Hesitant to move back from US to UK because of terrible state of NHS

[Star555]

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.

Nobody doubts that the NHS has its problems - but bear in mind that the media loves to exaggerate horror stories. Ordinary, positive experiences - which happen daily - don’t make the news.

Life expectancy is higher in the UK than the US I believe. Could you get private health insurance like you'll have in the US?

https://pmc.ncbi.nlm.nih.gov/articles/PMC2895526/

I would read some research rather than listen to anecdotes, but having experienced care in both countries the US is far better in many ways.

Brit US based.

Recent experience of family members is it can be a struggle getting NHS GP appointments. Of course it may not affect every single person but it is happening quite a lot and you sometimes have to fight to get that precious GP appointment. But once you get seen then their experience is normal service resumes somewhat although referrals can be slow.

Recent experience of a family member not being able to be seen by a GP was to go private for a diagnosis as they were increasingly desperate. Went to follow up with GP with recent diagnosis and was turned away as was told since they went private they had to keep paying privately. We are talking about a pensioner who couldn’t really afford it.

But this is one experience. Maybe it depends what needs treating.

The systems are really different (in some ways) and based on different assumptions. GPs are struggling, the population is ageing, and when primary care and social care are under pressure, the NHS starts to teeter as a whole. Maternity care is also in a bad way, in a way that has been predictable for some time but has now come home to roost. I’m certainly hearing far too many bad experiences. It’s also increasingly the norm for people to seek private treatment at a rate that simply didn’t happen even 15 years ago. But because there is such a bottleneck in training doctors - and employing them - even private care waiting lists are expanding.

I would still say that large statements that ‘the NHS is broken’ are bunkum. I still believe in the GP model - where you have extremely highly trained generalists at the front door of the NHS fielding the initial contact and directing operations/managing care with continuity; it’s a really efficient way of doing things. But because it looks expensive in up front costs, governments are always tinkering with trying to put cheaper staff up front, or overloading GP practices, which reduces efficiency and sends more people to A&E, seizing up the system.

I would personally say, don’t let it put you off - but then I would. Private health insurance makes a difference. Understanding what is different about the system makes a difference. Look for a good GP above all.

I’d also say that therapeutic services for children with significant issues are laughably poor here compared to the norm in any decent area of the US.

Get private health insurance. Covers most things.

Honestly? If health care is important to you are used to the standards that good insurance provides in the US, I think you are absolutely correct that the NHS will be a huge downgrade. Private health insurance in the UK is also nothing like health insurance in the US and it isn't really possible to throw money at the problem to pay for the same standard of service in my experience (ex UK to US expat, now back in the UK and praying none of us get seriously ill).

Obviously there are other factors where I would say the UK wins over the US, but good US private medical insurance beats the NHS plus private UK health insurance hands down.

Private health cover is a lot lot cheaper than in the US and you wouldn't be paying thousands to have the children you pla to have. For emergency medicine the NHS just can't be beaten.

This is exactly what I was afraid would be the case. Even for an "apples-to-apples" comparison (e.g. private insurance in London vs. private health insurance in New York) would you say that the standards of service are very different?

It’s a postcode lottery, my DH had cancer in his tonsil last year, and received amazing treatment. Operation at nearby teaching hospital, radical radiotherapy at the Marsden in Sutton, and dental checkups at St George’s in case the radiation had affected his teeth. He was 86 when our very good GP put him on the two week pathway. He has made a good recovery and is still being monitored every two months. I imagine that you would have to have private insurance in the States, you could do that here. I have had a new hip and knee, and the longest I’ve waited is about six months.

Depends how much you use it. Do you need a lot of medical care? When I was in my 30s, healthcare was not on my radar, the only assistance I needed was having 2 free babies.
Now in my 50s I am more aware, but the NHS has been fine for me. You have to be tenacious sometimes to get to a GP and able to advocate for yourself.

I think the UK will be a different place in two decades, maybe even an American healthcare system but if it really is something that worries you right now, then I would stick with what you know.

I went uk-us-uk. It’s very different and we have private Bupa. No where near as good as the health care we had in USA, and we had a lot of hospital stays and treatments over there. Had some good experience here with nhs and Bupa but still not comparable.

If you can afford private do so, but you would likely still need to use nhs a and e, ambulances etc. You can get quick access(same day/week) to private gp and specialist services either via insurance or pay as you go.

Have you spent any extended time in UK since you were a teenager? If you genuinely feel you prefer the culture, don't let health care stop you. The NHS is generally good in an emergency and for serious illness. Remember, people generally only talk about it when things don't go well.

There is nothing wrong with the NHS. Health services are the same all over the world, the NHS is still the best one

If you’re without any health conditions then you shouldn’t be overly affected by the state of the NHS.
Once you’re in the system too regular care isn’t too problematic.
Private healthcare is a buffer you could put into place to assist your predicament.

I have VERY extensive experience of the NHS, as do family and friends. While I don’t deny there can be problems, particularly with admin, I have found it outstanding overall

The US is a vast place with massively differing qualities of life. Many people have no health insurance or substandard health insurance. Many live very rurally and / or in poverty.

So general life expectancy figures will not be relevant to the OP if she has good health insurance and access to healthcare. In that case she would be having a varsity better experience than most people in the US. The problem with private healthcare in the UK is that it won’t help you in an emergency.

That’s a massive generalisation and simply not true.

Curious to know why the private care in both countries is beyond compare? I have used both and I found them at par for ‘regular’ illnesses. Sure if you have a rare kind of disease you might find cutting edge treatment in the US or some other country that isn’t available in UK. Curious to understand the detail behind your statement.

For what it’s worth my sibling who has lived in the US for the past 30 years on a highly paid job feels like people in the US are shackled to their jobs for want of health insurance. Whilst the quality is great in the US - he thinks having the NHS as a universally available option to everyone is a blessing he wishes Americans had. Incidentally we spoke about this just yesterday when he mentioned that some Americans are working well into old age just so that they can have health cover.

The NHS is not great but people don’t die or become bankrupt because they can’t afford healthcare in the UK.

How much is your insurance in the US?

4 people in my family including me needing health care me an operation absolutely brilliant fast service, my 93 year old dad loads of stuff falls, ops, eyes all wonderful no waits lots of care My dp recently very ill no waiting to see anyone all tests and seeing a specialist within a month. My dd blood tests on request talked through results advice given. This is in 3 different areas of uk I have not a single complaint with the nhs.

American bll and dh had sane op. Bil in US had check ups afterwards, lovely hospital, overnight stay, neat scar.
dh had no check ups afterwards, chucked out a couple of hours after op, awful mess of a scar and an infection!