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.

I agree with you. Labour just love to tax those that work and give it to those that don't work.

It's not just about hospital care though, either. An American friend of mine (also considering a move back to the UK) recently had to pay 400 dollars for each of her kids' epi pens. Our prescription charge is £9.90 per item - and many over here even complain when the prescription charge goes up!

It costs an absolute fortune to have a baby in the US. Nobody is in debt because of the healthcare they've received over here. State subsidised childcare is practically non existent in the US compared to here. Plus, just two weeks of paid annual leave also means that thousands extra need to be found for holiday clubs in the US.

And then take entertainment. My friend couldn't believe that you can get reduced rate children's tickets for sporting events over here - in the US, if you can slap a price on a seat then it's full price.

Then there's gun control of course. I don't generally wave my kids off to school in the morning and worry all day that some lunatic with a gun is going to murder them.

The UK has a lot wrong with it. But i genuinely believe that it's got the right approach to most of the important things.

Ultimately though, the NHS has saved my dh's life and I'm not in poverty as a result. It's on its knees of course, nobody can deny that, but all the more reason to support fixing it. And of course, if you have the money then you're still free to choose private health insurance.

What extra tax are you paying that you weren’t in June 2024?

I completely understand the frustration many families feel, because we’ve been through so much of it ourselves. We often find ourselves debating with nurses about drug dosages that require precise administration. Some of them get the calculations wrong, and we have to correct or challenge them.

A lot of the staff work part time and when we try to follow up on something important, they get irritated. One nurse even told me that she and her colleague would both be on long-term sick leave. When I asked who our point of contact would be in their absence, she started ranting at me about how they’re entitled to be sick and said she wouldn’t wish what they’re going through on me — me, a mother who fights for her daughter’s condition every single day. I can’t even describe how rude and oblivious that was.

She then started complaining that we shouldn’t chase them because the doctor has 150 patients. I was in disbelief. Because I have a scientific academic background, I tend to ask questions and want to understand the reasoning behind clinical decisions, but that often seems to make staff visibly hostile.

Once, a doctor even called me at work and spoke to me so aggressively that my colleague, who overheard the call, was left speechless. The doctor basically demanded that I say yes or no to staying under their care, right there and then, as if my daughter’s complex condition could be reduced to a snap decision. Only as I dare challenge their decision not to refer us to a neurologist which in the end they had to given my daughter’s condition.

For the sake of my daughter, I didn’t pursue a formal complaint at the time, but I was fuming. People often say the NHS is brilliant — maybe they’ve been incredibly lucky. My experience has been the opposite: a constant fight, filled with stress, rudeness, and indifference.

I clapped for the NHS every day during COVID, but now I deeply regret it. The way we’ve been treated has been nothing short of disgusting

Since the UK doesn't seem to have the equivalent of local urgent cares, isn't A&E the only after-hours option for things like bone fractures and infected cuts which require antibiotics urgently?

We have an urgent treatment centre where I live, which saves many a trip to the nearest hospital, 8 miles away. It's open daily from 8 am to 8 pm. They can do x-rays, prescribe meds, plaster straightforward fractures, etc. And whenever I've needed to see a GP, I've always got an appointment the same day or the next working day. The waiting time is rarely more than around 40 minutes, although it does tend to be longer on Saturday afternoons and Sundays when it's full of men with rugby and football injuries.

A few weeks ago, the GP referred me for investigations into something that could have been serious. The referral was made at 4.30pm and I was seen at the hospital the following morning, prescribed appropriate meds and saw the consultant the following day. A biopsy was booked and that was done 2 working days later.

I’d be more worried about having children without any family support. Your parents will be thousands of miles away as they get older.

Honestly stay. The UK financial outlook is gloomy, the job market is dire and salaries are a joke compared to the US.

Plenty of people raise kids without parental support

It's much harder though! (Source: raising children with both sets of GPs in another country and comparing to siblings on each side who live close by)

And you can access NHS111 by phone 24/7. They can prescribe and send a prescription electronically direct to your nearest pharmacy.

And it’s much harder.

Personal experience.

Yes if you’re successful stay where you are, for a while anyway. The gov here is going for it with higher taxes which hampers growth.

Much harder without any family support. Plus my elderly parents need increasing support so if we were in different countries it would be incredibly tricky.

Thank you - I'm not feeling very articulate this morning. I agree.

I don't think you can simply compare access to medical treatment in the US with that in the UK in the way you are doing.

It partly comes down to what kind of society you want to live in.

We have fewer additives in our food, can walk freely in towns and cities rather than have to drive everywhere. We are not over medicated because we can't buy many medicines over the counter and the NHS has guidelines on what is an effective treatment, so you are less likely to be over treated.

It matters to us that we all sit in A&E together, that there is no VIP fast track.

Come if you like the sound of that.

I don't think the OP has mentioned a partner? Maybe they have parents/family in the UK.

I would stay where you are OP. It sounds like you need more than average medical attention for your age, so you might find it hard to get good insurance here.

It's worth looking at what healthcare insurance costs and covers in the US & UK. I don't know much about US providers, but in the UK they will not usually cover any pre-existing conditions. Urgent medical or surgical care isn't typically available privately in the UK - I mean urgent as in treatment of fractures, appendicitis and so on - it's mostly elective procedures and outpatients. US insurers don't cover everything by a long way and will refuse to reimburse for some treatments.
The US tends to do better on cancer detection and survival rates but worse on outcomes for chronic conditions like diabetes.

Say what you like, but I've never heard of anyone moving to the US for its healthcare system.

https://www.ncbi.nlm.nih.gov/books/NBK537990/

there are actually quite a few cases where people with serious health issues get treatment in the US.

the Charlie Gard case made the papers because UK doctors disagreed and it went to court but it does happen.

Fair enough, there are of course cases where people go to other countries (not just the States) for particular treatments. But on the whole, I don't think many people make a conscious decision to emigrate to the US just because of its healthcare.

Well, no, I also don’t think people make a decision to go to the US just because of it’s healthcare.

i do think that well-educated people in high paying jobs think about the countries they can go to and work in and healthcare is part of what they consider.

i was at uni a long time ago and many of my friends have left the UK at various points, mostly for English speaking countries and quite a few of them are in the US. The general vibe I get from them is that yes, you do need to choose where you live quite carefully (eg one Asian bloke said he’d chosen to live in a very expensive area to make sure he didn’t get racially profiled or at least got profiled as “rich Asian”) and private healthcare is a must, but that salaries are a hell of a lot better and the overall package is better.

if you have money in America the healthcare can be a lot better than the nhs can offer.
I have a disability and a friend of mine has a niece with the same disability in the US. I was genuinely awestruck by the amount of support the niece was given - rehab, physio, hydro, seeing consultants etc. I got nothing like that.

I always wondered if the tech is actually better in America or is it just the speed of service

As you said though it's about money
I have an insulin dependent diabetic son here in the UK he gets all of his treatments and medication free
There are genuinely people in the Americam Diabetic Facebook group I'm in worrying about how they will afford their insulin which I find abhorrent .

just because the US healthcare system will treat you, if you can pay for it, doesn’t mean you should.

NHS healthcare is evidence based. You will get the treatment if it is shown to improve outcome.

keeping kids indefinitely on life support when there’s no chance of recovery is inhumane IMO.

I have only seen “treatment in the US” have a good outcome once. And that is when the treatment wasn’t available here- there was a multidisciplinary meeting and it was decided the treatment would be beneficial. So the nhs paid for treatment in the US.

in the vast majority of cases any effective treatment will be available on the nhs. If it isn’t, chances are it’s at best not going to do much, at worst decrease quality of life.

I am seriously disabled following medical negligence on the part of the nhs.

i understand that you want to defend the nhs but U have very bitter personal experience of exactly how bad it can be.

don’t talk to me about the nhs being evidence led.