NHS vs Elsewhere

[Noicant]

If you have experienced both NHS care and care in other countries AIBU to ask whether your experience was better in the UK or abroad? Feel free to elaborate. This is not a thread bashing NHS staff and it’s not a political thread.

For me definitely abroad, I mainly have endocrinology problems - treatment was prompt, I saw a specialist who was able to explain my results in detail and explain dosages and how it may affect other aspects of my health. I did have to pay an excess but one I was happy with.

YANBU - treatment abroad was better
YABU- treatment in the UK was better

My family or the immigrants travelling back? Even with private care with your regular doctor you don't really skip a queue. I had to make appointment like normally. You probably would skip it with private doctor, but there is not that much to skip since waiting times are not year or so + time with gp to get referral.
I spoke with my mum and she couldn't understand what would private health insurance do for her compared to her regular one🤦 I don't think we even have that. Can't find any.
I had a look and gynae examinations would now be like £30 if you are paying by yourself. Dentistry is more expensive as self payer. Like crown is about £300+ without insurance partial (or full) cover.

And while it was not supposed to happen, many kept their regular insurance running and paid in (it's taken from salary, covered by state or paid by you) so they were treated like any other including prices.

The NHS,maybe crap.in many ways but my son had a medical emergency last week for which I called an ambulance for they were there in minutes and he's spent th last week in critical care,the staff have been amazing I can't fault them ,without the.NHS, my 16 yr old son would have died I used to.world of the NHS,so.I do realise they have their limitations but they saved my sons life and I'm eternally greatful.

Work for*

Switzerland: had back pain while working on a rooftop, went to the doc next day. Ultrasound right there and then in the surgery, gallstones spotted. referred to hospital while still in the surgery, all lined up - the next tuesday in for keyhole surgery, 2 nights in hospital all done. Fantastic !

My (limited) experience of the NHS is that anything serious was dealt with efficiently and competently. Anything not urgent has been extremely hit and miss.

I have found French doctors extremely patronising (but competent). It was relatively easy to get seen. There's (or was?) a lot of red tape too.
I don't live there anymore but I have a few friends who still do and I hear there are waiting lists now.

This is probably the reality ,im.emotional right now because i.have witnessed first class care for the past week due my son being in critical care
but I realise non urgent and people with chronic conditions may well.have a different perspective.

I have lived in a number of different countries

When young, and nowt much wrong, then the convenience that comes from private (insurance) systems is great.

But if you have something seriously (and potentially expensive on an ongoing basis) wrong, then hell I'm grateful for NHS. Because making those decisions without reference to cost is invaluable

I think the WHO and other organisations actually have comparisons of different healthcare systems based on data rather than anecdote. Also, if you look at how the NHS was doing 10/20 years ago compared to other systems, and how it's doing now.

I live in The Netherlands. I find the healthcare here better then the U.K..for now. Thing is though that I pay €213/month for my health insurance package plus an excess of €385 and pay for things like contraception as well as some prescription medicines. Kids are free.

This gives me "free" treatment in any hospital of my choosing, physiotherapy, basic dental care (checkups and hygienist), 80% reimbursement on mental healthcare (if you need more long term mental healthcare it's 100% free). I can't remember what else.

I also pay 49% income tax.

I don't know whether fellow Brits really understand the amount of investment that's actually required and how much it's going to cost. I pay a minimum of €2941 annually for my (good level) healthcare. I think the cheapest policy this year is around €185 with the same excess, and if you increase the excess to about €750 you can pay about €100 per month.

The NHS is a brilliant system. It needs revising and updating but the idea is sound. The biggest problem, however, is that people expect it to be "free". Nobody will vote to pay higher taxes/NI contribution to fund it, or to pay between £1000-£3000 annually to access it, never mind both!

The NHS recently provided lifesaving surgery for DH. Excellent standard, as was the care on the CCU where he stayed for three extra days because of bedblocking. But nursing care in the ward was substandard in several ways - I am able to assess this. I am not really criticising the nurses, as they were short staffed and doing their best. But DH developed massive sepsis and ended up spending an extra week in hospital, requiring intensive nursing care. Those shortcuts were at best penny wise and pound foolish.

I really find it difficult to imagine that standard of nursing care either at the hospitals our joint American HMOs were affiliated to or in the EU countries I know well.

Also our health outcomes are poor on many measures compared to similar European countries, and even poorer ones. American outcomes really depend on whether you have access to decent care. That’s morally reprehensible, but those who do have access also have better outcomes. It’s the American without health access who bring their stats down.

PS I agree with PPs saying that a properly funded NHS would be viable, and even excellent. I am not convinced the electorate is willing to pay for that, however.

Btw health insurance in the Netherlands is basically a tax because it's illegal not to have it. The hospitals are all "public" (it's not like BUPA/Spire who have their own parallel system).

I've also lived in France and while I believe their healthcare is really good, I've found their bedside manner isn't. There's no privacy or dignity - I had to stand top naked for an X-ray with multiple people - men and women - coming in and out of the cabin to chat. It was horrific. I couldn't move and was crying. When the lady came to move my position she asked why I was crying and I told her and she said "Oh it's just like being at the beach!".

Had another doctor offer apologies to me when giving the positive result of my official pregnancy test, then proceed to tell me how much children ruin your life (he had none). He wasn't joking either. I changed dr and found a lovely one, but it was quite unbelievable. Also come across the stereotypical tipsy rural GP. I've had good ones, but it was hit an miss - and the misses were really bad!

PPS. Properly funded and properly managed!

The French health care workers are widely on strike, though. Not looking very happy in France.

In our family we have a load of dental issues going on.

We are paying privately.
We still have to wait MONTHS. MONTHS to get a filling, temporary crown or an initial assessment by an orthodontist.
My American relatives can't understand these many month waits for simple dental/orthodontic care.
Neither can I , actually.
if the system is so broken that even private patients can't get timely care. It is super super messed up.

My dad is with Blue Cross, albeit still Medicare. He has a chronic neck problem. Saw doc about it ~2 weeks ago. He's since had one scan (CT?) and in next 14 days he will get MRI, some xrays, and then consultation and clinical plan about what is causing his terrible neck pain.

Meanwhile I wait 3 months to get a small filling, when I'm paying for it privately.

I’ve had care in the American system. We have decent health insurance but have still had to pay out thousands for non-covered expenses. Some care has been exemplary and some pretty shoddy. Post-natal care, for example, was a bit of a nightmare.

But there aren’t long waits to be seen. And all the doctors I’ve had have seemed engaged and attentive. (Whereas NHS GPs have often seemed to be rushing and I’ve felt fobbed off on several occasions).

I do find the US system bureaucratic. I spent 4 months going back and forth between by doctor, hospital imaging and a specialist before I getting a course of physio approved for my shoulder, then had to do it all again because I changed insurance company and the second one didn’t trust the first one’s assessment. And then after it was approved the insurance company sent me a questionnaire I had to fill out giving details of how I got injured so they could decide whether or not to sue the owner of the stairs I fell down. I’ve also had to phone up a lot getting payments sorted out and chasing medical records and the like.

I’ve been in hospital in Hong Kong (government), Singapore (private), Jordan (private), Indonesia (private), Switzerland (local insurance funded) and the UK ( NHS and Private). Would always choose to go NHS… depending on the Trust.. over and above anything private here or abroad.

I ended up in French A&E in December. This was on holiday. 14 hour wait to be seen. I had cracked my head open and needed stitches. Was put on a bed though and “padded” before being told the wait. They were lovely and hospital seemed as nice as could be.

It was almost reassuring that it’s not only us with nightmare waits when you’re not in a life threatening situation but still need assistance.

The NHS is not free. It costs about £4000
per year per person. It is just that the higher rate tax payers in U.K. pay more for it and others don’t pay. So many people get it for free but many pay far more indirectly for it than they would if living in Eg Switzerland and paying 500 pounds a month.
Many of the higher rate tax payers now also have private health care in U.K. too. And many of those same people are powerful and wouldn’t mind privatisation (because it would be better and cheaper for them personally) and some would even benefit directly.
However, given the low wage economy the U.K. currently still is I really cannot see how poor people could also afford private health care. Ill poor people is very inefficient and leads to further problems in society which eventually means even the rich have a lower standard of living.
Yes, Swiss health care is better, but until people in U.K. get a high basic wage like in Switzerland, forget it.

This is so interesting

I think this quite hit the nail on the head

Swiss system - experienced it as a tourist. DH needed emergency surgery. Care was great, food was great, clearly significantly more money/beds/staff than we have in the NHS. Was free for us as travel insurance covered it. NHS did provide excellent surgical aftercare and physio when we came back to the UK.

Canada - have used the system there both as patient and physician. Massive waiting lists for secondary care (18 months or more) as GPs do far less chronic disease management and specialists work at a much lower intensity (I see 15 patients in a clinic in the NHS, average was 6-8 in Toronto as appointments were twice as long and there is no overbooking).

Very hard to actually get a GP as well, which meant that people who were less health-literate/engaged tended to present very late - these people tend to be on their GP’s radar in the Uk, if only to get access to other services.

Actual care once you were in the system was very similar to UK, both in terms of the physical environment, standard of treatment, and bedside manner.

Provincial healthcare is free to residents (paid by taxation) but doesn’t cover dental, drugs, physio, equipment like wheelchairs etc. So some of my patients were spending $200 per month on drugs, and lots more just weren’t taking them (many renal patients are on 10-15 medications to keep them alive). DH paid $80 for a week-long course of amoxicillin, would be £9 here.

Overall I think the average person gets a slightly better deal from the NHS, but not by a massive margin, and HCP working conditions were significantly better in Canada.

The main thing I noticed in France was how resolutely French it was! There a quite a lot of lovely extra services (like hand massages during chemotherapy) but everything is run totally for French speakers and for a French ‘ way of life’.

I was talking to a HCP about maternity services in England, and I told her that there are hospitals in big cities in England where 96 languages are spoken In The maternity ward. Everything we received through our local very rural GP in England comes in at least eight languages, and several different writing systems. She couldn’t believe it. I asked her what happened if a patient didn’t speak French. She just gave a very Gallic shrug.

Small Greek island with a clinic that ran Monday - Saturday.

I went to the pharmacy who explained it was a medical emergency. The dr was called and opened the clinic for me within 5 minutes.

The dr explained that I needed a gynae assessment and had consulted with the hospital on a larger island - they were happy to have me.

I explained I was returning to the UK the following day so she gave me 5 days of antibiotics there and then.

Came home, called out of hours at 7pm and had a call back at 3am (which I cancelled in my sleepiness). Cue having to start the whole process again. The process was frustrating and pointless.

Thankfully the Greek dr was aware of how it is almost impossible to get treatment in the UK. Our A&E regularly has 9+ hours of waiting.

On my to-do list is arranging private healthcare for me and DC.

@Allthegoodnamesarechosen to be fair to the French, this clip is the reality if there doesn’t happen to be an Urdu/Cantonese/Spanish speaker on shift at the precise time you need them.

We do have cordless phones (never use your own mobile for languageline! It is a premium-rate number, guess how I know this), but that aside that clip is less black comedy and more gritty documentary.

www.bigissue.com/news/how-much-does-the-nhs-cost-the-uk/

Not sure if the above link works for others, but it illustrates that the U.K. doesn’t really underspend compared to others. The US system sounds much more inefficient to me.
Having lived in lots of different European countries and Asia, I think care in the NHS is good once you get to see the right doctor. It is the getting there and communication that is seriously lacking compared to other high income countries. Accessing health care should be easy and straight forward and not a struggle. That makes for a healthier and happier population.