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An American doctor experiences an NHS emergency room

You know it’s going to be one of those days when one of the first tweets on vacation inquires about the closest hospital.

IMG_8896Victor, one of my 11-year-olds, had something in his eye courtesy of a big gust of wind outside of Westminster Abby. He was complaining enough to let me flip his eyelid and irrigate his eye on the square in front of Big Ben. (I’m sure several people thought I was torturing him).  Despite an extensive search and rinse mission no object or relief was to be found. I fretted about going to the hospital. It wasn’t the prospect of navigating a slightly foreign ER, but simply the prospect of the wait. While I am a staunch supporter of the British NHS in the back of my mind I envisioned a paralyzingly full emergency room and an agonizing 18 hour wait only to find he had nothing in his eye (the basic antechamber of Hell scenario). To ensure we really needed to go I gave Victor a choice between the emergency room and a toy store (Gunter’s 3rd rule), but he declined the toys so off we went to St. Thomas hospital, conveniently right over the bridge.

The hospital was on the aging side and a little drab, but clean and well-marked. I didn’t have to ask anyone for directions. We had to take a number to be registered, but waited less than 5 minutes. I gritted my teeth a bit in preparation for the we-are-not-from-the-UK conversation, but it wasn’t an issue at all. I offered my US insurance number for billing, but was told they didn’t need it. The clerk was, however, impressed with the fact that I flipped his eyelid and irrigated his eye before coming. “Well, you did all the right things,” and looking at his red and watering eye she smiled and said. “Looks like you are in the right place.”

Registration completed, we waited to be seen by the children’s part of the ER. A registrar (resident) did a quick triage within 5 minutes of our registering (also impressed with the eye irrigation) and then a nurse did his vitals and took a history. After that we waited less than 15 minutes for the registrar to do a formal assessment. He wanted ophthalmology to do the evaluation. I was a bit surprised the ER doc wouldn’t do it, but every facility is different and when they found out that Victor was born at 26 weeks and had retinopathy of prematurity they got a bit jumpy. Everyone does. I was ok with ophthalmology checking him out. What I have learned from years of medicine is don’t mess with the local order.

We were walked over to the urgent care clinic and were warned that the ophthalmology registrar was covering the whole hospitalIMG_8897 so it might be a while. This was our longest wait, about 20-30 minutes. She was very nice (also working on her PhD). Dr. Katie Williams (she gave me permission to use her name and her photo) diagnosed Victor with a corneal abrasion and easily snagged the offending speck of dirt wedged under his eyelid.  Once removed Victor exclaimed, “It’s gone!,” and within a minute or two the redness cleared up. She put in antibiotic ointment and gave us a tube to use at home.

“So where do I pay?” I asked Dr. Williams.

The answer: you don’t. Perhaps they might bill us, she just wasn’t sure.

I was about as dumfounded at her answer as she was at my asking.

I protested that it wasn’t fair. We had used services and I was very prepared to pay. I also have insurance that covers emergencies when out of network, so I was pretty sure I would be reimbursed at least some of the visit. However, we were just sent away. They do have my address so it is possible I will get a bill in the mail.


Victor and Dr. Williams

Victor and Dr. Williams


I am very curious what similar care would have cost in the US. The saddest commentary of all is that it is really impossible to tell as billing practices are so bizarre and opaque. My guess is it would be a minimum of $1000 in America for cash (which is egregious). If I ever get a bill from the UK, I’ll post a follow-up. If anyone has had similar care in the US and received a bill please do post in the comments. You can remain anonymous if you like.

But what of this idea that national health care means DMV-purgatory worthy waits, Dementor-staffed death panels, Saxon-age medical equipment, and incompetent care? Well, I can tell you we had great care at St. Thomas and Dr. Williams was fantastic. The slit lamp wasn’t brand new, but it worked just fine. Sure it’s an N of one, but I’ve been to the ER more times than I can count with my other son and this was as smooth as the best care we’ve had in the United States.

We could have hit the ER at an opportune time, but to expand my N I’ve also asked many people about their medical care while I’ve been in the UK. Not one person wanted to abandon the NHS. I’ve heard of excellent care and some care that was lacking, but the bad care has nothing to do with the “national” part. Rather it was diagnostic errors or a full hospice unit, things that I hear about with the same incidence back in the world of commercial insurance. Take away the accents and I could easily have been listening to a group of Americans discussing their care. With one exception, no one in the UK is left wondering what the price will be or gets an egregious bill.

It makes you wonder exactly what frightens Americans about the NHS?


948 thoughts on “An American doctor experiences an NHS emergency room

  1. As an American who has lived in the UK for 14 years I love the NHS – I have had nothing but good treatment any time I have had surgery and the last time I was in I told them I wanted to be in control of all of the medications that I brought in with me so that my normal medicine regime was not disturbed and they were very accommodating and I just had to tell them what I took and at what time so it could be recorded xxx

    Posted by Linda Hurwood | January 17, 2016, 7:32 am
  2. Fabulous fabulously written Dr. Gunter . All these years later , did you ever get a bill ?!

    Posted by Naiomi | March 29, 2016, 6:49 pm
      • And there in lies the major problem , you should have paid ,it should free at point of use for Britons ,not for the rest of the world

        Posted by Tony | August 22, 2016, 5:25 am
      • Tony, don’t embarrass yourself. I work for the NHS and providing this level of care for a little boy is nothing.

        Posted by Gareth | August 22, 2016, 2:24 pm
      • Not embarrassed at all so did I, therein lies the fault thinking it all costs nothing everytime the NHS dies anything it costs money. The hospital administrators should follow up for oayment for treatment received or obtain the insurance details. This happens in most other countries , I would not go on holiday to Spain just relying on my EH11 card and neither would you.

        Posted by Tony | August 22, 2016, 2:53 pm
      • It would probably have cost the NHS as much to create the bill as the treatment cost. Remember, they don’t do it for patients as a matter of course.

        Posted by Nigel Strudwick | August 23, 2016, 12:07 am
  3. ‘Emergency’ care is free to all in the UK regardless of country of residence as is care for HİV and Tuberculosis. İf you needed follow up there might have been a charge but anything through a&e is free. İt is a fantastic system although not perfect and despite the government and media trying to destroy it the staff and service is mostly first class.

    Posted by Lucie | August 16, 2016, 5:50 am
    • There wouldn’t have been a charge for any follow-up. All care is free under the NHS.

      Posted by Kai | August 21, 2016, 11:29 am
      • Not quite. You must be resident for non-emergency care.

        Posted by korhomme | August 21, 2016, 11:35 am
      • You have to be have been legally resident here for 6 months before you are entitled to free treatment. If you need followup care after A&E you have to get it back home for pay for it here. On return from overseas my husband and I weren’t entitled to free care (except emergency care) even though we are British citizens born and raised here, and paying NI and income tax for many years. For that reason his company paid for our health insurance. We think that’s fair enough.

        Posted by Kay | August 22, 2016, 4:20 pm
  4. Immediate and necessary is free through the NHS no matter what your nationality,you won’t be billed. We are ultra proud of our health service despite its many flaws g

    Posted by Sian Moran | August 17, 2016, 3:19 am
  5. My daughter recently had a serious accident in Mexico. I’m from Britain but live in Canada which also has universal health care. The first thing I was asked as my daughter lay critically I’ll was for my credit card to pay a deposit for care and insurance. I remember watching Michael Moores “sicko” where he compared health care systems. I worked for the NHS and am so proud of it. I think if you have the means to pay for care then you should, but ultimately everyone should have a basic right to access health care.

    Posted by Julie | August 17, 2016, 5:19 am
    • “if you have the means to pay for care then you should”, is a dangerous sentiment used in connection with the NHS. Government and business are keen to destroy it and intend to make those who have the means to pay do so. The fact is that everyone working in the UK already pays into the funding for NHS. There are multiple problems with the NHS in it’s current shape and a good deal of them are down to fragmentation and imposition of a totally synthetic Market process and associated levels of expensive non-medical tiers management.

      I know from my experience in international business that when you add a “value” chain to any service or commodity the cost goes up in proportion to the number of entities taking their margin.

      It strikes me as insane that anyone in the UK would think that moving to a model more like that found in the USA would deliver better service at lower (or par) cost.

      Government has managed to persuade some of the population that the NHS is broken and needs to be replaced, but starving it of cash in order to break it was probably the plan and Government should be called to account for not properly funding the service and for hampering it with needless layers bureaucrats.

      In the UK those who have the means are paying, but what they’re essentially getting is access to the same senior staff who sell their spare time to private Health Care entities like BUPA. The reality is that apart from having quicker access to diagnostics and nicer hotel services the standard of care is dependant on the standard of practitioners available to NHS users. Effectively BUPA and their ilk allow you to jump the NHS queue. In the event of any complications it’s not unknown for these folks to have to transfer patients to their nearest NHS facility for further treatment.

      Posted by kegould | August 17, 2016, 9:52 am
      • The US system is broken. Face it, the whole world is broken. Almost anything you can think of someone in politics is claiming is broken.

        Looks to me like the NHS is better than the US system. At that it costs one hell of a lot less. In the US they agonize over what such a system would cost the government. What they need to look at is what it costs the country. One way or another it’s paid for, you just pay less.

        Posted by BobKlahn | August 22, 2016, 10:40 pm
      • “Starving it of cash in order to break it” sounds exactly like the way government treats public education in America.

        Posted by swm | August 23, 2016, 5:18 am
      • This was in the context of a visitor using the NHS,what us wrong with asking for their insurance by the admin staff at the front desk nothing to do with medics who treat.

        Posted by Tony | August 23, 2016, 8:36 am
  6. I know this post is a little old, but I only just found it.

    I’ve seen a small portion of the US anti-NHS stuff – what I’ve read online, and what has been reported here, so I can well believe an American coming here would be expecting mud huts and rusty re-used needles. They never mention the fact that the UK has a higher life expectancy than the US, or that (despite the cliche) people in the UK have better teeth than people in the US, statistically.

    But I have to say, as a Briton, I love the NHS. It’s one of the greatest things this country has ever done.

    I’m quite firmly in the category of people who simply couldn’t afford healthcare if it weren’t for the NHS. I couldn’t pay independently, and I don’t think I could afford the insurance. And I’m self employed, so no employee benefits.

    Over my lifetime, I’ve been treated for seizures I had as a kid (2 weeks in hospital each time, once nearly over Christmas, which the nurses managed to make feel like an adventure), for innumerable coughs, colds, etc, dental treatment, and I’m currently being treated for ptsd. Yes there are problems – there are waiting lists, and it can be tricky getting a GP appointment, but it’s still probably the best thing about the UK.

    I was brought up by my Nana, and she used to regularly tell me stories about pre-NHS life. Specifically about her mother, dying at 48, unable to afford any treatment other than pain relief – and that only because she washed the doctor’s shirts to pay his bills. There are plenty of people who’d be in that situation again here, if it weren’t for the NHS.

    To add to that, my mother-in-law had a stroke at the end of last year. the ambulance was there in minutes (and they live in the middle of nowhere). She was rushed to a specialist stroke care unit, then a few weeks later transferred to a specialist stroke rehabilitation unit. She’s at home now, and has been for some months, but she still gets regular treatment sessions, regular sessions of speech therapy, and regular physio. Her care has been outstanding at every stage. And it has all been NHS.

    Put it this way, I might very well be prepared to fight to the death to defend the NHS. And almost everyone I know feels the same.

    Posted by sarahjanessite | August 17, 2016, 7:19 am
  7. The NHS is invaluable in GB and because we have a good system we have really cheap private hospital plans too. I belong to Benenden health £8.49 a month and the if a waiting list on the NHS is a bit long then Benenden will do it….they also give you £1,400 to cover any specialist (up to £5,000) for separate illnesses.
    Couple of years ago I had a lump in my mouth…they agreed to pay to have it removed at our local Nuffield in Woodindean.

    As they have to compete with the NHS it’s really cheap!
    I have had many dealings with the NHS too….and by having very low cost medicine it takes the strain off the NHS lists.

    Posted by Karen Butterfill | August 17, 2016, 10:37 am
    • Your really cheap “private” insurance is a mirage. It’s only possible to offer a product that cheap because of the way that privatised health care leverages NHS resources. If all health care in the UK went over to the American model you’d be out campaigning against the high price of health care.

      Posted by kegould | August 17, 2016, 11:16 pm
  8. The NHS is a fabulous institution and should never be privatised. My only experience of emergency health care in the US was when I had a bad reaction to insect bites. Attended a PromptCare clinic and was seen very quickly but only after I’d paid the $200 upfront fee. I was prescribed a course of steroids which I was dreading finding out the cost of however this was only $7. But all in all a costly 20 minutes! That same summer (2010) my friends in the US were very interested in how the NHS worked but we’re largely not interested in paying for others care who “didn’t take care of themselves”. Thats not really the case with the NHS (though some may disagree!) and it didn’t matter to them that it would likely be way less expensive than their current insurance.

    Posted by TAC76 | August 17, 2016, 1:31 pm
  9. Great article good job she wasn’t visiting west Yorkshire it would have been a different experience. Especially Dewsbury .

    Posted by Gary Smith | August 17, 2016, 11:18 pm
  10. I am really pleased that you got excellent care from our NHS for free at that too!
    Unfortunately for us poor minions the story is quite different 99% of the time!
    2 year 4 month wait for a child mental health assessment for my now 9 year old, the same 9 year old is on a 22 week waiting list to see a neurologist after an MRI scan found multiple cysts on her brain(This is my child & I have to sit back & wait with pure worry over what is happening to her brain)
    3 accident & emergency visits over 3 weeks for my very sick 2 year old granddaughter after being told she was misbehaving resulted in an eventual diagnosis of diabetes insipidus.
    My then 19 year old daughter discharged from accident & emergency after displaying stroke like symptoms & vertigo because a CT scan showed nothing! Fast forward another week & she lost her memory, a full 9 weeks after initial symptoms diagnosed with a rare disease (Susac Syndrome) she’s 23 now & has brain damage & is disabled!
    Now I’m aware of others who have had positive experiences but the negative experiences far outweigh the good, I feel our NHS has a lack of care because the staff are so overworked, Great Britain is bursting at the seams & the NHS has took full force of this! In the meantime we are suffering from a lack of care & extremely long waiting lists..

    Posted by tjcov1 | August 18, 2016, 2:25 am
    • I’m really sorry that your experiences have been bad, but it’s not because GB is “bursting at the seams” – it’s because the NHS is critically underfunded. And THAT is a political choice by a government intent on strangling social healthcare to death.

      Posted by kopicbloodaxe | August 22, 2016, 1:47 am
      • Totally agree. Scotland does not have the same levels of immigration as England, but its NHS has nany of the same problems, Child mental health is not only underfunded, but suffers from a lack of available qualified staff. In my area that has really been helped by the appoinment of a new child psychologist. She’s Polish.

        Posted by Gayle | August 22, 2016, 11:09 am
  11. You won’t get a bill. It’s free at the point of delivery. For everyone. For now. 😊

    Posted by Donna muir | August 18, 2016, 2:57 am
  12. So glad you had such a positive experience. Whilst on honeymoon in Florida some 23 years ago, my husband was taken ill with gastroenteritis. As it was only the second day, I thought he was taking the vow of “in sickness and health” to the extreme as his temp was really high and I did wonder if we would be going home together! I took him to the local doctors via a cab, both of us really worried. The first thing I was asked for was a credit card, before they asked his name or enquire as to the problem. 😟 I am so very grateful for our NHS.

    Posted by Jackie Mash | August 18, 2016, 4:35 am
  13. Having been an A &E nurse for 8 years and then moving to the US 13 years ago I have a slightly different persoectitive. The NHS is fabulous, in the US physicians are so concerned about malpractice suits they spend a lot of time and consequently money on extra tests (to cover all the bases). Additionally as a nurse in the south of England I earn less than a nursing assistant in the US. A newly graduated nurse where I work in the US earns >$30 an hour that is double that of a new nurse in the UK. Is it any wonder healthcare costs so much in the US?
    I hope the UK protects its national treasure it really is a gem!!

    Posted by Gilly | August 18, 2016, 5:16 am
  14. I have a friend that is Canadian born (to US parents) grew up in the states, served as a medic in the US forces. Has travelled the world as a medic is married to a US woman nurse. Lives near the Canadian border, both at times cross o er to use the Canadian health service. Both will tell you it’s a mess and a socialist haven and the US is better off without it!!

    Posted by Paul patience | August 18, 2016, 7:56 am
    • Parts of the Canadian system are a mess, but it works. And what we have is 4,000 times better than anything Americans have. If it’s such an overall mess. Why would anyone come across the border to avail themselves of our service? Would it be because we have world class doctors? Maybe the world class research and development? Would it be the cost, because the doctors who stay in Canada aren’t greedy, money grubbers afraid of getting sued every time they treat a patient. We have a great, if somewhat faulty system.

      Posted by Vicki | August 18, 2016, 8:34 am
    • If it’s such a mess and the US is better off without it (presumably meaning the US system is better) why do they go to the trouble of crossing the border to make use of it? Why not stay at home and make use of the superior service?

      is it by any chance because they cannot afford to do so?

      Posted by Danikat | August 23, 2016, 8:25 am
  15. Posted by Paul patience | August 18, 2016, 8:13 am
  16. I’m an American born NHS Accident and Emergency doctor (ED Resident). Your experience at our hospitals is fantastic and one I find, happily, as standard. I would please ask you to make a donation to St Thomas Hospital. Overseas visitors are not entitled to free care in the NHS; we will always provide emergency care but our NHS is crumbling under the weight of finance and this is one way you could please show your gratitude.
    The doctor who treated you was entirely wrong about payment for overseas visitors, and it would benefit future patients such as yourself to have the NHS in place.
    Please make this financial payment-for-treatment-received to hospital in question.

    Posted by Dr A | August 18, 2016, 4:31 pm
  17. Last year my wife suffered a cardiac arrest in her sleep. Her shaking was so violent it woke both me and our 3y/o daughter (who had sneaked into our bed in the night) and I had to keep her alive as best I could with CPR while we waited for an ambulance. It arrived inside 5-10 minutes, but she was so far gone (prior to me waking and beginning CPR) that it took 4 shots of adrenalin and 3 defibs just to maintain a really faint pulse. All credit to the paramedics who transferred her to the ambulance and then spent half an hour working to get her breathing spontaneously again. It was only then that they took her up to the local hospital’s A+E where she was immediately intubated, ventilated and sedated to stabilise her condition in resus in order to receive a CT scan, an MRI scan, be diagnosed and then moved into the Critical Care Unit. Then she was hooked up to a vent and at least 6 computerised IVs and arterial lines and nasogastric tube were inserted. She went on to spend a month in coma under constant care of a team of registrars, nurses, CCU consultants and specialists from other teams – dieticians, neurologists, cardiologists, physiotherapists, radiologists, anaesthetists and the list goes on and on.

    Despite the professional consensus being that she was beyond recovery the whole team were reticent to withdraw care and allowed her to continue at her own pace with the result that she eventually defied expectations and regained consciousness. She suffered severe hypoxic damage to the parietal and occipital lobes in her brain and lost all vision, most movement and had her short term memory recall seriously affected. This, combined with a month in coma had left all her muscle mass atrophied so she as unable to even sit up unaided. She was transferred a short time later to cardiology to focus on that aspect of her care where she remained for a further month, during which she underwent a surgery to fit an implantable cardioverter defibrillator (ICV) to mitigate any future incidences. Once the cardio team were happy with her condition she transferred to a smaller hospital, closer to home, while she waited for a room in a specialist neurological rehabilitaion centre attached to another hospital. Even during this time her care and rehab continued with the Occupational Therapists (OT) and Physiotherapists beginning their work to teach her to sit up, stand, walk and feed herself again. After a short time here she moved to the rehab centre where she remained resident for 9 months with more intensive Physio and OT sessions. Throughout the whole journey she has been visited by other teams of specialists – dietary, speech/language therapists, opthamologists, cardio (following up) and remained under a consultant neurologist who specialised in rehabilitation. When she was discharged from hospital her care transferred to our local authority and the OT community team who continue to visit, set goals and work towards them. We have been provided with a wheelchair, DAB radio, bath seat, perching stool for use in front of the washbasin, had handrails fitted in the house and had the outside access to the house modified. She’s also attended outpatient clinics for opthamology, cardiology (check-ups on the ICV) and GP to review her meds. The local pharmacy delivers her prescriptions to our home and her condition (registered blind) means that even these don’t come with the usual small prescription charge.

    Total bill (at point of use) to date = zero. Of course, I have paid into the system through general taxation, but there’s absolutely no way that private health insurance would have covered all of the costs incurred throughout her treatment. Just sitting down and trying to count the number of people who have been directly involved in her care from the moment I dialled 999 to now boggles the mind. The NHS is an amazing service. It saved my wife’s, and mother of my daughter’s life. It continues to give her a life back and won’t stop until she’s gone as far as she possibly can in recovery. The only treatment not covered by the NHS (and it’s a shame, as it really works!) was HBOT which is run fairly locally by a charity and which we had to pay for personally. But I can’t begrudge this one additional treatment not being available on the NHS, because they have provided us with so much already.

    And for this reason I will always defend the NHS against its detractors and attackers. It’s a world class healthcare system that delivers much better value to the end user in terms of personal financial cost and relative quality of care than many private systems.

    Posted by TJ | August 18, 2016, 5:01 pm
    • In the US, a health crisis like almost certainly would have led to a “medical bankruptcy” for most families, which in turn sets folks on a path to financial ruin and homelessness. It’s truly dystopic. People live in fear of illness, hanging on to horrible jobs they hate because they can’t lose their insurance. Our labor is basically extorted through fear of dying without healthcare.

      And, there’s another side to our system in the US, that no one talks about, and that’s how difficult it is to heal in a healthcare economy of that’s marked by scarcity. If you don’t have the money to pay for services you *might* find treatment if you’re diligent and extremely lucky, but you’re treated like you don’t deserve treatment, which takes a huge toll psychologically on the patient. And even then, your treatment will likely be spotty — and people let you know that you’re there by their good graces. I know someone who died b/c his cancer medicine was cut off for a few months due to bickering with his insurer. His illness couldn’t accommodate the lapse in treatment.

      I didn’t have insurance until my mid-30s, and was accustomed to being treated as an outsider in the health care system. Then I contracted an infection in my spine which led to months spent in a hospital. Most of that time was spent without a diagnosis. I was told I “must have AIDS,” and suspected of malingering because they couldn’t find a source for the pain that creating intense spasms in my back (osteomyelitis at L1, L2 was the cause). Once I was diagnosed there was even a sense that I didn’t deserve treatment because this is a disease that usually only hits drug users, so they didn’t want to treat my pain. Despite it all, there wasn’t a day I woke up thinking “thank god I finally have insurance,” because without it I would have been kicked out of the system, the infection would have taken over, and I would have died. The whole process took from May until December, and during that time, once I was diagnosed, I needed constant IV antibiotics. Any break in that regimen would have killed me. I didn’t have the energy to feed myself and I couldn’t walk, so I surely didn’t have the ability to fight with administrators about how to get the medical care I needed.

      In Florida alone, six people die every day because they lack insurance. That’s 2,190 a year, in one state alone.

      Posted by Brook Hines | August 23, 2016, 7:23 am
      • Some very sobering words there, I hope us Brits take note and fight to preserve our wonderful NHS. As for Americans that are reading this, please don’t believe the propaganda you are fed and fight too for have a system that provides for everyone as a matter of human right.

        Posted by Vicky | August 23, 2016, 9:19 am
  18. I am English and well used to the mostly-wonderful NHS (it has its problems as does any country’s healthcare) and also lived in the US for 17 years so have experienced the US system which is excellent (again, not without some problems) but you do have to pay.
    Anyway, my son was visiting from the US and within 24 hours of arriving had chest pains. We took him to the Accident and Emergency (A&E ot ER) in Worcester. The nurse said there was no way he was having heart problems because he was a fit 17 year old. They did a test and I have never seen such quick action once they diagnosed a potential heart attack (very quickly assessed).
    He was quickly wheeled into a trauma room and assessed as well as being given initial medication. The doctors decided they did not have the right facilities so he was to be transferred to Queen Elizabeth in Birmingham.
    I went with him in a white knuckle ride in an ambulance (I was in the front and am sure they never got my fingernail grip marks from the dashboard) to transfer him.
    He then spent three days in a Coronary Care Unit and was given the all clear – turns out it was an infection giving false heart attack symptoms.
    When my ex-wife (a nurse in the US) asked what the bill was, expecting a new mortgage to be required, was amazed when the doctor scoffed and said “his Dad is English so he is too, no bill”.
    Wonderful care from the doctors and nurses throughout the process and Andrew was treated wonderfully.
    Here is hoping we never get rid of it.
    Oh, and as for the US, I had great care when I had my knee repaired from a rugby injury at the Hospital for Special Surgery in Mew York but thankfully had 100% coverage or would probably still be paying for it.
    The NHS is not free (as some people misguidedly think) but it is, in my opinion, worth every penny of tax we pay!

    Posted by Nick Hughes | August 18, 2016, 11:24 pm
  19. As a UK taxpayer I find it grossly incompetent that St Thomas failed to bill their American customer for the care they gave his son. I appreciate that they get paid anyhow so that explains why they can’t be bothered but there is no reason at all that they should pose as the International Health Service.

    Posted by David in Kent | August 19, 2016, 7:23 am
    • A&E care is free to all at the point of need regardless of nationality.

      Posted by Fi Brown | August 21, 2016, 5:16 pm
    • Emergency treatment is free throughout the EU and Europe in general for everyone including visitors – can you imagine what the admin cost to the NHS would be if they had to break down notional costs of the treatment St Thomas’s gave this family? Much cheaper just to deal with it. Had the patient needed further treatment the family would have been liable for charges. Fast, cheap, efficient, effective.

      Posted by Kay | August 21, 2016, 6:18 pm
  20. I am an American living in the UK for about two years now. A British friend of mine made the comment after I was complaining about someone jumping the queue (cutting in front of me in line) for carpal tunnel surgery (while we were all waiting in the hospital in our gowns 🙂 ) that we don’t pay in money for the NHS services, but we do pay in time. Everything takes aaaaaaaages to happen. I waited for eight months for this surgery when I’m the US I would have probably had it within two weeks of deciding it was needed. Everything just takes a lot longer. And it’s not free. We all pay for it with our taxes. It’s just free at the point of delivery.

    Posted by Mary Beth | August 19, 2016, 9:07 am
    • You could have had your carpal tunnel treatment more or less immediately if you were prepared to pay privately, but private medicine costs a lot more because of the inefficiencies involved in the extra admin and profit required by insurance companies and medical providers. You do have to wait a little longer for non-essential treatment because the NHS runs at full capacity (and then some) which makes it highly efficient financially if not quite so effective seen by the patient waiting for non-urgent treatment. I feel your impatience but I bet you weren’t even once tempted to nip back to the US to get your op done there.

      Posted by Kay | August 21, 2016, 5:38 pm
  21. @NHSmillions on twitter, many many users of the service telling their stories.
    I promote our NHS Scotland at any opportunity I have, it’s one of the many reasons why I voted YES in the referendum.
    I do know that in Scotland we take your details and generally send a bill on but I’m not sure how that is dealt with at the hospital at the time..

    Yes our NHS has some issues, but what major company throughout the world doesn’t. Cant please everyone, even when they pay buttons or even nothing (those unemployed) but I LOVE it. And do not want to lose it.

    As for moving to Australia, us Scots move for the weather, the job is a perk, living under Westminster rule isn’t all that great, especially when they are managing NHSEngland and Wales into privatisation.

    Posted by Debbie | August 19, 2016, 11:12 am
  22. Had a similar experience in the UK when my then 6 year old son got a painful ear infection. Off to hospital – Emergency Setvices. He was looked at within 10 minutes, given a shot of antibiotic, given antibiotic tablets (10 day supply), treated with gentleness, kindness and professionalism. I’m and out in 35 minutes and when we offered up our insurance information to pay for the services and the medications, we were told there was no charge. Even though we were foreigners (Americans) in the UK – no charge. We could do the same here, our insurance and pharmaceutical industries just will not allow it… And they have spent hundreds of millions fighting universal care. Here in the USA it’s about big business and their profits – ALWAYS about the money. Always.

    Posted by Ellen | August 19, 2016, 3:04 pm
  23. What frightens me is our government running a National system as their”rules” with Medicare and Medicaid make no sense most times and cause patients to not get adequate care – too much and too little – making docs do work arounds. PS – I’m a pediatrician in a small town, solo private practice, level 3 medical home with 55% Medicaid

    Posted by Judy | August 20, 2016, 6:39 am
  24. You won’t get a bill, its covered in our taxes. Its perfectly acceptable for tourists to use in an emergency, as your situation was. The NHS is great, the management of it not so much. I feel thats why some doctors leave, better pay and working hours abroad.

    Posted by Laura Lindsey | August 20, 2016, 8:20 am
  25. I am very pleased you enjoyed our wonderful free NHS. We do pay for it via a tax called National Insurance around 15% both employers and employees pay on. I imagine at some point you will get a bill. They NHS are suppose to making non UK/EU citizens pay for our services. But whether you do actually receive the bill time will tell. Our NHS is struggling financially due to Government cutbacks and high wages of men in suits. All Brits are very proud of their NHS and we are desperately trying to protect it from being privatised.

    My sister has worked for the NHS for over 30 years.

    Posted by Heather | August 20, 2016, 9:45 am
  26. Myself and my son have had plenty trips to the ER nothin city and rural and I have never waited more than about 40mins to be seen. And to be fair, that was more minor injuries so nothing emergent.

    I am very proud to now work for NHS Scotland. All our goal ever is or has been; patient care.

    People like to denigrate my fellow colleagues but let me tell you, if you had to put up with half the nonsense they did; you wouldn’t last two minutes in the job.

    Is it perfect? No. Healthcare can never be perfected. It changes too quickly, too often.

    My colleagues don’t live to make you wait for hours in and A&E but people need to realise; you have been triaged for a reason. That reason is to determine whether, if something emergent comes in, you can wait without it impacting on your health. One of the biggest problems in A&Es is people attending with no emergent conditions, when they should attend a minor ailments centre or the GP.

    We have an outstanding service, whatever may be said, and we have patients not clients. People are not frightened to come to hospital or GP for fear of the bill. People can safely be treated and medicated without wondering how long it will take them to pay it off. People should no be slave to healthcare. Healthcare is a universal right. With a little taken off my wages every month I know that if I break my leg, am in a car accident, fall down the stairs; I can get and ambulance, be triaged, seen by a doctor, go through a battery of tests, be given medication, stay overnight in hospital and be discharged without ever seeing a bill. I can go home in the knowledge that I have nothing to worry about.

    I wish more countries would adopt this system. People shouldn’t be avoiding their health over money. People should die because they cannnot afford medication. It simply should never happen.

    Posted by Gillian | August 21, 2016, 1:53 am
  27. I’m a Brit and very proud of our NHS. We all know it is creaking under pressure from increasing population and decreasing resource. I’ve also lived in the western USA for several years and experienced healthcare there. Both systems have advantages and disadvantages but I’d opt for a national system any time.

    I think I’d summarise the two systems thus: the US healthcare system is at its strongest when everybody’s sick; the UK healthcare system works best when everybody’s healthy.

    Posted by Graeme Bagnall | August 21, 2016, 10:58 am
  28. Just wondered if the US government are worried about unemployment from nationalised care? Years ago read an article (I’m an accountant, sorry) that said as much money was spent on the administration of the US health system as the entire NHS….
    Agree with others, hospitals should bill overseas visitors, but cost of chasing unpaid invoices and belief of medical staff in free service means they rarely are. Donations are welcome.

    Posted by Sfw | August 21, 2016, 11:52 am
  29. Not exactly similar but a sprained my ankle in new York state last May. €3000 (about $3600) was what my insurance was billed for 2 xrays and one tab of zofran plus 2 mins of the doc’s time. I’m a GP myself and thought that was abolutely scandalous.

    Posted by Michelle | August 21, 2016, 1:20 pm
    • You’re so right, it’s absolutely scandalous, your insurance company being charged money which bears no relation to the service you got, and if we all have to pay insurance, we pay for it in the end. British friend of mine took child to doc in US for ear infection, didn’t object to doctor’s charge but just flatly refused to pay the £200 charge for the antibiotics which she knew cost around £5. She was an NHS nurse and was fully insured. She just refused to let them charge her insurers that money, and they did back down.
      Famously, BUPA refused to pay £200 for a tub of talc the hospital billed them for. It was a BUPA hospital.

      Posted by Kay | August 21, 2016, 6:03 pm
  30. While a Student in England I was a victim of a horrific car accident. I was rushed to St. Bartholomew hospital (the oldest hospital in London, I believe) 5.3 minutes before the car I had been in blew up. At St. Bartholomews I received amazing care with a huge dose of love. I had a severe concussion, a total of 14 fractures in both legs, dislocated vertabrae, deep cuts and abrasions all over my body and face as well as partial scalping. They stiched me up, popped everything into place, plastered me up and were by my bedside 24/7 for a month. They helped me study for my A level exams, they talked with me about anything and everything, they helped me heal physically and mentally. The pain was excruciating, the fear of my future overwhelming. They healed me. All these years later, I am happy to report I’ve had a good life and have many more years to come. Not I, nor my international US insurance, was ever billed for ANYTHING ! Can you imagine the bill I’d still be paying off if it had been in the States?!?

    Posted by Deirdre Regina Shula | August 21, 2016, 10:09 pm
  31. All Children Under the age of 16 in the UK (regardless of resident status) are entitled to free NHS treatment.

    Children under 16, and young people aged 16, 17 and 18 in full-time education*

    You get free:

    NHS prescriptions

    NHS dental treatment for any course of treatment that starts before your 18th birthday or, if you are in full-time education, your 19th birthday

    NHS sight tests

    NHS wigs and fabric supports

    You also:

    Get help towards the cost of glasses or contact lenses
    May get help towards the cost of repair or replacement of glasses or contact lenses
    May get help with travel costs for NHS treatment.

    Posted by daniel | August 22, 2016, 6:20 am
    • Well thats ok then Pity its not reciprocated, would Dr Gunter treat someone for free?

      Yes the NHS is a remarkable organisation but cannot treat the world for free. If the good Dr was able and willing to pay she should have or at very least made a donation.

      Posted by Tony | August 22, 2016, 7:17 am
      • Absolutely agree and any other non National Health contributors. Makes me wild after worked for over 40yrs.

        Posted by Jeanne Jackson | August 22, 2016, 10:10 am
      • It’s not so bad, the kid is only 11 years old. I have always worked and paid my share. Not quite 40 years, but I’m only 34. I don’t mind kiddies getting free treatment. Compared to what is cost in the U.S. It probably seemed like they got away with robbery. But I think not. If that day out at the hospital would have cost $1000 in the U.S it would only cost $300 here,due to how much more efficient we are. And the doctors and nurses would have been there anyway. So as long as nobody had to do overtime because of this one child. The actual cost was negligible. And the money Dr Gunter spent here in V.A.T alone probably more than covered it. So if we get a visitor from the U.S and he or she does not use our healthcare system (like in 95% cases) we are making a profit.

        Posted by Daniel | August 22, 2016, 11:05 am
      • It’s not treating the world for free. It’s treating the small number of people who have an accident.

        You want to let them die rather than treat them? The cost of the coroner, and the mortuary would outweigh a few minutes of a doctors time, the pence that an xray costs and some generic antibiotic cream. I dont think the total cost of that care would be more than £20 it’d cost them more than that to collect it.

        Posted by cstreet | August 23, 2016, 1:13 pm
  32. Should you need NHS treatment and you have not arranged insurance, you will be charged at 150% of the standard NHS rate, unless an exemption category applies to either you or the treatment. If you are coming for more than six months, you may need to pay the immigration health surcharge.

    Some services or treatments carried out in an NHS hospital are exempt from charges, so they are free to all. These include:

    accident and emergency services – not including emergency treatment if admitted to hospital
    family planning services – this does not include termination of pregnancy or infertility treatment
    treatment for most infectious diseases, including sexually transmitted infections (STIs)
    treatment required for a physical or mental condition caused by torture, female genital mutilation, domestic violence or sexual violence – this does not apply if you have come to England to seek this treatment

    Posted by Christian | August 22, 2016, 6:48 am
  33. Our girl had a suspected broken wrist on Saturday night at 9.45. I called the no emergency helpline, spoke to a lovely lady who took all the details. Could be a long wait for a call back so she went and badgered her supervisor til she could speak to them. Best go to A&E. We got there twenty minutes later and she had called ahead so they already had the details, no need to go through it all again. Waited less than 30 mins for triage. Nurse was certain there was no break, er doc could confirm if there was tendon damage, likely to be a two hour wait (it was Saturday night after all!). We decided now that a break had probably been ruled out, we would go home and come back if anything changed. The thing that took longest was travelling there and back, And that was on a Saturday night!

    Posted by Gayle | August 22, 2016, 7:13 am
  34. I am English, and unfortunately I had a miscarriage while on holiday in America. They over- treated me and refused to let me miscarry naturally and insisted on me having a d and c amongst other things, all the while criticising the NHS. I was billed $5000 dollars for the privilege. Three years later, I had another a miscarriage in the uk. I phoned the early pregnancy unit at my hospital and explained what was happening and asked to be left to miscarry naturally. They respected my wishes and gave me follow up advice and what to look out for etc etc all free to me on the NHS. My first experience of this event was harrowing and traumatic and left me with PTSD (I’m pretty sure), however my second experience couldn’t have been more opposite. I love the NHS.

    Posted by Louise | August 22, 2016, 3:21 pm
    • I am very sorry for your loss. You may have been overtreated for two reasons. First, doctors and hospitals make more money when they give more treatment. More importantly, though, they’re afraid of being sued. So they overtreat to avoid being accused of negligence. I am appalled that they would not allow you to miscarry naturally. They were practicing “defensive medicine” to avoid being sued, rather than *caring* for you as a person. That’s a very sad part of our system.

      Posted by Barbara | August 22, 2016, 7:14 pm
  35. I twisted my ankle quite badly while visiting my son in Seattle earlier this year and needed to get it assessed and x-rays, etc. Fortunately I had purchased travel insurance before my trip. The exercise cost over $2,000 yet it would have cost nothing if it had happened in Australia, where I live. I love our socialised healthcare system here. Nobody goes bankrupt in Australia due to medical bills.

    Posted by SANDY | August 22, 2016, 8:25 pm
  36. I’m very happy that you had such a great experience here. It makes me proud of our universal healthcare system and how well it works. We as a society firmly believe in accessible healthcare for everybody, and for good reason.
    However, it is not at all reciprocal between here and the US. I would have to pay a small fortune for the equivalent service over there and even with expensive insurance I still have to co-pay.
    Your son was in essence treated at my expense. British citizens’ tax money. I think it only fair that you insist on paying for the service received.

    Posted by Mia | March 7, 2017, 6:17 am
  37. You went to one of the top research hospitals in the UK, in no way representative of hospitals across the country.

    Posted by Dee | March 17, 2017, 7:39 am
    • I had my first child at one of the top research hospitals in the UK, and it was a disaster. A great research hospital doesn’t necessarily have great patient care.

      Posted by Barbara Brawn | March 17, 2017, 9:46 am
      • To the moderator – could you please delete my last name? I wasn’t aware it would post when I registered. Thank you!

        Posted by Barbara | March 17, 2017, 10:10 am
    • Before my retirement, I was the consultant in administrative charge of a small A&E Dept among the ‘dreary steeples’ of Tyrone and Fermanagh.

      The Associate Specialist who did most of the work had had several years’ experience in ophthalmology, and passed this onto others. Of course, the Dept had a slit lamp.

      The care here would have been identical to that given at St Thomas’s — if anything, it would have been prompter.

      I refute utterly your suggestion that only teaching hospitals in the NHS are up to scratch.

      Posted by korhomme | March 22, 2017, 12:46 pm
      • That’s Norn Ireland and is a hospital that caters for a handful of people. Most A&E departments that dont have massive funding because they are in strategic locations and are renowned teaching sites or ones out in the sticks that serve 10 people are representative.

        Go to a general hospital in London or in an average size town and you will have the experience most people have.

        Posted by Dee | March 31, 2017, 5:26 am
    • (This is a reply to your reply; I can’t post it directly.)

      Yes, and no; it’s more complicated than that. And Norn Iron is a rather different place from England.

      Nevertheless; one major teaching hospital in Belfast was forced to close it’s A&E because it couldn’t get the staff.

      In my locality, the well-functioning A&E Dept was turned into a ‘Minor Injuries Unit’, with serious cases going elsewhere. I also worked at ‘elsewhere’, and was fully aware of the delays in the A&E there; I also had the experience of trying to manage patients in beds in the corridors in the Dept. Sometimes, the place was so full that it was physically hard to move.

      In the past, A&E Depts were called ‘Casualty’. This name came from ‘casual’ patients who walked in off the street; this system was greatly enlarged during WW2. At that time, if a GP saw a patient needing hospital admission, the patient was admitted directly to the ward. Later, rebranded A&E Depts became triage stations for all patients, whether admission was required or not — a sort of ’empire building’ if you like.

      And today’s problems relate to all of this; people find it hard to get GP appointments, and GPs are overworked with numbers of patients, so the patient betakes themself to an A&E dept. (And A&E means ‘accident’ and [major] ’emergency’.) A hospital is thus the ‘lender of last resort’.

      While it’s easy to describe the problems, it’s much harder to solve them. Far more medical and nursing staff are needed, even if this is called ‘shroud waving’, and that needs more money which the government in the UK is very unwilling to provide, despite what they say. Some, and I don’t think they are paranoid, see ‘death by a thousand cuts’ as the start of the slippery slope leading towards much fuller privatisation of the NHS than now exists. And the winners of this will be those with connections to private health care firms; The previous SoS, Mr Lansley is one such person. Jeremy *unt co-wrote a book a decade ago about privatising the NHS. (Yes, I did mean *unt, it’s not a typo.)

      Posted by korhomme | March 31, 2017, 7:21 am


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