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.

It’s not easy to get private maternity care in the UK OP so if you are planning to have children, I do not recommend you come here. Private maternity care is practically non-existent outside London and our private medical insurance policies don’t usually cover it anyway. So you would have to pay out of pocket.

No, it's really really not.

Private health care relies on nhs for anything complex or dangerous. They aren't set up for stuff beyond the bits that make them profits. The nhs may be slow and frustrating but they've saved the life of pretty much everyone I know including me at some point so I'm very grateful for them.

Do you even use private health insurance? You can literally throw money at services.

you can also pay for treatments out of pocket here and they are far more affordable than the US. That is what many people do

The state of healthcare in the UK is so poor that you often have to talk to a totally medically unqualified receptionist for them to decide whether you even see a doctor. This is the case in London as well as other parts of the country. We have very good private healthcare as a family and it's noticeable in the last 5 years or so that it's even a bit of a wait for an appointment, tests etc for this. A family member who is an NHS doctor (London based) told us all that we all need private healthcare to protect ourselves against the NHS being the only option. In your position I wouldn't even consider moving back to the UK.

Agree with the first part of this comment. Private healthcare here often don't include things like pregnancy and birth in plans

I’ve lived in both, I had very good insurance in the US, the care I did recieve I felt was very poor, with staff unable to make decisions due to poor clinical knowldge and in some cases purposely attempting to give me the wrong treatment due to being scared to go against senior staff. I would personally never use any form of health care in the US again.

As a healthy 30 year old I'm surprised that top of your UK Cons list is poor aceess to free health care for an as yet undiagnosed illness in the future.

If you are serious about planning a move you need a pros and cons for both countries across a range of issues rather than looking at one hypothetical problem, that you can mitigate with insurance in isolation. Once you meet a partner and have dc you will likely stay in the US. How does that make you feel?

I have had a mostly good experience with the NHS. No problem getting a GPs appt, including on the same day when necessary. DD treatment for a chronic physical condition has been excellent. Mental health support (CAMHS) appalling.

I wouldn't think about whether you want to come forever. Think about coming for a couple of years for the experience, travel in Europe etc. You will probably have an initial high, then a low when everything seems difficult.

You might return to the US thankful that you can, or you might stay long term. But it will be based on what is best for you, individually, rather than on other people's anecdotes.

If you're in R&D, have you thought mainland Europe instead given you have no real ties to the UK? In many countries you'll get better pay, healthcare, housing, childcare, schooling and work life balance than are currently available in the UK. Not to mention food and weather! Many companies and institutes now work in English and a lot will sponsor visasfor STEM grads. Said as a STEM Brit who's moved round Europe and won't be going back.

Just a thought @Star555 but who is going to care for your parents in the US when you are in the UK. There wll come a time when they are frail and need you.

In general the level of training is still the best in the world. I am a highly trained specialist - my job doesn't exist in the US in the same way because they don't train in my specialty to the same level. Someone with my job title in the US would be much theory based and have no where near the clinical experience and knowledge. And that is often the case here - age 40 and up clinicians anyway.
I do about 40% of my scope of practice because there is no money to fully use my expertise. And that situation is the norm.
If you use private it is often a gateway and if it is complicated you will have to be ported over to the NHS as private simply doesn't have the same complex treatment ability. And they won't do it anyway because complex care is too expensive and the private system here is geared up to take cheap quick and easy patients. But for everyday stuff you're seeing the same people in a nicer setting and it's faster.

If it’s an option for you, for quality of life reasons and stronger economic prospects, I would settle in an EU country rather than the UK.

Unless you or your family have a serious health condition, the state of the NHS wouldn’t be a particular factor. The provision is patchy rather than failing all over. A&E is struggling everywhere, and that’s a problem if you need it, but I haven’t been to A&E for 16 years - it isn’t a regular event unless you are accident prone, have a poorly managed condition or a sudden crisis.

I have been impressed when I had a health scare last year, and my Mother’s treatment for cancer has been consistently excellent. I hear the same from other people.

I imagine the care her parents choose to organise will be the ones to provide care, children aren’t free ready made carers.

@Lasecretaire does the training also include how to be condescending, reductive, keep people waiting 105 minutes after their appointment time without an apology and the ingrained mysogyny that ensures women are treated less favourably than men, pastorally, clinically and in the context of pain relief.

It doesn't matter how specialist parts of the NHS are when invariably the scummy patients are treated like sh1t with rafts of time to waste.

Sorry I got that wrong. I used to go on a different forum with mainly Americans posting and they seemed to be forever booking colonoscopies.

OP have a look at the costs for private care, either with insurance or to pay out of pocket. A friend's daughter has just had her gall bladder removed privately, it cost her £4000. I have no idea what that would cost in the USA.

I've worked in both the NHS and private healthcare. Private hospitals can be good, but as previously stated anything complex goes to the NHS.

Wen the old Duke of Edinburgh was having some cardiac issues he was sent from a private hospital to St Bartholomew's.

The royals tend to use the Lindo wing of St Mary's hospital, the private wing of an NHS hospital to give birth.

No, and our parents don't expect us to physically care for them but DH needs to liaise with and organise MIL's carers and I have had to advocate for mother and step vis a vis the NHS as they have become older and frailer. For example make mother's phlebotomy apppintments digitally because she can't and the phlebotomy admin won't help and elderly lady in her late 80s to make an apppintment over the phone. That's a particular aspect of the NHS that is unhelpful and totalky unacceptable.

Private healthcare is very affordable at your age. It’s unlikely to be more than about £1000 a year. It usually includes GP or you can pay for a GP appointment if you can’t access an NHS GP easily (mine is v good). You then just use NHS for emergencies or a chronic illness if it’s not covered which is where it’s very good

I live in London and have an excellent gp service on my doorstep. Also very close to large teaching hospital and over the years have had excellent service. One of my DC has medical problems and he was under care of an excellent consultant for years. It's possible I have been lucky.

Isn't one of the challenges in US - what happens if you lose your job? Future kids may not be as economically secure as you or your parents. Something to think about.

You only ever hear the bad in the media regarding the NHS. Think about the amount of hospitals there are in the UK, and the millions of people that are treated successfully daily. Then, perhaps think again? If it hadn't been for the NHS, I wouldn't be typing this post today....twice my lifetime I have nearly died....and twice my life has been saved. Yes, the NHS does have issues, nothing in the world is perfect. If it makes you feel more secure, pay for private insurance in case you need it whilst here.

My BIL just had a leg amputated in the US. The way he was passed from pillar to post by different doctors and hospitals because they were going over his insurance with a fine tooth comb was shocking. Clinical decisions were not driving things.

My DM was in 'rehab' care in NYC (it's a kind of half way house to prevent bed blocking in hospitals). I went to visit her. It was awful. Run down in some places, not been decorated since the early 90s by the look of it and my mum was totally ignored by nurses (at best they ignored her at worst they were incredibly rude and lacked compassion). My expectations of private US healthcare were a long way different from the reality. It was a wake up call, for sure. Her care was worse than I'd expect here - certainly no better.

Less guns though.

My experience with the NHS has been positive. I recently had a mental health issue and saw GP twice and mental health nurse within a fortnight, had HRT prescribed without any issues and mental health follow up was great. My cousins in the US have really struggled with chronic health issues and struggled to get appropriate care with long, long waits. I think in both countries it’s a bit of a postcode lottery.

Uk based here, but lived abroad for some years a while back. My father needed heart bypass here. OP kept getting cancelled. We were writing begging emails to the consultant, they said no, if he's not got worse there's nothing we can do. He was a heart attack waiting to happen. Finally got a date that was not cancelled about a year later. After care in ICU was great. On the ward afterwards was awful. Sometimes his oxygen was connected, sometimes not, no-one noticed except us. He couldn't feed himself but they just left his food on the tray - he was basically starving to death until we rented a flat nearby and one of us would stay to feed him each day. Bed didn't go back properly so he kept slipping down the mattress and ending up in a heap at the bottom - again, no-one noticed. One day they insisted he walk to the loo unaided. He fell and cracked his head open on the loo.

It was just awful.

I say if you can afford it, go private. If not, stay where you are.

I'm so sorry to hear about that awful aftercare. However, that was exactly how my DM was treated in the US.

UK private care is far superior to most US private care so if people only have experience of private care in the UK that's what they think US care is like. It isn't.

The added dimension is that everyone sits around a sick person's bedside talking about money .