(BRUSSELS) - The French healthcare system is failing to keep up with the likes of the Netherlands and Denmark but is still significantly better than its British counterpart, according to a study released Thursday.

The annual 'Euro Health Consumer Index' put the Dutch healthcare system at the top of its list of 31 countries, hailing it as a "truly stable top performer" after the Netherlands took top spot from Austria, which led the way in 2007.

"The Netherlands have started early on the work on patient empowerment, which now clearly pays off in all areas," said the study by the Brussels-based health analysts, Consumer Powerhouse.

Denmark beat Austria to second place and also leapfrogged countries like France, which was first in 2006 but dropped as low as 10th on the new list because it "could not keep up with the improvement rate" according to the report.

The British healthcare system, though rising four places up the good practice ladder to 13th still found itself two places behind former Soviet satellite Estonia, which drew praise for providing the best value for money.

Estonia "demonstrates how to deliver quality performance with relatively low levels of expenditure," according to the report summary.

In general the 'Bismarck' healthcare system beat the 'Beveridge' system.

Named after Prussian Chancellor Otto von Bismarck and used in countries such as Germany, the Netherlands, France and non-EU member Switzerland -- all in the list's top ten -- the Bismarck system is based on social insurance, where there is a multitude of insurance organisations which are organisationally independent of healthcare providers.

The Beveridge Model, named after William Beveridge, the social reformer who designed Britain's National Health Service, produces healthcare systems where financing and provision are handled within one organisational system, such as the National Health Services of Britain and Nordic states.

"These systems tend to have low costs per capita, because the government, as the sole payer, controls what doctors can do and what they can charge," the report said.

Only Norway and Finland -- with their smaller, more easily-managed populations -- squeezed into the top 10.

The list, first published in 2005, is devised using indicators in six categories: patient rights and information; e-health; waiting time for treatment; outcomes; range and reach of the services provided; and pharmaceuticals.

It includes the 27 EU nations and four others.

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