To hesitate to move back from US to UK because of terrible state of NHS

[Star555]

(Apologies for the double post; posted on Living Overseas board but realised it's probably better to post here to get the perspective of MNers who currently live in the UK rather than the US)

I'm a long-term expat (in my 30s) living in the US. My parents and I moved to the US many years ago when I was in school, and although I have always thought about moving back home as an adult (I love history and culture and easy access to Europe, which the US woefully lacks), my parents are settled in the US and don't want to move back because they think the UK is in a bad state (failing NHS, high taxes, older infrastructure, etc.) One parent had a major operation recently and is under ongoing treatment at a top hospital here in America, and they think they would not have had received timely care like this in the UK given the current state of the NHS.

I have been on the fence about whether moving back home would be a good choice or not, and am thinking about it more seriously now given the US government situation, although my parents are against the idea. I don't mind the lower salaries in the UK so much (I have a STEM postgraduate degree and would likely have a job at a company in/near London), but I am mainly concerned about the state of healthcare. I have heard so many horror stories about overflowing A&Es and huge waits for life-saving treatments in the UK. I am currently single and don't have any close family or friends in the UK that I could count on for support if I were to need major medical treatment (touch wood). I would be willing to pay (or my employer would pay) for private insurance, but am not sure how much it would truly help.

Has anyone else decided against moving back to the UK, or decided to move out of the UK, primarily because of the sorry state of the NHS? Is access to timely medical care really that bad in London and the South in general? On one hand, I want to return to my homeland and raise (future) children there because of the culture, etc. but on the other hand I want reliable, high-quality medical care for myself and any kids I might have.

Firstly, much of what you describe you would see your GP with, not A&E. Secondly, there are also urgent care units and walk in gps here, and minor injuries too if you want to avoid A&E.

Secondly, you can get health insurance here too, if you choose to.

Thirdly, wait times are generally based on need, so critical cases will be seen very quickly. Equally, potential cancers are seen on a “two week wait” basis where you will be seen in less than 2 weeks.

Don’t forget, nhs care is free at the point of use but funded by national insurance contributions, which you won’t have been paying so you are being critical of a system you don’t know, which others will have paid for you to use. It’s not a perfect system by any means, but it’s still miles better than the health inequalities of the US.

@RogueFemale Have you lived in the US for any length of time? If not, please don’t be so dismissive. The OP’s parents have spent years in both the US and the UK so they actually do know how the infrastructure differs.

Yet another thread having a go at the NHS.

I live in a city. There are two large 24 hour supermarkets within a 15 minute drive (clothes, household items, books). There are 24 hour pharmacies.
Free museums and art galleries galore.
Decent public transport. People complain about the trains but at least we have a train system.
How are your food standards and food safety regulations over in the US? Growth hormones in meat? We refuse to import American meat. Chlorine washing meat? Untested additives in food and drink?
I get 6 weeks paid annual leave. How much does the average American get? I have an option to buy an extra 10 days.
How much paid maternity leave would you be entitled to in the US? Are your maternity rights protected in law?
People criticise the UK and posters on here say we've become a 'third world country ' - were nowhere near perfect but thats bollocks.

Agree with all of this. I think the US is probably 'better' for very wealthy people, but for your average person, the standard of living is higher in the UK. We also have a higher life expectancy.

I always used to agree with this, but it's increasingly common that people die or nearly die in A&Es in the UK because of problems with their care (or lack of it).

It’s not common at all. A poster posted the stats a few pages ago.

And on the other hand when my then 16 year old son collapsed suddenly we phoned 999 the paramedics were there within minutes they immediately diagnosed him being in Diabetic ketoacidodosis ( we had no idea he was Diabetic) hooked him up with fluids oxygen etc blue lighted him to hospital, took him straight through to resus ,he was in critical care within an hour
I'm not denying there are many many problems with the NHS but in a life saving emergency they were brilliant.

That’s terrible, I’m so sorry. I hope he’s better now?

Yes hes doing very well thank you .

I agree. The US always ranks way below the UK in world rankings of health care systems. For example:

https://www.internationalinsurance.com/health/systems/?srsltid=AfmBOopp10aaHK9aLHV53oFTkrZaitoXO-oJW-VL4TuEgqXlbPSpKTFj

Are there stats for someone nearly dying rather than just dying or having to receive more care then they otherwise would have because of poor management?

I wouldn't bother trying to balance all the anecdotes.

Just as your experience of living in the US will vary wildly depending on your individual circumstances, so would living in the UK.

You're young, healthy and child free, with good earning potential. Presumably a dual citizen?

Why not come for a couple of years and see whether you like it. Make the most of the higher level of paid annual leave and proximity to Europe.

Then decide for yourself.

my parents are settled in the US and don't want to move back because they think the UK is in a bad state

This made me laugh, as if the US is in a really great place right now!

Well I guess if there aren’t, you are lacking in data for your assertion.

there are stats about the length of time that people spend in a&e before being admitted or discharged

I think if you’ve got money, the US system is of course far better. If you don’t - it’s a disaster..!

But as others have said, you can always get private health insurance…!

Do you really want to have children in the US? Every Brit I knew there with children has now left. As a pp said: school shootings.

But I appreciate that you were asking about the NHS. It depends where you live. I have been registered at 6 different GP surgeries over the last decade. The two that had good Google ratings (4.2 and 4.3) were terrific. The two times I needed to go to A&E they phoned ahead and I was seen in the relevant clinic instead of A&E within an hour of arriving at hospital. It was not hard to get a same-day appointment if needed. The doctors were wise and kind. The other four surgeries (kept changing after a house move took us out of the catchment area of the first good one) were bad in different ways. One was indeed exceptionally bad. Thankfully I didn’t need to go to A&E during that period. (My children did, but pediatric A&E is great for anything serious and not too slow for more minor injuries — which was what we had.)

Last week my son had earache which began and worsened on a Sunday afternoon. Went to Boots, saw a pharmacist, left 45 mins after considering going with free Amoxicillin syrup and a reassuring look inside his ear.

When I had appalling earache in the US (lived there with fancy health insurance 20 years ago) it took a day to be seen and my eardrum burst.

Get Bupa. We have it via work. A lot better then the NHS

No.

because by definition that’s really hard to measure.

it is generally accepted though that as deaths due to waits at a and e have increased over the last few years, it’s likely that “near misses” and decreased quality of care have also increased.

Even estimating the excess deaths is difficult although there is general agreement it’s happening on a fairly large scale. There isn’t really historic data on this because pre-Covid hospitals were largely hitting the 4hour target and people were being seen quite quickly.

https://fullfact.org/health/accident-emergency-delays-excess-deaths/

The best there is on waiting times is this:

https://www.bmj.com/content/388/bmj.r119

patients who waited 12 hours have double the mortality of those who waited 2 hours.

We moved back to the UK from Hong Kong in 2017. The NHS is dire. It’s the worst part of being back. Yes, we have private medical insurance, but you’re stuck with NHS A&E for emergencies (I use a private hospital in London for accidents/X-rays etc). We’ve had to call paramedics twice since we moved back and they were amazing. We’ve also been admitted to a ward with a young child who was very poorly and the doctors and nurses on the ward were fantastic too. The experience of A&E (after being dropped off by paramedics) both times was horrific!!! My son was very poorly (they were using 5 different thermometers all wildly inaccurate and writing his vitals on different pieces of kitchen roll!!). He went grey and his oxygen sats dropped to 85. I made a massive fuss to get us up to a ward with proper care, which was then brilliant.

There’s a massive jealousy in the UK if you’re successful. With the forthcoming budget, and the economy in general, I’d stay where you are.

"I heard A&E is really bad"

"How often are you going to A&E? What a stupid reason to worry. Anyway, I heard abortions are illegal in the US"

"How often are you getting abortions?!"

Anyway only read a couple pages of the thread but OP with advanced STEM qualifications and thinking that will get a job that will sustain her in London is mental. Stay in the US where they'll compensate you for your skills. I don't understand leaving the US for political reasons when you can simply move to a different state, there is such variation.

If you do move to uk and have children make sure you move to a city with a children’s hospital with an A & E. The NHS is generally good with children’s care but you won’t ever want to wait with them in pain in a general adult A& E.

Not something i've ever considered with any of my children, its not an every day occurence is it

Anyway, NHS vs "US healthcare" makes zero sense to compare - there is huge variation on the US side both in terms of what's legal (if you want abortions and gender transitions for your kids there are some US states where you'll be much better served than the UK) and what your insurance pays for / how much your copays are.

You can't just compare the systems when you're deciding to move - what's the point in knowing that the NHS is an excellent safety net for the very poor, if you're not very poor? Or that you can access amazing topnotch care in private hospitals in the US if that's not something you can afford?