Living in the UK

Going to a different topic now...last night my mother in law was over and we were talking about whether they would move back to the uk at some point (she’s American, he’s british and they currently live in Tunisia). He seemed like he was interested, but she started talking about how terrible the nhs is, how it’s going bankrupt, how there’s a terrible shortage of doctors etc and would be sub par.....I know each system has its flaws, but I feel like here in America you might get quicker care if you’re paying for private health insurance, but if you’re depending on Medicaid or Medicare you’re going to be waiting for a while to be seen too. Not to mention you have crazy high costs of health coverage and then if something major occurs you can go bankrupt from medical debt. Is the NHS as bad as she claims? Do you get terrible treatment???


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I have a chronic health condition and the NHS isn't *great* for things like this but it is passable. I'm having trouble getting meds because they want me to start back at the beginning, with things that don't work or have caused adverse reactions. But for care, any referrals I've needed have happened and quickly, but the standard of care when the NHS is paying is lower for doctors who practice on both. Shorter appointments and less attention. Even with insurance in the US I was regularly waiting six months to a year for new specialists so the wait times are literally no different. But if you have something there are limited NICE guidelines for you could be paying a LOT for private care (Lyme disease comes to mind... They just rewrote those guidelines and intentionally left out that a bullseye rash isn't always present and it can take years for all symptoms to surface.) Many employers include some sort of private health coverage, but they rarely include pre existing conditions so you can get help quickly for new diagnoses and injuries just nothing chronic. And I no longer have to worry about the $1500 it will cost to go to the ER, which is a good bonus when things are iffy. And they have 111 who you can call for advice if you're unsure if you need to be seen urgently.

Is the NHS as bad as she claims? Do you get terrible treatment???

I've been in the UK for 11 years, and have dealt with the NHS for minor stuff you see the local doctor for (earaches, eye infections, etc) as well as big things (the birth of two children, major and minor surgery). In every case, the doctors and nurses I've dealt with have been excellent, and I have no complaints at all about the quality of treatment.

What I had to get used to is that the NHS only goes as fast and as expensive as it needs to in order to treat whatever is wrong with you. If you're having a heart attack they'll go very fast, or if you've got cancer and go to a hospital that specializes in it, you'll get the highest quality treatment that's available. On the other hand, if you've got a sore elbow, you may be told to put ice on it and rest for a few weeks to see if that works before they start sending you out for x-rays and MRIs.

My wife and I are both freelance, though, and having the NHS, and not having to worry about health care for ourselves or our children, has been worth its weight in gold. The fact that you can go see a doctor whenever you want without having to worry about costs - not only costs for the appointment, but you also don't have to worry about the costs of whatever tests they're going to order or of any treatment you're going to need - is amazing.

p.s. The other thing that took a little getting used to is all the NHS facilities - local doctors offices and big city hospitals - are government buildings, so while they're perfectly functional, they're nowhere near as pretty as US medical facilities. When living in New York I had to go to a hospital in Manhattan, and my English wife said, "This isn't like an English hospital, it's more like an airport with all the glass and chrome." 

In my experience, you really need to advocate for yourself with the NHS. 

Yes, the NHS is broken.  Yes, the NHS is having some major financial hurdles.  Yes, the NHS is severely overstretched and desperate to recruit more doctors and nurses.

That being said, now that I've "learned" the system, I am grateful for it.  I love that it doesn't matter that one person makes boat loads of money and one is homeless.  Both be given the same level of care.

I've had two extremely high risk pregnancies with healthy babies.  Things are different.  With my first, I was on the ward after delivery.  There were 7 women with our 7 babies.  Made for a few interesting days (usually people are discharged ASAP but as I was high risk, I was kept in for a bit).  But my hospital keeps private rooms for extenuating circumstances.  Which I unfortunately had with the my second, as he was in the NICU for a bit.  So I was given a private room as they didn't want to put me on a ward with women and their babies when I didn't have my baby.  And I still think bathtubs in hospitals are weird... but that's just me.   

I'm almost over the fact that I didn't get an epidural for either....  almost.... 

The NHS is underfunded.

Not having to worry about the bill when using the NHS is the biggest factor for me. And having the option to go private if you want to will give you the best of both worlds.

My husband was severely injured in the US and I can honestly say that dealing with the huge amount of bills constantly arriving was worse than learning to cope with his new and life changing disability. And the treatment he received there was completely limited to how much the insurance company would pay for. From what I have observed, he would have had much better care had he been living here at the time of his accident.

Is the NHS as bad as she claims? Do you get terrible treatment???

No and no.
It's desperately in need of more funding, but I've never had anything other than top-notch care.

I have three family members that have had major health problems and they have all been let down badly by the NHS. I'm sorry to say that.  Coverage is completely unpredictable and we even have a phrase for it - "postcode lottery". Some people get wonderful care and others get poor care.

Within the first six months of my wife being in the UK she saw a rat in the ER... not a great introduction to the NHS...

Thanks to Government cutbacks minor injury care in my town has be downgraded from professional nurses in the local hospital to volunteers in a temporary building in a grocery store car park. I think that is something you would expect in a third world country.

In the interests of balance, I have a relative in the US who broke her leg and the doctors couldn't see it on the X-ray, but my untrained wife could and had to point it out to them...

I have three family members that have had major health problems and they have all been let down badly by the NHS. I'm sorry to say that.  Coverage is completely unpredictable and we even have a phrase for it - "postcode lottery". Some people get wonderful care and others get poor care.

Within the first six months of my wife being in the UK she saw a rat in the ER... not a great introduction to the NHS...

Thanks to Government cutbacks minor injury care in my town has be downgraded from professional nurses in the local hospital to volunteers in a temporary building in a grocery store car park. I think that is something you would expect in a third world country.

In the interests of balance, I have a relative in the US who broke her leg and the doctors couldn't see it on the X-ray, but my untrained wife could and had to point it out to them...

The post code lottery is very real for so many things, including access to benefits when you qualify. It's definitely worth researching every area you'll be living in. If I'd been a bit south in Surrey I'd have almost no care for any of my conditions. And I know to never go to one of the local ERs in the middle of flu season, they had patients sleeping on the floor of hallways during the last one it was so over crowded. But you can also find that in the US, it just depends on how taxed the hospitals are in your city.

You do have choice in providers, and if you have a condition that needs specialist care you can be sent to London or other research hospitals. If you know how to ask for what you need you will be ok. But if you trust that the doctor always knows best you may struggle more.

The post code lottery is very real for so many things, including access to benefits when you qualify. It's definitely worth researching every area you'll be living in. If I'd been a bit south in Surrey I'd have almost no care for any of my conditions. And I know to never go to one of the local ERs in the middle of flu season, they had patients sleeping on the floor of hallways during the last one it was so over crowded. But you can also find that in the US, it just depends on how taxed the hospitals are in your city.

You do have choice in providers, and if you have a condition that needs specialist care you can be sent to London or other research hospitals. If you know how to ask for what you need you will be ok. But if you trust that the doctor always knows best you may struggle more.

I’m a nurse myself, so I definitely know how to advocate and push push push. I’ve had to do that with two of my children here for a problem they had as infants. Is researching the hospital much the same as researching the schools you choose?? Is there a way to see about the standard of care in particular areas? I take metformin (typically prescribed for diabetes but that’s not why I take it) would it be super hard for me to have continuity of care there and get a prescription or would it be a huge battle to prove why I need it??


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I’m a nurse myself, so I definitely know how to advocate and push push push. I’ve had to do that with two of my children here for a problem they had as infants. Is researching the hospital much the same as researching the schools you choose?? Is there a way to see about the standard of care in particular areas? I take metformin (typically prescribed for diabetes but that’s not why I take it) would it be super hard for me to have continuity of care there and get a prescription or would it be a huge battle to prove why I need it??


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You may want to read the NICE guidelines for your condition and see if metformin is an approved treatment. They *just* came out with a GP guide for mine so I'm hoping they read it and it improves my care, but I will be forking out the funds to see a private specialist in hopes that nudges them to prescribe the meds I was on or something comparable.

You may want to read the NICE guidelines for your condition and see if metformin is an approved treatment. They *just* came out with a GP guide for mine so I'm hoping they read it and it improves my care, but I will be forking out the funds to see a private specialist in hopes that nudges them to prescribe the meds I was on or something comparable.

Thank you, I’ll look into that document. Also, I might be mixing two ppl, but someone said a lot of companies provide private health insurance. Do you still have to pay a premium or how does that work??


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Thank you, I’ll look into that document. Also, I might be mixing two ppl, but someone said a lot of companies provide private health insurance. Do you still have to pay a premium or how does that work??


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I did. I think it can be a mix, but it's wayyyyy more affordable than the US. I am just starting my first UK job and they offer coverage included, but my husband had BUPA and we would've had to pay like £10/mo for it and due to the pre existing conditions it wouldn't have covered anything. My company has optional dental and vision coverage too so I'll be learning more about that.

Re the private health care, it varies massively between companies, as to what if anything is offered, and whether you need to contribute. By way of example, my company offers cover with AXA which seems to me to be fairly comprehensive (though it does not include dental), and we do not contribute to the cost (though it is taxed as a benefit in kind). There is also a circa £175 excess/deductable applicable annually. I would imagine a company like IBM would have something similar.

If you have to go this route, you can also buy cover on the open market. I pay for a plan for my adult daughter and it is comprehensive (no dental or vision, but those could be purchased optionally).  With a 250 pound deductible (which does not apply to GP visits), I pay 43 pounds a month. [Compare to $847 a month, with a $500 deductible, in the States for a similar plan. Three years ago.]

If you have to go this route, you can also buy cover on the open market. I pay for a plan for my adult daughter and it is comprehensive (no dental or vision, but those could be purchased optionally).  With a 250 pound deductible (which does not apply to GP visits), I pay 43 pounds a month. [Compare to $847 a month, with a $500 deductible, in the States for a similar plan. Three years ago.]

Wow


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