Brine and Lisa Henschen, a long-serving manager in the NHS, both coming to Northeastern’s London campus to speak with the class.
On the day Northeastern Global News joined the class, they were hearing from Anthea Allen, a senior nurse who worked in intensive care units during the coronavirus pandemic. Allen published a book, “Life, Death and Biscuits: The inspiring diaries of a critical care nurse on the COVID front line,” about efforts to improve morale and conditions for nurses during the crisis.
The practitioner told the students about the “nightmare” she and her colleagues found themselves in at St George’s Hospital in south London. Patients would die without her ever knowing their names and she didn’t know who her colleagues were due to each of them being covered head to toe in personal protective equipment.
As politicians pushed for more ventilators to be made available, Allen went onto the airwaves to get the message out that more skilled nurses would also be required to operate the machines, given that, in the NHS, they are more likely to apply them than a doctor.
“I thought, ‘I’ve got to do something,’” she told the students. “This is absolutely crazy — the world does not know what is happening.”
Nursing student Tyle Asamoah said hearing firsthand from people like Allen was useful as she wants to be part of creating a better health care system.
“Previously, before coming here, I understood that both systems [the U.K. and the U.S.] have their own issues,” said the 19-year-old from West Virginia. “But I really want to understand where both went wrong and how we can increase both productivity and the quality of care.
“I feel like having the opportunity to come here and learn, I really like it — it is very engaging, very immersive. Because just sitting in a classroom, yes, you’re going to learn a lot, but actually having the ability to see it and hear it from people who actually live here and experience it, like we heard just from Anthea Allen, it’s really inspiring, to be honest.”
Saagar Shah, a first-year behavioural neuroscience major, said he decided to head to London for the course because he wanted to understand a health care system that he felt was “completely opposite” to the one he had experienced in the U.S.
“The U.S. is very privatized, it’s a lot more financially focused, and that’s really the priority there,” said Shah, who hails from New Jersey. “The government really isn’t that involved in general compared to the NHS, where it’s pretty much all public, there is very little private financing and finance isn’t really a concern for patients.”
Shah, 19, said it had been “fascinating” to hear from people who had “actually worked within the system” and to hear “what their thoughts are” on the NHS.
“It is one thing to read from a slide show or be lectured on something,” he continued, “but it’s completely different when you have people literally telling you their personal experiences.
“Especially people that either had such a large impact, like Steve Brine, who came to speak to us, or even the guest speaker [Allen], who worked the front lines and just happened to make a huge difference. She wasn’t expecting to, but she did. That was very surprising and very interesting to hear.”