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.

Private medical insurance is often paid for by your employer. Mine cover me as a benefit and I pay an extra £60pm to add DC to my policy. Private medical care is fast and excellent. I’m not in A&E regularly, just twice in the last 4-5 years, once with DD when she had appendicitis earlier this year - she was in a bed in a ward within about 3 hours and operated on the following day. Once with DH with a bad cut to his head - again, he was seen within about 45mins (tbf it was a bad cut and he’d passed out a couple of times).

For things like antibiotics etc you will be waiting for hours at A&E because it’s really not set up for those sorts of things, but there are walk in urgent care centres that can deal with those sorts of things. It’s very difficult to get a standard GP appointment when you need one, bit I use a private GP via medical insurance for those now. I worry about what would happen if I needed an ambulance, they do seem like a bit of a lottery.

At least you won’t go bankrupt in the uk because you or your family get a treatable disease, I have two friends in the USA who lost their houses because their children got cancer and they had to pay 10% of the enormous medical bills on top of having to rent a flat near a children’s hospital

Private GPs are available online anywhere in the country.

My private healthcare allows me a telephone consultation 24 hrs a day, 7 days a week. I can have a video consultation between 8am and 10pm, 7 days a week.

I’ve randomly just remembered that I had to take DH to a&e in NYC in 2023 for a perforated ear drum. We were in there 9 hours, and people were ordering take out to a&e whilst they waited.

surely that’s not an unusual experience I’ve had?

), 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

think about what you are saying here. You’re contradicting yourself.

if there were “huge waits” for life saving treatment, then the life saving treatment would n’t save lives because people would die waiting. Which would shorten the queue and the waits wouldn’t be long.

Plus considering out life expectancy is higher than the us then clearly this isn’t true.

don’t just believe everything you hear.

“overflowing a&e’s” tend to do so because people aren’t using it appropriately. If you can wait 10 hours to get seen chances are you could have gone to MI or your GP the next day. You are usually triaged straight away, seen immediately if you need to be. The ones waiting long hours do so because they can wait.

But don't you think that if the economy gets fucked then the NHS will be as well?
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Weekend are emergency appts only usually. Likely not with your gp. Register for a gp with the e-consult you send in your issue on app and they triage and call you back same day if necessary

Are you being serious? As other people have said you could get private health care cover.
The UK is many things but we still have free healthcare, state pension and support, strict gun laws. We have an incompetent government but we don't have a convicted felon setting himself up as a dictator.

For a lot of the "emergency" issues you describe you would go to a GP or your pharmacy not A&E. Think I've been to A&E 2 or 3 times in my lifet (late 50s) - it shouldn't be a regular event for every issue.

Yes, there is the online option. We have private GPs you can visit too - that's quite unusual, I think.

If you want weekend gp appts you will want a private gp, probably easy to find in London, I’m in Scotland and there are a couple of in person ones available near me and I also use an online gp/nurse service with bupa

It seems astonishing to me that a fit and healthy 30 year old should base their entire future around availability of health care for them and children they don't have and might never have.

“overflowing a&e’s” tend to do so because people aren’t using it appropriately. If you can wait 10 hours to get seen chances are you could have gone to MI or your GP the next day. You are usually triaged straight away, seen immediately if you need to be. The ones waiting long hours do so because they can wait.

You couldn't be more wrong here. It's true that A&E gets used for ailments that ought to be monitored by a GP, but that's not likely to get better because there are no GP appointments.

And once you are triaged you still have to wait for hours, even with chest ppain and breathing dificulties.

I suddenly developed a serious chronic health condition 15 years ago which meant I could no longer work. It’s the sort of thing that could happen to absolutely anyone, but nobody thinks it will ever happen to them. I’ve had many regular appointments, scans, blood tests, minor surgery and physio free of charge. My prescriptions are also free now that I’m in my 60s. The NHS is far from perfect, but it’s there for all of us if serious illness or injury happens. You might have to wait for non urgent appointments, but you will get seen eventually at no cost. If I lived in the US, I know I’d have been made bankrupt many years ago!

Budget for private health care, you have never paid into the system ie National insurance what make you think your “entitled “ to it free ?

OP - do you have any friends and/or family in the UK as it appears you are listening to what's being reported in the USA about, 'socialised,' medicine?

In our family we have had a few instances of dreadful unsafe neglect in a A& E
My Dad missed a chance of being saved through mis-diagnosis and died. Complaints are just fobbed off and they never learn. Maternity services are appalling, figures for still births very bad. Sen provision in crisis social care is also in crisis and reform kicked in the long grass. Prison and justice system in crisis. Most town centres a mixture of banks, betting shops, vape shops, charity shops and little else.
on the good side, you don’t send kids to school fearing a mass shooting, but Knife crime is rife.
we do have some beautiful countryside and beaches..
just come with your eyes open op

You want to emigrate from the US because Trump is in charge and he's right wing.

But you're not sure about coming to the UK because it has a left wing health service?

You hear the horror stories. You don’t hear all the stories of when the NHS gets the job done well. Over the last year, we’ve had a couple of A&E visits (one for DS, one for me) which have been quick and uneventful. My GP practice is outstanding and far better than the private equivalent.

Triage does exactly that. If you wait for 10 hours with chest pains and bragging difficulties, it’s because you’re not having a heart attack.

I’m not saying mistakes aren’t made it in triage process but pretending people who need life threatening medical treatment are made to wait 10 hours just because is unfair

I’d come to the UK just for this.

They’ll have to pay anyway. Isn’t it £3k ish healthcare supplement with the visa before she’ll get visa/ residency?

Are you in the SE? I am and I think it’s more typical here for the in person availability around here.

I need the GP for one of my children when visiting relatives and it was online only.

bragging difficulties?

Are you for real?

And no, you do wait for hours.

From a quick search:

In England the standard for A&E (accident & emergency) departments is that 95% of patients should be admitted, transferred or discharged within 4 hours of arrival.

However, performance is currently well below that target:

• In recent data, around 73% of patients attending A&E were admitted, transferred or discharged within 4 hours.
• The median time spent in A&E for all patients is around 3 hours in recent years.
• For patients who are admitted to hospital, the median wait in A&E rose to approximately 4 hours 46 minutes in March 2025.