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The London American – the National Health Service

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Sorry for the break, Londontopia readers – I have been ill. However, this means that I can now write to you about the lovely NHS! The system is sort of in turmoil at the moment, with governments moving toward American-style privatization of medical care and cutting budgets left, right, and centre.

Everyone is in an uproar, as doctors like to both be paid and be able to offer good healthcare, and patients like to receive free or nearly-free healthcare. Look at Obamacare – it’s basically America’s attempt to imitate the UK (or at least Canada), because health and medicine in the US are like rams in a continual head-butting contest. On the other hand, surveys of Britons say that they are actually satisfied with care at the moment, but that many are extremely worried that the quality will decline if privatized. (I agree.)

The National Health Service (currently) operates on the principle that healthcare should be free and available to all individuals. My friend was a rugby player and now receives physical therapy for her knee for free. If you go to the emergency room (here called A&E – “accident and emergency”), you don’t have to present proof of insurance for them to see you.

I believe ambulances are free, as well. As a student staying for longer than six months, I am covered by NHS. Tourists and short-stay visitors are not covered. They can still go to the A&E and clinics, but will have to pay a small fee.

Additionally, prescriptions are only about £7-8 each, but are FREE for British citizens with long-standing conditions such as diabetes and epilepsy. I’ll say it again: FREE. (If only they had my US prescriptions here – sadly, many drugs are different, and some are not offered at all.) Pharmacists seem to have much more flexibility in prescribing than in the US (they are real pharmacists, not just pharmacy technicians), and things like codeine are available behind the counter without a prescription. Oddly, though, you have to be over 18 to buy knives, and you get cross-examined when buying hydrogen peroxide.

The downside of the NHS, though, is that things can take a long time. It’s like the time I took my friend to a Chicago ER for a cut on her hand that we thought should get stitches. People are put in an order and taken when a doctor is available based on severity of trauma. Of course, people in diabetic shock, with stab wounds, with severe burns, with trouble breathing, with debilitating conditions, et cetera, will all be seen before a healthy college kid with a cut. No matter how bad your 7-stitches injury seems, the intake nurses are gonna bump you all the way to the back. You could say the NHS works like an ER, with prioritizing based on severity.

You also have to see a GP (general practitioner) before you can see a specialist who actually gets things done. In the fall, I had a terrible ingrown toenail. I knew I needed a podiatrist, and I knew the procedure would take all of ten minutes. I went in to the GP at my university clinic – which luckily has walk-in hours – and said, “I need a podiatrist.” After the GP made the same diagnosis, he said that I would probably not be able to see one for at least three weeks, because they deal with more pressing matters. He recommended I find a private clinic.

Here is how the NHS’s problems are kind-of-but-not-really solved: private clinics and hospitals. There is a class divide, it seems, between people who have to use the NHS and people who choose not to. There are advertisements at work for private insurance. Princess Grace Hospital, near Baker Street, is an entirely private hospital. I lucked out finding a place that was open on Saturdays – an old-style pharmacy in Soho called John Bell & Croyden, which has a variety of private clinics in addition to direct-to-consumer sales of medical equipment (wheelchairs, glass beakers, scalpels, professional-grade toothpaste and the like). They do same-day appointments and were very friendly and quick – but I had to pay. Private hospitals are popularly believed to provide better care – but then, they haven’t had their budgets cut. However, all the NHS doctors I’ve seen have been competent and professional, and that’s only the ones at the university. I’m sure they are all pretty great and deserve more.

A final note on ambulances. For the last four years, I have lived across the street from a hospital. Every night, in addition to the 171 bus announcing itself hourly and being in Midway Airport’s flight path, I fell asleep to the sound of police cars, sirens, and the occasional medical helicopter. When I moved to London, I thought I would finally be free of the noise. Drunken revelers are fine, as I can just yell at them; that’s to be expected in a city. But not two days after I moved in, I found a terror – an ambulance dispatch. They have two ambulances there most times, painted bright lemon yellow with those terrible flashing blue lights that I can see through my fifth-floor windows. Fortunately they don’t go by very often, but they do park anywhere but the designated ambulance spots, causing cars to swerve dangerously.

Since I walk by every day, I’ve actually found that they have multiple types of vehicles – first I saw the ambulance moped, then the ambulance bicycle. This is just as you imagine – a bicycle painted bright yellow with stripes and saddlebags full of equipment. According to the EMT I talked to, the bicycle carries everything an ambulance has except a backboard, and it has the benefit of traveling in the bike lane and through parks and alleys.

Finally, one day some horse manure appeared outside my building. Crap, I thought quite literally. Where did this come from? Then, a few days later, I heard a familiar clop-clop outside my window. I opened it to look, and saw none other than a large chestnut horse in an ambulance yellow-and-stripe blanket. I can only assume this is used for “romantic emergencies” such as women drowning in ponds, and suddenly a hand pulls her out of the water onto a beautiful horse with a handsome EMT…

Ambulance Bicycle! Image credit cyclinginfo.co.uk

Relevant Link: http://www.HBF.com.au Health Insurance

Author: Stacy

Stacy is a graduate student in archaeology currently living in London. She enjoys visiting museums, riding the tube, splashing through puddles, and giving directions to lost tourists. She also writes a blog about pies.

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4 COMMENTS

  1. I lived in Edinburgh for two years volunteering for the National Archives. I am also a UK citizen (living in Oregon). When it was discovered that I had bowel cancer, I was in hospital in 3 days. When I wanted to see a dermatologist (GP first, as you said), my appointment was for 3 months later (actually took 10 weeks). Typical, you may say. But when I returned to Oregon and wanted to see a dermatologist when the problem flared up again – guess what? Three months to the day! Keep in mind that each region of the UK (and esp. the different nations of the UK) have different NHS Trusts. ALL meds are free for ALL Scottish citizens. Another difference I noted: if my appointment was for 9 a.m. – the nurse called me straight into the doctor’s office (not another waiting room!) right AT 9 a.m.! That has NEVER happened to me here! Not having to call my so-called insurance company (the company of NO) every month to ask about some claim or other was a great relief! Were it not for our grandkids here, we’d probably move back!

  2. We’re very proud of our NHS Stacey and woe betide any politician who tries to meddle with it. It’s struggling through funding these days for a number of reasons. Firstly, we are all living too long now. When the NHS was set up in 1948, the average life expectancy was about 65 to 70 years old. So the system could cope with the number of elderly people who needed it’s services. But more people are living longer now. Secondly, A&E departments did not suffer the onslaught of patients they now receive who have drunk too much or overdosed on drugs. Alcohol rehabillitation, drug care, needle exchange etc, all has to come out of the budget too. There were no miracle – and expensive – drugs around in 1948 either. If what was available didn’t cure you then you died. But the huge advances in medical science have made most things cureable – but at a cost. When somebody reaches the age of 60, all prescriptions are free for the rest of their days. So imagine the cost to the NHS of a patient who needs £50 worth of medication every month, and who then goes on to live till they’re 80.

    No, you are not required to pay for an emergency ambulance in Britain. Yes, the bicycle paramedic has been very successful in London and has been extended to other cities. Many of our streets are pedestrianised and impassable to vehicles and the only way to get help to a patient quickly is by the trusty bike. And that horse? Sorry to spoil the romantic illusion but it was a police horse. But don’t be too disappointed – all paramedics in London are handsome blades!

  3. I am probably taking this too literally, but GPs should be able “to get things done”, as well. They’re probably underpaid and undervalued as they are here in the US…my father was a GP and he was able to remove ingrown toenails and diagnose and treat many dermatological conditions.

  4. As a visitor to London I had the need for both an ambulance and A&E and did not have to pay even a small fee. I thought the care was top notch and I was never asked to pay a thing.

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