Up until this week, I had no need to try out the British healthcare system. But then I sprained my ankle, which made me think perhaps it was time to visit my local General Practitioner (GP).
In the UK, the NHS is the agency that oversees the comprehensive and (largely) free public healthcare system. The obvious big plus is that everyone, rich or poor, can access medical care. The big minus is that the process of getting an appointment can be long and painful, and as in the US, no patient wants to resort to going to Casualty (the ER).
When we moved to our neighborhood, we knew from word of mouth that we should “register” with our local GP’s office. That’s the way it works – new neighborhood, new GP. No shopping around through all the doctors available in your healthcare plan (a la US private healthcare).
What I learned this week is that there are two ways to get an appointment with your local GP: (1) you call up whenever you want and see when the next available appointment is (usually a week away); or (2) you call up the day you want to go at either 8:30 am or 2 pm for the few spots that are set aside each day for “day of” appointments.
I worked from home today, hoping to use Option #2 in order to get some immediate advice on how best to treat my sprain, which wasn’t really getting better despite ice and ibuprofen.
At 8:15 am, I started the redial game. It was like trying to get a reservation at Per Se before they’d opened! Busy signal-redial-busy signal-redial.
At 9 am, I finally got through, and of course all the walk-in morning slots were booked. The GP office told me to try again at 2 pm for an afternoon slot.
2 pm saw pretty much the same pattern as at 8:15 am. I ended up making a “regular” appointment for next Monday, at which point my ankle will probably have healed or ballooned into something nasty and crying out for Casualty.
My experience has not been the most impressive, I think.
I asked the local pharmacist at Boots where I could find naproxen (sold as Aleve in the US). Alas, naproxen is a prescription-only medicine in the UK. That’s kind of sad to hear considering how risk-averse I have (until now) considered the FDA. Who knew naproxen was that powerful that only a doctor can prescribe it?
Anyway, I’m limping a little less as the days go by, and Jon is going to be my mule and bring back some Aleve from the US this weekend.
All things considered, I hope I don’t ever really need to use the British healthcare system, because my choices will then be to wait a week to see a doctor, spend a day watching nasty trauma cases rush ahead of me at the ER triage, or pay a lot of money out of pocket to see a private doctor.
As a big John Rawls fan, I support and respect a universal healthcare system, but as someone lucky enough to have had private health insurance in the US, I’ve got to admit that universal healthcare (as practiced in the UK) is a definite step down. Theory colliding with reality once again. Do you choose equality over a possibility for higher-quality service? I suppose you don’t if you’re likely to be among the lucky ones who can get the higher-quality service in a less-equal world.
Perhaps you should have tried an NHS Walk-In Centre (or in your case, Limp-in Centre). They’ve been set-up recently to cater for just your sort of situation.
NHS service varies greatly across different depts and locations…. you were unlucky.
Well, how about getting private healthcare in the UK?
the comparison is not between the need to have US private healthcare only and having to use UK public healthcare. Its between the need for private healthcare in the US and a choice between private and public (or a safety net if you can’t afford private) in the UK. I know which situation I prefer.
Hi Troy London,
Thanks for your interesting comment. I deeply respect the UK’s system of universal healthcare, but the reason I think it’s accurate to compare my experience with US private healthcare with the service I’ve received (more than once now) with the NHS is because, as a professional, in the US, I would pay very little for private healthcare thanks to employer-provided insurance, and in the UK, for me to have a comparable-cost option, the NHS is it.
I could always seek private healthcare in London, of course, but it would cost much more than it would in the US because I don’t have comprehensive private health insurance through my UK employer. (My impression is that most UK employers don’t offer this type of health insurance because the NHS exists). I’d imagine there are other well-paid professionals in London who would choose to go to the NHS before taking the step of paying out of pocket for a private practioner.
I suspect you’re right that NHS service and skill varies with location, but in my neighborhood, I have yet to be fortunate enough to find an NHS practioner who provides service like what I used to enjoy in the US. And if I should move to a more expensive London neighborhood to get better NHS service, then I suppose that’s an interesting shade of gray to add to the concept of universal healthcare.
At the end of the day, the UK system is superior if (as I believe) the definition of “superior” is to ensure the greatest number of people receive at least basic medical care, but as I am lucky enough in the US to have had private health insurance, I can’t help but feel that I have taken a step “down” in terms of the care I was used to receiving in the US for the same minimal out-of-pocket price.
>I could always seek private healthcare in London, >of course, but it would cost much more than it >would in the US because I don’t have >comprehensive private health insurance through >my UK employer. (My impression is that most UK >employers don’t offer this type of health insurance >because the NHS exists). I’d imagine there are >other well-paid professionals in London who would >choose to go to the NHS before taking the step of >paying out of pocket for a private practioner.
I totally agree with this comment. I am an American who recently was hired to work in London by a large multi-national bank (incidentally, I’m moving to Islington, which is how I found this blog) . What I’ve found is that companies that provide adequate private health care in the US consider themselves to be let off the hook for it in the UK because of the existence of the NHS. The problem then is that the actual health care available to you – without paying through the nose – is a steep drop from that provided under the much-maligned American system. For those of us who are, as you rightly say, lucky enough to have had proper health coverage in the US, moving to the UK is a big disappointment from a healthcare perspective. That may not elicit much sympathy from people who think that we (who had good coverage in the US) are simply “rich” and are therefore unsympathetic characters. But when the the UK system benefits large companies at the expense of employees, it’s problematic.
Hi Rob,
Thanks for your comment and hope you move to Islington. It’s a fun and well-located neighborhood, my NHS complaints notwithstanding!
Best healthcare is in France!
Even in Malaysia, I think it’s less frustrating even if I have to pay!
Sorry to hear you had such a bad experience. I’m American and have been in London for 5 years and I have never had trouble getting an appointment at my GP. It makes me wonder why people in the same city can have such vastly different experiences.