By David Jones
A grim Soviet tower-block, cheaply built just before the 1980 Moscow Olympics - presumably to further the grand illusion of caring, sharing Communism - the North Estonian Regional Hospital is hardly the most inviting place.
The frosted paintwork is grimy and peeling, and there is a liberal smattering of graffiti on the exterior wall.
We may be in the Baltic state of Estonia, but it appears much like many inner-city hospitals in Britain.
Step inside the Perspex doors, however, and a remarkable transformation occurs - for now you are in the model healthcare environment.
The first thing that strikes you is the smell : a wonderful fragrance that seems to be wafting from the flower shop in reception and mingles with a lemony detergent.
It is infused with the inviting aroma of home cooking from the restaurant. Next, you notice the spotlessly clean linoleum floor, which is buffed to such a shine that you really can see your reflection in it.
And then there is the calm, reassuring ambience in the waiting-room (where, in fact, there are very few people waiting) which is more like a theatre foyer, with a cloakroom attendant, huge pot-plants and eye-catching artwork on the walls.
By now, the contrast with most hospitals back home, with their depressing interiors, interminable queues and questionable hygiene, is palpable.
And, as a lifelong NHS user, seeing what can be done to improve even the most unprepossessing of hospitals this week - with limited resources but first rate management and properly-channelled effort - has made me angry and ashamed.
Last month, when the public health service in Estonia - which didn't even exist 15 years ago - was ranked two places higher than Britain's in a new league table of European healthcare systems, the news was greeted with a mixture of embarrassment and disbelief.
Of the 31 nations that were rated, Estonia was placed 11th, while the UK came 13th.
But in the 'bang for buck' category, which rates health systems according to their value for money, the result was even more humiliating.
Estonia came top and Britain languished in 17th position. In Britain, the shock was understandable: how far had the mighty NHS fallen that - in the very year that it marks its 60th anniversary - it had been trounced by a fledgling democracy which gained independence from the Soviet Union only in 1991.
A country whose older citizens can remember the dark days of command-economy medicine, where painful dentistry was performed without anaesthetic and queues could only be jumped by paying a bribe to one's doctor.
A country, moreover, whose population of 1.3million is less than the number of employees who work for our NHS, and which spends four times less per head of population than Britain on healthcare.
The staff were not exhausted or demoralised
Predictably, the Department of Health refused to accept that we had really lost to Estonia.
Health Minister Ben Bradshaw insisted that the league table - compiled by an independent Swedish-based research organisation partly funded by the EU - used 'flawed methodology and old data'.
Perhaps he is right, yet having spent a hugely impressive week in Estonia, visiting hospitals, clinics and family practices to examine this tale of two very different health systems, I would suggest that we have much to learn from this admirable little country on the roof of Europe.
Here, money is not wasted on endless tiers of bureaucrats. Instead, it is used to hire as many top quality doctors and nurses as possible, and arm them with the best affordable equipment and medicines.
In choosing which cases to prioritise, and which drugs to use, these highly motivated (and often very youthful) professionals are not hidebound by penny-pinching managers and bodies of outside 'experts'.
Refreshingly, they are trusted to judge their patients' best interests for themselves.
Perhaps more importantly, the hospital staff I met - though equally dedicated as our own - were not exhausted by ludicrously long hours and demoralised by low pay.
But the real difference I found was one of attitude at the very highest level. If Britain had done well in some international survey, the result would doubtless have been trumpeted from the rooftops.
Yet in Tallin, the satisfaction came with a degree of caution. 'Of course we are delighted about our little success,' Andres Tsakhna, adviser to the 34-year-old Social Affairs Minister, told me.
'But we still have our problems and there is so much more to do.'
Meanwhile, when I attempted to compare the performance and conditions at two hospitals with a similar number of beds - one in Estonia, the other in the UK - one was left to wonder which of them was formerly run by Soviet commissars.
Media relations officials at St Helier Hospital in the London borough of Sutton refused to allow me to look around.
And when they were asked to supply easily accessible information such as the number of patients treated and how many staff it employs, they said we would have to use the Freedom of Information Act. A damning indictment.
No doubt there are many fine doctors and nurses at St Helier Hospital, battling to do their best in the face of the huge difficulties facing the NHS.
Yet how are we supposed to measure their effectiveness against that of their Estonian counterparts when we are not even allowed inside to take a look?
Compare this attitude with that in newly transparent Estonia, where the majority of facts about the health system are available online.
There, under a new e-health scheme, patients will soon be able to view their own medical records - and even make appointments - by entering their national identity card details into a computer.
Then again, remembering the criticism that has been levelled at the embattled trust which runs St Helier Hospital, their defensiveness becomes more understandable.
NHS campaigners last year branded it 'the meanest trust in Britain' after it set out to slash a £24million budget deficit by, among other measures, banning hot lunches for patients and removing alternate light bulbs from the corridors. Its deficit is now 'only' £8 million.
However, according to a pressure group, the trust's spending on external management consultants ('What are those?' one baffled Estonian administrator asked me) have almost trebled in three years, to a staggering £1,670,000.
This dubious use of funds surely provides one clue as to why, while every Estonian hospital patient I have met has praised the standard of care, one disgruntled St Helier patient was moved to write the following on the NHS Choices website: 'The ward was filthy. The wall above my bed was bubbling and plaster dust was falling into my face.
'Staff just do not care. They are very condescending, sometimes totally rude - I would not wish this hell-hole on my worst enemy.'
So the question persists, why is the Estonian system so different - and how have they done it?
Asked this very question, Andres Tsakhna unwittingly repeats a mantra that will be familiar to British TV viewers.
'The price is right!' he says with a wink and a shrug. He explains what this means.
Unlike the NHS, which is funded by an invisible proportion of income tax (this has increased from £903 per head in 2003/4 to £1,149 this year), Estonia's healthcare system is financed by a central insurance fund.
Each working citizen contributes 13 per cent of his or her salary, an amount deducted at source.
There are no private insurance schemes
The money is used to buy medical services at prices agreed annually by the fund, hospitals and Social Affairs Ministry.
There are no private insurance schemes in Estonia, so everyone receives the same standard of treatment - though it is sometimes possible to pay extra for a quicker operation or a better class of room.
Interestingly, there is one important proviso. To be eligible for treatment, you must register for work - making yourself available for employment training schemes and any job that is offered.
Excepting children and pensioners, if you don't work or are not registered to work, the hospital door remains firmly closed.
The very small percentage of the population who refuse to work or look for work are entitled only to emergency care.
The price the central insurance fund pays for drugs, operations and hospital accommodation is invariably 'right' in Estonia's healthcare marketplace, as it is in everyone's best interests to keep it that way.
'Our hospitals know they must include everything in the price they charge, and that there is no additional money coming if they go over budget,' Mr Tsakhna says. 'That is why they are so very efficient.'
The politicians also know they are under pressure to deliver. Two years ago, amid a public outcry, an Estonian cancer patient was denied expensive drugs.
But in a landmark court case, the decision was reversed - whereupon the law was immediately overturned to make these and other costly new treatments widely available.
There should be no surprise, then, that Estonia scored better than Britain in the category covering the speed and deployment of drugs.
There is also no nasty old drugs rationing organisation like Britain's NICE in Estonia.
Nor are Estonians, by nature patient people, prepared to tolerate ridiculously long waiting times.
To be fair, there are queues for some non-urgent operations here; just not as many as we have in Britain.
Cataract sufferers in Estonia can have to wait 18 months, for example, and for some orthopaedic conditions, two years is not uncommon.
It should also be pointed out that when it comes to treating some major diseases, notably diabetes and cancer, the NHS is still better than Estonia's system, according to the league table - though only just.
However, should an Estonian doctor fail to find an appointment for a patient within three days, he can expect to be fined.
Dr Eero Meriland, a GP who spent 18 months working in Kent, put it succinctly: 'If we had such long waiting lists in Estonia as I saw in England, there would soon be a change of government.'
During his time in Sittingbourne, Dr Meriland was impressed by some aspects of our primary healthcare system. One thing he strongly disliked, however, was the reluctance of GPs to refer patients to specialists - a habit he seemed to ascribe to arrogance, though he was far too polite to say so.
Later, in the university town of Tartu, where Estonia's best medical teaching hospital is based, I met a young urology surgeon named Mihhail Zharkovski, who has just witnessed the appalling dangers of this failing first-hand.
A few weeks ago, he examined a 51-year-old music teacher who had been living in London with her two children for more than ten years, but had returned home for medical treatment because she was unhappy with her GP there.
'Nothing is more important to us than cleanliness'
For some seven months she had been complaining of passing blood in her urine and low abdominal pain, yet this doctor had refused to send her for tests.
Instead he treated her for cystitis, without any success. In her desperation, she had gone back to Estonia, registered for work to become eligible for health insurance and gone to see Dr Zharkovski.
Though only 29 years old, he has already performed scores of operations, gaining invaluable experience that would be unthinkable at his age in the British medical system.
He immediately suspected bladder cancer and sadly his diagnosis was correct.
A scan revealed a tumour the size of a lemon, which he will remove next month in a process that will hopefully save the woman's life, though at an avoidable cost.
'If we had operated six months ago we might have been able to make a substitute pouch for the bladder, but now it's too late,' Dr Zharkovski told me.
'Now she will have to wear a bag for the rest of her life. So you can understand why she is angry.
'In Estonia, if you find blood in the urine you must always send the patient to hospital as an emergency, and they are seen by a specialist the same day. If an operation is needed, it takes place almost immediately.'
Had he thought of writing to the GP to inform him of his error? He smiled wistfully. 'How do you think a British GP would react if he received a letter from an Estonian surgeon, telling him he had made a mistake?'
The question needed no answer. That is a pity, as Estonia's vibrant, enthusiastic healthcare professionals clearly have much to teach us.
In the A&E department at East Tallinn Central, the matronly figure of Dr Helve Breiberg marched me round treatment rooms which positively sparkled.
'Nothing is more important to us than cleanliness,' she said, and she clearly meant it.
On the equally spick and span rehabilitation ward, youthful Dr Anneli Nikitina looked nonplussed when I told her how long and hard her British counterparts were forced to work.
'It would not be allowed here,' said the doctor, who works a strict 40-hour week. 'How can they do their job efficiently ?'