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.

Erm - I have had private care in the UK and private in the US. it's really not comparable. "Private" in the US is basically everything while in the UK it's really concierge care.

the thing about private care in the UK is that it's really focused on elective procedures. It's very nice as a supplement, and it absolutely will get you faster consultations, but some things are really only done on the NHS.

But as I said, this wouldn't be a decisive factor for me unless I had a specific scenario, and even in the case I gave personally, that's also because of the issues with moving countries. I don't know that I would move specifically to the US for the services we've had, but once they're all set up, switching it all is a massive thing.

Completely agree

Is your health potentially so poor you're willing to live in a country with Trump as President and anti vax Kennedy in charge of health? If so, it's probably better you stay there isn’t it?

This is true I have a friend whose operation in a private hospital went very wrong, they sent her home with infection because they only had day surgery covered in the plan, she got sepsis and was lucky to survive, obviously NHS care to save her life after she collapsed at home.

i am a fan of private dentistry, but even then, my dd has very complicated orthodontist plan as she was born without all her teeth, and our local hospital is excellent, she has been seen by several senior doctors to plan her treatment, can’t imagine the cost or willingness to do that privately.

John Oliver last night was looking at how in the US older people are being persuaded to swap Medicare for a private version which costs the government far more and gives individuals far less coverage. I would have thought US healthcare would be a #1 reason to leave!

I'd love to know how much your parents are paying for healthcare insurance and what the deductibles are, what state your in etc. knowing a few people in the US and hearing they pay like 5, 6-700 hundred dollars a month for HC, to a Brit sounds mental. and these are young-ish people.

If you're that worried about the NHS, take out private health care in the UK. I think mine is approx £1800-2000 a year and covers me, my wife and three children.

There’s just no comparison even with private insurance. As much as it pains me you’d be mad to come back now. You can’t pay your way out of sleeping in a chair for 12 hours while in excruciating pain in AE. Have a look at the scandals with maternity care…the NHS has completely fallen over. People here don’t realise what a shocking level of care they’re receiving. It needs to be properly sorted and properly funded. It is currently neither of those things. You truly take your life in your hands needing even first aid care here.

Perhaps you should have a look at the death rates between the US and the UK. The U.S. consistently reports higher maternal mortality rates compared to the UK and other high-income nations. 2023 US rates were 18 per 100,000. The UK was 12 per 100,000.

Both are shocking tbh, but don't distort the facts. I absolutely love people bashing the NHS, but they are the first in line when they actually need it. Yes, it's far from perfect, but if I had to get ill as an average salaried employee, I'd 100% rather it be in the UK than the USA. Just take a look at prescription prices in the UK Vs the US, take a look at the difference between the cost of cancer treatments and giving birth.

TThere's no doubt the US is a leading force in health care, that is, if you have the money to pay for it.

The reason for that is many poor women in the US have little or no access to maternity care. In the UK everyone gets (pretty crap) care, but it is better than nothing. SIXTY FIVE per cent of NHS maternity units are unsafe. That’s a national disgrace and nothing for the OP to come back for.

Medicaid would pay for them in the US. It’s the middle class (in the American sense) that get hosed

I disagree. Many private services are absolutely cutting edge and are far better than the NHS including cancer care. They deal with many complex and dangerous conditions. It’s possible that not all private hospitals do but certainly the main ones in London do as do the private units of most NHS teaching hospitals. I only use the NHS when I have absolutely no choice.

We moved back from the US 5 years ago. I have private medical insurance for the family that I buy as part of my company benefits. It covers private GP service and non emergency care

We use our NHS GP for most GP apts; our old GP was absolute shit with a 6+ week for an apt so we went private a lot. We’ve recently moved and it’s totally different - highlighting this to show how different it is even within the same city

We use NHS for emergency stuff and our private insurance for items we know there’s a massive wait for ie i’ve. been referred to orthopaedics for a shoulder issue, gynae for anaemia. Our local NHS trust is known tho for being particularly bad with massive waits - my dad lives 25 miles away in a different trust and it’s totally different

DS’s treatment has always been prioritised on the NHS with minimal waits

One of the biggest things we’ve had to adjust to from the US is the lack of preventative care thru the NHS such as yearly physicals, mammograms, colonoscopy etc. Again, you can do all this privately. The other adjustment is how long it takes to get x-rays / scans done, and results from that and blood tests

On the plus side, we’re not paying approx $900 a month + a yearly $6000 excess on our health insurance policy, like we were in 2020 in the US, so it’s weighing up what’s important to you

I’m sure OP is considering all aspects of the decision but wanted to talk about healthcare in this specific instance.

There’s no need to talk to somebody like this.

You're probably right. But in my experience, when you really need the NHS they are there.

I always used to say that too but I don’t think it’s often the case anymore. You could have a heart attack and not rely on an ambulance coming.

It’s just obvious you’ll not get the same standard of care in the UK as you would
in the US. Nor will you have a better salary and housing/other ‘stuff’ will be of poorer quality. You just have to weigh up those other things and see if they matter more.

People have emotional ties to their heritage that can’t always be wiped away by rational thinking. I keep wondering how ‘American’ my kids will feel. So I totally get it. Good luck.