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.

There are big regional differences in care. In SE England you will be fine. Elsewhere not so much.

Like many things in life, you hear more about the bad than the good. I'm not going to pretend the NHS is perfect, or that I haven't been frustrated with them on many occasions. But personally, when it's been needed, it's been amazing.

In my area of the UK, I can always see a GP same day, guaranteed. With the A&E, The longest anyone in my family's had to wait was 4 hours, and that was waiting, x-ray, seeing a doctor, interim treatment and coming up with a plan. A few months ago, a parent required an ambulance - it wasn't immediately life threatening, but reasonably urgent, category two to three. Within 3 hours of calling 111 for advice, they'd had a call back from the doctor, ambulance called, arrived taken to hospital, in a bed, tests taken and some interim treatments started.

A child of mine has a serious health condition, and is under about 9 different departments. I have niggles about efficiencies, but from past experience I'm confident that if I need to speak to a doctor about something that cropped up urgently, I could do so immediately, and have done on many locations.

If you years ago tests were conducted so quickly for my mother, that we all assumed she was under the suspected cancer pathway. Nope, they turnaround time was just very quick. Equally my sister sent a message to the GP to get on a waiting list for a test last week, expecting it to be months. She's got a date for a few days time.

When you look at the statistics, most people think that everyone's waiting for 12 hours plus an A&E, but 75% are treated, admitted or discharged within 4 hours, and only 7% 12 hours plus. That's 7% too many, but it's not some epic trip for most people. But because we only hear about bad and not the good, people don't realise this.

Our private healthcare over here isn’t that brilliant either to be honest. There was a recent clinic in Glasgow that took on procedures for the NHS and majority of the patients ended up needing emergency treatment on the NHS because of failures!

Thankfully I'm healthy with no chronic health issues, but I have been to urgent cares so many times (injuries, infections, pneumonia, etc. that needed immediate treatment). I went to the emergency room a couple of times too when the urgent cares were not open on weekends or late at night.

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?

My mother in California has Kaiser - she pays deductible, co payment and god knows what else to see a primary care physician. She had cataract surgery last year and ended up paying something around £2500 despite being fully insured.

Me: in the UK - had several admissions for gallbladder issues; emergency admission and then on waiting list which ended up being 3 weeks. Key hole surgery done and dusted. Obviously zero cost at the point of delivery.

yes, the NHS has issues, but oh my god I'd rather roll the dice here...

The horror stories always float to the top of the news / social media.

Like ......school shootings.
Having your country run by a ...what is that exactly ? Peadophile, fraudster..misogynistic... Whatever ..so round of applause for voter iq.
Raging inflation.
Partisan local law enforcement.
Military law in peaceful places.
Loss of women's autonomy over their own bodies.
An obesity crisis

And you are concerned about free healthcare not being quite "up to scratch" ..google uk healthcare v U.S. on virtually a standard and its better.

Well all the interactions I have had with the NHS have been just grand - it may be worth checking specific areas - we can get a doctors appointment same day for urgent and within a week for anything else , I know it’s harder elsewhere

our a and e does struggle at times but the two (!) people I know who have been there this month all have nothing but praise

As things stand currently in the UK there is no way in a million years I would choose to leave the US to live here.

I think if you have a lot of money it is probably better in the US. If you have less money, it is probably better in the UK.

If you are planning to have kids here it might be worth budgeting for private schooling as well as private health care.

I'm a very solid labour voter and have always believed 100% in state medical care and schooling. However, the knock-on effects of the covid years mean that we are now payiing £8k annually for health care and our child has been moved to a £35k school. I really never never thought I would say that.

I think it depends if you want really expensive medical care and live shooter drills in the US, or cheaper slightly shoddier health care in the this country and potentially home schooling or private school here.

Private GP (and some NHS ones) work weekend. Pharmacies can prescribe antibiotics, pneumonia can be treated before it develops, and there are Minor Injuries and Acute/Urgent Care Centres. Again, cuts should be seen before they become infected.

Yes, a broken bone is likely to require A&E or Minor Injuries. However, if you expect to break enough bones to need to go on a regular basis (I’m almost 50 and have never broken a bone, despite being an adrenaline junkie in my youth) then perhaps there is an underlying health condition that you have which also needs to be seen to separately.

NHS is better than the non free health care in the U.S. Either use the NHS or get decent private care similar to the U.S.

We have private care, absolutely brilliant.

I went to my GP concerned about a hereditary heart condition in August - 2 months later I have had 2 x ECGs, a 40+ health test including probability testing for various conditions including diabetes, advice on preventative health care, a heart ultrasound and a blood test, all with results within days.
My MiL and FiL have both had operations in the last week and recovered well.
Both my parents have had timely health investigations recently.
DH had back pain and was seen by a GP within 24 hours and had a prescription a day later.

I’m not saying there aren’t issues with the NHS - it does need more funding etc - but I don’t really see it’s on its knees? And the current government - like them or not - have clearly prioritised the NHS because waiting lists are down and they have put a lot more money in.
Honestly the NHS is a reason I would stay in this country, not leave it.

You're also forgetting the U.S govt employees are currently without pay, since 1st October.

One of my dc lives in the US.

they hate US healthcare. They have good insurance apparently, but navigating it is a nightmare, they’re never sure whether they’ll end up with a massive bill, and getting further treatment and referral on is a nightmare as even if a dr recommends you have to get insurance approval.

they much prefer the nhs. Much easier, point of care access, no fear of bills, and referral to any appropriate specialist if indicated. A dr says you need it, you get it.

plus the option to pay privately if they want. Blood tests etc are quick and easy, same day, and less ££ than the co pay on their insurance.

the disposable income there compared to here is much the same when you factor in healthcare and other bits. £200/month in NI is nothing compared to paying insurance premiums and 401k in the US. Plus lose your job you don’t lose your healthcare.

Some places do have private GPs but it's not that prevalent. But I have an NHS GP and don't struggle to get appointments- it really varies.

Everyone uses A& E, even with private cover, but it makes you part of a bigger system, where you know that everyone will be treated. I think that's worth something.

On the other hand if you raise kids in the US they might get shot at school. Literally.
I don’t get the conundrum honestly.

Check ypur rights to access nhs as you have not been resident in uk

But if you do reside here nhs is free at point of access you do not get that in usa

Least of my worries if I was leaving a country thats criminalised abortion and loves firearms.

Oh yes! The good old US where having cancer could literally bankrupt your family!

I broke my arm in America, the bones were sticking out and they wouldn’t take me to hospital until I proved insurance…

Two months ago I went to my GP for what I thought was a routine appointment and 20 minutes later was in an ambulance, rushed straight through A&E into resus where a team of heart specialists worked on me for 24 hours. I was then moved onto a ward where I again received excellent care. Since discharge I have had further tests, investigations and my first appointment with an excellent cardiologist to discuss my long term treatment options. You'll see many people complaining and A&E is problematic in many areas but if it's serious, once you're in the system, things do seem to work well.

No, she can't.

There are no A&E in the private hospitals.

If you’re not concerned about school shootings then stay where you are?

What things would attract you to the U.K.

do you envisage needing a&e often?

This is very reassuring to hear! Can you get same-day appointments even at weekends? Are you located in London / Southeast (if you don't mind sharing an approximate location)?

The U.S. salaries are way higher and the taxation is lower. Your stock market has been booming and you are pretty much self reliant. I certainly wouldn’t worry about the NHS, because unless you have a chronic illness, you shouldn’t need it that much. Positives are that state schools are of a higher standards, our culture and history is way superior, but at the moment I would say stay there. You are more American than British and I think you would struggle. House prices are ridiculous here. People are fed up. Give it a couple of years and see how things are going here. Hopefully better!