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.

My DIL is American . Her granny lives in Idaho and has 97 guns of varying sorts stored in her house and a bullet making machine in her cellar. She carries a gun in her car and in her handbag at all times. My sons UK granny has 0 guns in her house. She doesn't carry guns, knives or mace spray in her car.

Im usually the first to slate the nhs but when it comes to true emergency care they are excellent. If you go to a&e for a true emergency you will be treat quickly and well. And if you have private insurance for the rest then you're in a pretty good position

Which noone said. However you seem
determined that people are left with heart attacks in a&E which isn’t true and turns out, isn’t even your limited experience.

it’s very common to blame medics when your loved one doesn’t get the care they want.

this is why people get so upset about elderly people waiting hours on trolleys. But the reality is, despite their discomfort and understandable upset, they do not have a medical need that prioritises them above the genuine heart attack/ strokes.

You seem very determined to minimise my experience.

I wonder why.

We do have private health insurance and have used it on occasion. But to be honest the NHS has been fine when we have needed it. Wouldn't have another baby on an NHS ward though.
I'd rather the flawed NHS than being at the mercy of insurance alone any day of the week.

OP, I can well believe it that in many cases care is prompter and provided in "shinier" facilities in the US.

But like everything, you have to look at the overall perspective. My father has terminal cancer (leukemia). He has had two courses of chemo over the past few years, requiring expensive care and long stays in isolation units with specialist nurses. He's also been in and out of various hospitals with infections due to the leukemia, and a lot of time and effort has been spent making him comfortable. He's had life-prolonging drugs costing thousands per months. Multiple senior doctors have had meetings specifically to discuss his treatment and how best to proceed. He's had hours of various doctors' time trying to work out the causes of his various infections and the best combination of drugs and medicine to treat them. They're coming to the end of what they can do for him (the type of leukemia he has is aggressive and has a poor overall prognosis) and he's been referred to palliative care. But so many medical professionals have fought the fight alongside him, and he has the small comfort of knowing that no stone has been left unturned and what has been learnt will help the next patient who presents with the same disease. Not all aspects of his care have been perfect - he's been left to sit in chairs for hours, shunted into side rooms, had ambulances delayed and hospital transfers take place in the middle of the night, had nurses not turn up and had a few gaps in the basic care provided. But my god has the NHS been there for him, probably to the tune of hundreds of thousands of pounds of treatment that he could never have afforded to pay even modest co-pays on, even had his insurance not lapsed or reached its limit. Cost has never been an issue - everything that could be done for him, has been. And the main expense to us and my parents has been the hospital parking charges.

Because it’s your personal experience and doesn’t reflect the overall state of NHs Care in this country? Isnt that obvious?

As everyone else has said, just pay for private medical insurance in the UK. Personally, if you have been living in the US (as a immigrant) for quite a lot of your working life, then you shouldn’t just be able to move back to the UK and have access to our NHS (if you haven’t paid in).

I’m in the SE and happy with my local healthcare. My GP surgery is great- I use the econsult system and usually get a text or a call the same day either offering an appointment if required, or telling me they’ve issued a prescription which I can pick up that same day. I have never needed to go to A&E in my nearly fifty years (touchwood!) so can’t comment on that but my husband has been a few times with sports injuries and has rarely had to wait more than a few hours.

Dentistry is an absolute shitshow though- although NHS dentistry exists in theory, large numbers of people can’t access an NHS dentist (I can but I’ve been with the same one a long time- most people I know don’t have an NHS dentist). But I imagine you’re used to paying for dentistry and you can continue that here. Private dentistry is good here as far as I’m aware. Although I have an NHS dentist, I have had to go private for some things which the NHS doesn’t cover (root fillings, implants) and the private clinics I’ve used were excellent.

My recent experience -18months ago I woke up with heart palpitations. Did an econsult and had a GP appt at 11am. GP said I needed to go to Short stay unit at hospital for tests.
Went to A &E and within 10 mins called into short stay unit. Over the next 6 hours I saw 3 doctors including consultant had 3 ECgs, 2 blood tests, lots of obs, given tabs to lower heart rate, got a diagnosed with Atrial Fibrillation given loan of a portable ecg.
Over the next 10 days I had phone calls from a dr on virtual ward, had appt with cardiologist and had an ultrasound heart scan. Since then I have had 2 more cardiologists appts.
I was really impressed with all this. i know there are a lot of issues in the NHS but you don't hear about when things go well.

I could agree with you, but then we both would be wrong.

I’m from the us and have lived in the uk for a long time, parents from both places. I’ve been feeling pretty down about the uk for the past decade, it’s sad, BUT… I would never ever live in the us again and I’m so glad my daughters aren’t us citizens. Doctors in A&E saved my ex’s life. I don’t ever wait more than a week to see a GP. I gave birth here and it was understaffed and a bit “bare bones” compared to Portugal where my other one was born, but fine. If you have something like an autoimmune disease like I do (I thought it wouldn’t happen to me I was so healthy!), being in the states would be awful. My neuro consultant is fabulous!

I’ve lived in both countries and I feel loads more secure in the UK

I moved from an EU country with a mutual insurance system to America and then to the UK.

I think it’s six of one and half dozen of the other, OP, but like you I say that from a position (so far) of privilege. The top end of US health care is more aggressive, which has pros and cons. Our NHS health care in the UK has generally been very good, but we also have private insurance. I used it once for a surgery for something more annoying than desperate.
I wouldn’t give it up easily, even though it is a big expense mainly used for peace of mind.

The social/economic/political scene here undoubtedly has its problems, but they are nothing compared to the dysfunctional American system. I am not a Tory supporter but I was proud of Rishi Sunak and Jeremy Hunt when, conceding the election last year, they both spoke gracefully about how important it is to keep democracy working smoothly. A big contrast with the American political climate. (I think plenty of Labour snd Lib Dem politicians would have spoken similarly)

I wouldn’t be put off as I compare the two countries.

ER/A&E is usually a vanishingly small part of any access to a health service.
In an absolute emergency eg, car accident etc, our A&E is second to none. If you have an infected cut etc, go to your doctor (private insurance doctor).

I’ve just had the misfortune of being admitted to A&E twice very recently (first time in 55 years) and both times it was nothing short of caring and professional.
I’m not naive enough to think this is always the case for everyone, every time, but wow, it was slick (and free!)

I have private medical cover and wouldn’t be without it for routine medical issues. It includes virtual GP appointments, however the few times I’ve genuinely needed the NHS - ie child having a serious asthma attack, she was in resus within mins of us presenting at a&e, child with a dislocated shoulder (on multiple occasions) was put back in within 30 mins, child needed major spinal surgery was done in 14 days (admittedly took a long time to actually get to see the neurosurgeon, but once they realised how serious it was. The care was great). So in actual emergencies they are generally pretty good.

We’ve then used private for the shoulder repair surgery, physio, knee surgery, numerous other investigations.

My local hospital has a minor injuries section, an urgent treatment unit and the usual A& E area, which includes a mental health unit. There is also a separate A& E for children.

Everyone is triaged pretty quickly then sent to one of the three areas. We have used it quite a bit over the years especially as you can legitimately go there with minor injuries.

We also have a bigger hospital a few miles away which has a dedicated heart and stroke unit, plus 24 specialist services like ENT.

We have found the treatment to be excellent in all of them.

Also, if you call 111, they often set up an appointment for you at one of the bigger GP surgeries, or get you an emergency appointment at eg the eye clinic.

One of my daughters has epilepsy and has had numerous visits to A& E, hospital stays, tests etc. She sees a consultant every year and the epilepsy nurse every quarter and is on a cocktail of drugs - she will never have to pay for any of this (she will never work).

Once you get into the system it is amazing.

The NHS is far from perfect ,but it's free at point of contact
My son is an insulin dependent diabetic and all his insulin ,needle, s Dexcoms ,eat etc are free ,as are all his other medications
Compared to the American Facebook group om on where many US citizens are genuinely worrying about how they will afford their insulin ,which they can't live without ,I know where I would rather live....

@Jabtastic I’m not sure that’s strictly true- I had pretty good care atA&E here in Bath, we have a fantastic new cancer centre ( part privately funded) and they sometimes use a really nice modern private hospital In Recent times for quite a lot of non urgent surgery and my GP is good too . Admittedly it’s ‘a posh area’ - but the same may be true in certain other non south east areas -

Do you have health issues that make this such a key factor in your decision? People complain loudly about things that go wrong but don't talk so much about what goes well.

I've been to a&e once for myself and several times with family and always been seen in a reasonable time. Once with my child we were out in an hour including seeing a dr. My child was referred to SALT end of may and we had triage app in July. I called my GP surgery last week and they saw me same morning parts do work as expected

People don't tell you the good bits only the bad experiences. The key is knowing what service you need and not sitting on problems until they get worse. There are always a few people in A&E who could have been seen by out of hours or minor injuries or by a pharmacist when the issue first started.

Honestly even with all of its faults I'd rather a system like the NHS whereby if I feel poorly I don't need to consider how much this will cost me to sort or even if my policy covers it.

You only wait ages in a&e if you basically don't need to be there.

Believe me, go in with a child struggling to breathe, whether its a baby with bad bronchiolitis, or a 5 year old with severe croup, and you get seen pretty damn instantly.

A lot of people in the UK do not understand what "emergency" means.

Friend got a brain tumour. We both know our way around the internet. Concluded the NHS treatment path she was going to be put on was exactly what she would have received at the Mayo clinic so she did not pursue private options. We do not live in London or SE.

I live in the outskirts of London and our A and E is awful. The waits are horrendous, the place is packed and the staff are (understandably) grumpy.

The last time I went to A and E , I had injured a knee and couldn't put any weight on it so couldn't walk. I asked the triage nurse where the loo was and she pointed and then said "I'm not taking you and nor is anyone else'" . I then had to hop on one food to get to the loo in front of a packed waiting room - so embarrassing. Then I saw the doctor and he diagnosed a Baker's cyst at the back of my knee without examining it. A few days later; a physio examined it - there was no Baker's cyst.

I complained to PALS in writing. A doctor phoned me up and said that both the nurse and doctor had now followed their training and they would be individually reprimanded plus all the safe would get some extra training as a reminder.

A friend of mine reckons it's quicker to drive to A&E in Norfolk because the wait times are so much shorter.

OP- if the shit really hits the fan, the NHS will look after you but if you have a non life threatening injury, I would expect to be waiting a minimum of 4 hours in my local A and E and it wouldn't surprise me if I had to wait 10 hours.