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 experiences op:

• top notch antenatal fetal medicine care
• excellent nicu
• world class picu treatment
• expensive medicine for my daughter's health condition
• plus a couple of surgeries etc

My DD has had care that would cost an absolute fortune in the US.

Oh yes that’s the other side of US medicine my dc hates.

the over treatment and over medication of heath.

we’ll do x, y and z. Here’s drug a and b. For a common cold you’ll get given a whole pharmacy. Chicken pox is anaesthetic dressings and antivirals.

the idea of “wait and see”, or self care at home seems completely alien. No well we could do an mri, but the treatment would be the same so it’s a waste of time. It’s straight to whole batteries of tests.

being able to demand treatment, even when it’s futile and will worsen quality of life with no increase in outcome.

and don’t get me started on yearly pelvic exams at the age of 18.

overtreatment can actually be counter productive, or even dangerous.

as long as you’re insured, of course.

Our local private hospital has its own urgent care department that you can access through private health insurance. London is bound to have similar

Where i live (south east near london) we have:

• minor injuries which is walk in and where you'd go with broken bones etc, including on a weekend
• out of hours GP who'd get your antibiotics prescribed for an infection, including evenings and weekends (usually you get referred from 111 etc)
• normal hours GP (can get same day appointment via online system).
• if you had a serious infection (eg sepsis risk etc out of hours then there's A&E

I have had use private healthcare in the UK recently because the NHS let me down. Same for my dad, my BIL, my MIL and FIL. My mum was also let down by the NHS recently but didn’t have private healthcare to fall back on so she really suffered, for a long time and in excruciating pain. I wouldn’t come here without sorting health insurance before you even step foot off the plane. It won’t help in an emergency, we’re all at the mercy of A&E for that which is worrying. I was sent to A&E recently by my GP and what I saw there was harrowing. I’d stay in America if I were you.

My DH would say the same, sadly. He has cancer and it's been a real hard slog, firstly to get a proper diagnosis, and then to organise treatments, consultations, etc. It is indeed an almost daily fight just to get the basics sorted, such as the monthly pre-ordained series of appointments etc for blood tests, two different infusions, collection of drugs, etc. - it's the same pattern every month, but the NHS staff are unable to sort it properly - it's literally "cut and paste" from what happened the previous month, but they just can't do it. Some don't understand that there aren't 4 straight weeks in a month, so that the dates are 28 days afterwards and not the same day of the month. It's as if they've never done it before! One of infusions was temporarily moved from being on a four week pattern to being on a 5 week pattern and it fried their brains trying to work that one out!

Do you have an illness or expect to be ill? In my 30’s it wouldn’t have crossed my mind - rightly or wrongly! However your parent is probably right they probably did receive more timely treatment. In the US your healthcare is private and you can get the same in the UK if you are happy to carry on paying.

Do you/are you planning on having kids, if so I’d say UK is much better bet… you can send them to school fairly confident they won’t be gunned down in their classrooms which is a massive bonus

I think the difficulties in the NHS are over egged a bit but we do not live in London or the South East. My husband was diagnosed with cardiac valve failure a few years ago and was in having open heart surgery within the week so if anything urgent there is no waiting lists. I have friends on cancer pathways and hernia issues and all have been seen relatively promptly. My son in law is on a list for hip replacement which is expected to take place shortly. So it is not all bad but it may be regional.

Surely in the US you have to pay for private healthcare so you can always pay for a private health insurance policy here too?

Its also not universal, I have had the mis fortune to visit A&E twice this past year, only my second and third times, I too am 46

I waited 1.5 hours the first time and only 45 minutes the second to be seen - I can't knock the service at my South West but London commuter zone hospital.

Do the seemingly endless mass shootings not worry you?

The OP doesn’t have any choice other than to sort out private healthcare since they won’t be eligible for the NHS anyway.

Some pharmacies can prescribe antibiotics for certain conditions. There are also out of office GPs and Same Day Emergency Care within hospitals. It’s not just A&E. Although yes broken bones, heart attacks etc have to be A&E. Answering this is probably similar to someone from the UK saying they are worried about shootings if they moved to the US. It’s a risk but depends on whether you feel it is worth it. I do get the impression you would struggle not to worry about it most of the time if you lived here.

What is fhe reason you want to move back? It’s just perspective and what you want
from life. Yes if you need a&e you may be waiting around in a crowded waiting room foe a bit. But you will still get seen and dealt with for an emergency. If you have private healthcare as well you’ll be absolutely fine.
If you have money youll be ok. Personally everything else about the usa sounds scarier but I dont live there.

you are definitely not being unreasonable op. It’s a shit show here and the labour party are awful (as are all the others ). Society is changing, and not for the good

My BIl is currently arranging a shoulder replacement for his mum in S. Africa -this includes shopping around for the shoulder himself otherwise the hospital and insurance will rip him off to high heaven.

my SIL is a nhs nurse and said shoulder replacements aren’t that common on people of her age in the uk (or at all) unless you’re a swimmer or something by the time your shoulder runs out you have so many other medical problems it does nothing to improve your quality of life (and won’t for BILs mum)

but of course ina profit making system quality of life doesn’t matter. You just keeping spending spending spending because that’s what the doctor tells you you need

Hospitals get ratings! Move near one with a highly rated a&e 🤣I will say that a lot (but not all) of the horror stories are in hospitals up north and some more remote areas.

On a side note, the effect on everything from the NHS and schools to the economy, of the shut downs and furloughs response to Covid, is seriously under acknowledged, I think.

Same for my son, though he was 8 so minus the fetal medicine care and nicu care.

7 weeks in PICU
3 months of inpatient cancer treatment
5 surgeries including 2 emergency surgeries
multiple medications
many xrays, CT scans, ultrasound scans and heart echo scans
physio
OT
10 months total in hospital

Yes and as another PP also said there’d likely be a waiting period anyway for NHS eligibility.

Im just surprised you’re so hung up on the state of the NHS as a currently young healthy person where those risks can in the main be easily mitigated by prioritising your savings as you’ve got decades of work ahead of you. But also becuase I’d think any such fears would have been easily displaced surely by current levels of gun crime in the USA which are sometimes just arbritary in nature and often can’t be mitigated against.

In 2023 there were 19.5k fatal shootings and stats show that gun violence disproportionately affects the younger crowd to the extent that gun violence has become the leading cause of death for American children, surpassing other causes such as car accidents, cancer, and drownings. That’s truly horrifying and what I would be more concerned about getting away from given your comments about future safety of any children you may have. And of course all countries have crime but I think the whole gun ownership mentality is just so ingrained in US culture that they’ve just resigned themselves to accepting these facts which is quite mind boggling to those outside the US.

There are many reasons
but stay in the US @Star555
holiday for the culture

YES! I was just thinking today how quickly we’ve all forgotten that we ❤️ the nhs 🌈🌈

Well define “immediately”.

an infected cut can wait a few hours for assessment or walk in the following morning. Generally you would have some sort of leeway before requiring “immediate” antibiotics. It will take time for an infection to become non localised. If for some reason that point hits at 2am then yes you would go to a&e for IV antibiotics.

many injuries like sprains and strains can wait.

if it’s truly an “need immediate care” situation then a&e is the best place anyway. If it’s a “should get seen sooner rather than later” then Minor injuries or urgent care only shut between midnight and 7am.

if I can wait 6 hours in an a&e waiting room to get my injury seen to I can wait 6 hours and go to urgent care in the morning.

there are lots of 24 hours GP services anyway. In London a lot of them are attached to your a&e- fil went with a sore knee once and saw the GP at 9pm. Turned out it was an issue that required iv antibiotics and he was admitted and sorted before midnight.

Fractures would be A&E but there are many out of hours systems across the country. This isn't my area but my friend used them and was very impressed. It was drive through which was why she was so excited to tell me about it!
https://www.badger-group.com/

OP, I’ve been in a very similar situation to you, and am in the UK now. I have private healthcare through work but also have used the NHS for pregnancy, and a&e (both me and my child). I have close friends in the US and lived there for ages so am familiar with both systems.

I can’t fault the UK private healthcare, it’s been amazing and so much cheaper / easier / better than what I’ve heard from US counterparts. All insurance processes will be somewhat difficult but the health insurance process I hear from friends in the US is a nightmare; by comparison, it is nowhere near as difficult here to navigate.

I have elderly relatives in the UK who’ve used a combo of nhs/private for various serious illnesses and been amazingly well treated.

I found the NHS for the whole pregnancy experience really well run (minus the postnatal ward but no one enjoys that!) and I’ve never had serious issues with A&E waits, they’ve been particularly quick the couple times I’ve had to go with my child.

The one thing I’ve found maddening about the NHS though is GP services - so annoying trying to get an appointment. But again you can go private for that.

I can see there are other reasons why someone might prefer the US over the UK. But (assuming you can get private healthcare here alongside the nhs) - healthcare seems a mad one to choose the US for.