The National Health Service (NHS) in the United Kingdom is famous the world over. When you consider emigrating to the UK healthcare can be a primary factor in your decision, so it’s good to know what awaits you in Britain with regards to healthcare in the UK.
The British health system is basically split between public and private providers. Private companies using a mix of public and private facilities to get their clients the best deal have sprung up in recent years. In the majority of cases private healthcare is chosen to avoid sometimes-lengthy NHS queues, or to seek procedures that aren’t available in the NHS.
The healthcare on offer from the NHS is generally good; just how good depends on whom you ask. In 2000, the World Health Organization ranked UK healthcare as 15th in Europe and 18th in the world, but a 2010 Commonwealth Fund report ranked the NHS as second overall in a comparison of seven developed countries’ healthcare systems. When the report was updated and the number of countries analyzed increased to 11, the UK did better, coming top overall and best in many categories.
The NHS operates a network of hospitals across the country. The regions of the UK – Scotland, Northern Ireland, Wales and England – each operate their own NHS so your experience will be different in Glasgow to what you’ll find in Cardiff or Belfast, and different again from Manchester.
Your first contact with the NHS is likely to be either a GP (General Practitioner) or a hospital, depending on circumstance. When you move to a new area and register with a new GP practice, you’ll usually be asked to have a basic health checkup; this usually includes a blood pressure measurement and other basic checks, and is typically carried out by a practice nurse rather than the GP. Visits to a GP are free – though a £10 charge is currently being discussed – but prescriptions on the NHS carry a small charge: £8.05 for most prescriptions or £16.10 for some specialized equipment. It’s a flat rate regardless of what the prescription actually entails and it’s the only cost: you don’t pay for the drugs or medical equipment you need, only the prescription charge.
Registering with a GP is important. You’ll go to the GP for anything that isn’t a real emergency, and being registered with a GP is what entitles you to other NHS services – though if you show up injured at a hospital they’ll treat you first and ask questions afterwards.
You have freedom to choose which GP’s practice you ask to join- but they have the freedom to refuse you unless you live in their catchment area. This and convenience mean most people simply join the nearest one, but many catchment areas overlap – ask friends and co-workers what the local practices are like before you join one. Many GP practices have a website where you can check on the doctors’ experience and qualifications.
If you join the wrong one you can transfer, and you don’t have to notify your current GP of your intentions, though you will have to sign up all over again at the new practice. When you sign up to join the practice you’ll be asked to fill out a questionnaire and may be asked for ID – many practices do this, and all practices can, but none of them are legally obligated to.
Once you’re signed up you’ll be issued an NHS number. This will allow medical staff across the UK access to your health records.
GP’s surgeries will be the place that you pick up things like asthma inhalers or antibiotics for minor infections, and they’ll be where you go to ask to be referred to specialist outpatients clinics. Typically if you have a long-term, serious health problem the NHS will send you to a specific clinic, some of which are developing world-leading practice in their fields. If you have asthma or COPD there are specific outpatients’ clinics – but there are clinics for treating chronic pain too. You’ll typically also see your GP for cancer screenings and inoculations, though childhood vaccinations will usually be carried out at school by visiting teams of specialist nurses. GPs are responsible for referral to medical specialists such as endocrinologists or dermatologists too.
If you need a GP’s appointment you can usually phone the surgery and arrange for one within a couple of weeks. Most practices have a system of getting more urgent appointments quickly, and in many cases you can simply go to the surgery and wait until a doctor is free.
Dental HealthCare in the UK
One aspect of medical care that the NHS doesn’t comprehensively cover is dentistry. There is NHS cover, but it is restricted and the patient has to make higher payments, though these are still heavily subsidised. NHS dentists will provide treatment that is clinically necessary for health, but no more; any cosmetic procedure, for instance, will have to be carried out privately. What is and isn’t considered clinically necessary isn’t always cut and dried: your child might be referred to an orthodontist on the NHS because her crooked teeth are more likely to decay in the future, for instance, in the process ending up with a more regular smile.
NHS treatment charges for dentistry fall under three bands. These are:
Band 1: this band covers examination, diagnosis (including X-rays), scale and polish, and application of flouride varnish; during Band 1 consultations your dentist will advise you on how to prevent future problems, and dental emergencies are covered by Band 1 too. The charge is £18.50 for Band 1.
Band 2: this band covers everything in Band 1 as well as fillings, root canal work, and extractions. The charge for Band 2 is £50.50.
Band 3: includes the treatments in both the other bands, plus crowns, dentures, bridges and other complex procedures. Child orthodontics also fall under Band 3, and the price is £219.00.
If you have completed one band, but you need further treatment within two months in the same band or a lower band, you do not need to pay again as long as you have discussed it with your dentist. A complete guide to the NHS treatments available is here.
Pregnancy in the UK
The final area where you’re likely to come into contact with the NHS a lot is during pregnancy and childbirth. Some fertility treatments are available on the NHS, depending on where you live – regional NHS management structures offer slightly different services, leading to a result known in the UK as a ‘postcode lottery,’ so the same person might be eligible for the same service in one city but not in another.
Again, a pregnant woman’s involvement with antenatal services will usually begin via her GP, and then proceed to referral to a midwife who will conduct antenatal sessions leading up to birth. Some antenatal services are aimed to inform, such as information on nutrition and lifestyle as well as training in pelvic floor exercises, breastfeeding workshops and more. There will also be regular screening and tests, and you will get at least two ultrasound appointments during your pregnancy. You can choose to give birth in a hospital or at home and will be attended by an NHS midwife, often the one who saw you through your antenatal care.
Private Healthcare Facilities
Though the NHS is available to all, some people prefer private health insurance – though it’s not a popular choice, with only 6.3% of the population making this choice. One benefit of choosing private healthcare is that it allows you to have more choice over the kind of healthcare you receive – while the NHS offers choice it does restrict certain types of treatment and you have to find a doctor who agrees with you that the treatment you want is medically necessary before you can have it. It’s surprising how often this is the case – plastic surgery, breast enlargement and reduction operations, and other ‘cosmetic’ procedures are regularly performed on the NHS because of doctors’ opinion that the patient’s quality of life makes it clinically necessary – but private patients still have more say. The other benefit is that NHS provisions are often overstretched and private facilities often aren’t, s private patients can avoid queues.
If you’re thinking about using the private sector, you don’t always need insurance – sometimes you can just show up and pay, though the costs will be higher this way. The UK’s most popular non-state health provider is BUPA.
Good healthcare in the UK is open to all, and particularly to pregnant women and children, so you can rest assured you’re in good hands!