Friday, 30 October 2009

Reflections on the UK Health System

I have talked to several Americans who've had really horrible experiences with the UK's National Health Service. Others have been full of praise and thoroughly surprised by the level of attentive care they were given. Here are my general reflections about how you might find the care over here, especially as it differs from the American system. I realize being totally unbiased is not possible, but I'll do the best I can.

The fundamental thing to remember about the NHS is that because they are a branch of the government, they do not function like the American private practice system. In short, their primary aim is not to please you. Health care workers have little incentive to make concessions, do things your way or bend over backwards for you. This is because their livelihood does not depend on your satisfaction with their work--they are paid by the government, not by you. This is not to say, of course, that health care professionals in the UK are heartless and lazy. I cringe just typing that sentence. I have had some wonderful doctors here who have worked hard on my behalf and shown a great deal of care about me and my family. I have also had some who nearly put me in tears because of their calloused, unconcerned and unmotivated air. The funny thing is, I could say the same thing about doctors I've had in the US. The difference is, in the US, you have the choice to leave and go find a doctor you like better. Your options here are much more limited, often non-existent.

As a result of this foundational difference, here are some things you might face (based on my experience and that of friends):


1. Dead ends: You may feel that your doctor in the UK will not try as hard you think he/she could to find solutions to your health concerns, particularly if the problem is complicated. For instance, a friend in his 30's, after snapping the arch in his foot, was told by his UK doctor that he would never walk again. He was offered no further assistance. He flew back to the US to see his doctor at home and was walking again within a week.

2. Rigid Compliance to Rules: You may feel your health care provider cares more about the rules or the system than about your needs. We recently had a friend whose NHS prenatal classes were completely canceled. When she asked her midwife how to proceed, i.e., how/where to get the replacement classes, she was told she'd just have to go without because the other classes were full. Another friend was forced to leave her doctor's appointment after 10 minutes because her time was up. They didn't care that she had more questions and concerns to discuss.

3. Limited Options: As I said above, your choice of a health care provider will likely be somewhat limited. If you don't like the practice you're at, changing practices will not necessarily be a sinch if it's possible at all. In my experience, you are only permitted to register at the practice that is nearest where you live. The exception is if there is a practice that generally accomodates the University students, though these practices often have heavy burdens placed on their resources and you may find better care at the one closer to home.


Remember, it's free. Whenever I face something unpleasant, I remind myself that the care I'm getting is 100% free. I was talking to a friend in the US last week who's about to have a baby. Adding herself and the new baby to her husband's insurance plan is going to cost them $700/month. Having the baby, even with insurance, will cost them several thousand dollars. Sometimes I can hardly believe we don't have to think about those enormous expenses!

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  1. Jackie I had no idea this blog existed. Fun stuff. Even though I don't plan on moving to the U.K. it's fun to here your written voice.=}

  2. Hey, thanks! How would you like to write a counterpart about moving to Japan! :)