Healthcare in the UK (specifically England)

lilly1326001

Mmm... On a coffee high
Super Member
Registered
Joined
Jun 22, 2011
Messages
163
Reaction score
5
Location
In your mind
Is health care specifically tied to your job if you live in England?
 

Parametric

Super Member
Registered
Joined
Sep 17, 2007
Messages
10,818
Reaction score
4,684
No. Not unless you have additional private healthcare funded by your employer. Everyone is covered by the NHS.
 

lilly1326001

Mmm... On a coffee high
Super Member
Registered
Joined
Jun 22, 2011
Messages
163
Reaction score
5
Location
In your mind
Thanks for the quick reply! Just clarifying: the government doesn't make it cheaper to get healthcare through an employer (by not paying taxes on it) opposed to getting it individually?
 

Parametric

Super Member
Registered
Joined
Sep 17, 2007
Messages
10,818
Reaction score
4,684
Thanks for the quick reply! Just clarifying: the government doesn't make it cheaper to get healthcare through an employer (by not paying taxes on it) opposed to getting it individually?

I think that's a fundamentally American question that doesn't translate to the British system. I don't need to acquire healthcare, through an employer or any other method. It's a universal right that I'm entitled to as a British citizen. Some high-powered employers offer additional private healthcare benefits, but 99% of the time you can get along just fine with free public healthcare.
 

BunnyMaz

Ruining your porn since 1984
Super Member
Registered
Joined
Feb 14, 2011
Messages
2,295
Reaction score
412
Age
40
Yeah, it isn't a thing you get given through a job, it's a right. And in fact, we have programs in place to increase access to healthcare for the poorest in society. For example:

Prescription medication is already a lot cheaper than in some other countries, but people in receipt of certain benefits, unemployed people and retired people get free prescriptions.

Some dental care is free for those groups as well.

Contraception can be accessed for free if you're under the age of 25 - IUD, condoms, the pill, you can get it all gratis. In the case of condoms, the free ones are available in sexual health centres, but anything on prescription is free at the place you get it from. (That said, I had my IUD put in last year and still didn't pay for it... I think it's specifically the prescription stuff that has the age limit?)

Also, the NHS is technically an insurance-type thing, but we don't get billed for healthcare. Say, for example, I broke my leg. I wouldn't need to bring any documents to the hospital with me. I wouldn't have to talk about costs at any point. I would never see even as much as an itemised list of what my care cost.

Re: the above, I'm not completely sure what you're asking, but I think I can guess? Does it help if I say the NHS isn't an opt-in OR opt-out thing. Everyone gets it from birth, and although your NI contributions are listed separately on your wage slip under the taxes, there is no option to not pay it.
 

Cath

The mean one
Super Member
Registered
Joined
Mar 23, 2006
Messages
8,971
Reaction score
2,298
Age
50
Location
Here. Somewhere. Probably.
Website
blog.cathsmith.net
What others have said, in the UK access to healthcare is a right and provided to all (mostly) free of charge. There is no fee to access a doctor, and nobody is denied care. Some groups may have to pay for prescriptions, but that's a fixed cost.

People living in the UK can purchase private healthcare if they want to supplement the care they receive on the NHS, but they get the same doctors and nurses (usually after finishing their NHS shifts) and old NHS equipment, so I've never understood why anyone would choose to do that.
 

Buffysquirrel

Super Member
Registered
Joined
Nov 12, 2008
Messages
6,137
Reaction score
694
Well, homeless people can find it difficult to get healthcare, but yeah, generally it's free-at-the-point-of-service for everyone. People with certain medical conditions, eg cancer, diabetes, get free prescriptions, and I believe pregnant women get free dental care?
 

Torgo

Formerly Phantom of Krankor.
Kind Benefactor
Super Member
Registered
Joined
Apr 7, 2005
Messages
7,632
Reaction score
1,204
Location
London, UK
Website
torgoblog.blogspot.com
It's worth pointing out that the government over here just opened up the NHS to the private sector health care firms that a lot of them invest in as individuals, the hounds. The NHS that is free at the point of delivery and and open to all is being legislated out of existence. It's a sad and shocking story that the BBC, to their eternal shame, has largely failed to report.

So things might not be quite the same in a few years' time, I'm afraid.
 

ClareGreen

Onwards, ever onwards
Super Member
Registered
Joined
Apr 28, 2010
Messages
791
Reaction score
121
Location
England
Prescribed female contraception - the pill, the injection, etc - is free for as long as you need it or want it. I've no idea about IUDs.

Condoms are only free from the sexual health centres, but can be bought from any chemist or supermarket.

In comparison to the US, we pay a ludicrous amount of tax. We have a sales tax and an income tax and car tax and a house tax and many, many more; part of that is called 'National Insurance', and ostensibly that's what we pay to get our healthcare and our pensions. It's not that we don't pay for it, it's that we've already paid for it as a nation.

If you want quicker service or access to procedures that the NHS doesn't cover, you can go privately. Private insurance options also exist, but if you don't mind waiting the NHS will cover most things.
 

shaldna

The cake is a lie. But still cake.
Super Member
Registered
Joined
May 12, 2009
Messages
7,485
Reaction score
897
Location
Belfast
Is health care specifically tied to your job if you live in England?

No. Some employers have private or semi-private schemes, such as Benenden, but they are optional.

Thanks for the quick reply! Just clarifying: the government doesn't make it cheaper to get healthcare through an employer (by not paying taxes on it) opposed to getting it individually?

The vast majority of healthcare here is free - the exceptions being things like non-essential cosmetic surgery etc.

Prescription medication is already a lot cheaper than in some other countries, but people in receipt of certain benefits, unemployed people and retired people get free prescriptions.

England still pays? Perscription meds are free here for everyone. Although they used to cost £3.65 unless you were under 16, over 65 or unemployed.


Also, the NHS is technically an insurance-type thing, but we don't get billed for healthcare. Say, for example, I broke my leg. I wouldn't need to bring any documents to the hospital with me. I wouldn't have to talk about costs at any point. I would never see even as much as an itemised list of what my care cost.

To clarify, everyone who works pays what's called National Insurance, which all goes into a big pot to pay for everyone's healthcare (among other things) it's addtional to things like your taxes, and you still ahve to pay it even if you have a private health scheme.

Re: the above, I'm not completely sure what you're asking, but I think I can guess? Does it help if I say the NHS isn't an opt-in OR opt-out thing. Everyone gets it from birth, and although your NI contributions are listed separately on your wage slip under the taxes, there is no option to not pay it.

This.
 

Priene

Out to lunch
Super Member
Registered
Joined
Aug 25, 2007
Messages
6,422
Reaction score
879
National Insurance is in effect a form of taxation, but it was never designed to pay for health care. In its original form it was there to pay for pensions and other forms of state benefit.
 

girlyswot

Super Member
Registered
Joined
Sep 1, 2007
Messages
2,227
Reaction score
389
Location
Cambridge
Website
myromancereviews.wordpress.com
We actually don't pay much more tax, on average, than in the US. See this table of effective tax rates (including direct and indirect taxes).

We certainly pay less in tax than the average American would pay in tax + health insurance. The cost of healthcare (whether paid via taxation or by individuals) in the US is dramatically higher than anywhere else in the world. Oddly, this isn't all that effective.
 

BunnyMaz

Ruining your porn since 1984
Super Member
Registered
Joined
Feb 14, 2011
Messages
2,295
Reaction score
412
Age
40
It's worth pointing out that the government over here just opened up the NHS to the private sector health care firms that a lot of them invest in as individuals, the hounds. The NHS that is free at the point of delivery and and open to all is being legislated out of existence. It's a sad and shocking story that the BBC, to their eternal shame, has largely failed to report.

So things might not be quite the same in a few years' time, I'm afraid.

This is true and infuriating. That even the Beeb can't be trusted to report on something as important as the stealth dismantling of the NHS is criminal.

That said, we still get the same access to stuff. Services are as accessible as they ever were - the difference is private companies run for profit, so when they take over little things in the NHS, the result tends to be drops in quality. MRSA became a problem following the privatisation of cleaning services in hospitals, for example.

We actually don't pay much more tax, on average, than in the US. See this table of effective tax rates (including direct and indirect taxes).

We certainly pay less in tax than the average American would pay in tax + health insurance. The cost of healthcare (whether paid via taxation or by individuals) in the US is dramatically higher than anywhere else in the world. Oddly, this isn't all that effective.

Indeed! I wouldn't swap our system for America's any day of the week. Say what you like about it, but we get incredible value for money with the NHS. I remember when I was working in holiday insurance, our customers would rant and complain about how expensive insurance for holidays to America would cost them. Until they needed healthcare out there. They were shocked - absolutely astounded - to find out that, say, ambulance use and bed use were charged for, and how much everything costs.
 

ClareGreen

Onwards, ever onwards
Super Member
Registered
Joined
Apr 28, 2010
Messages
791
Reaction score
121
Location
England
We actually don't pay much more tax, on average, than in the US. See this table of effective tax rates (including direct and indirect taxes).

We certainly pay less in tax than the average American would pay in tax + health insurance. The cost of healthcare (whether paid via taxation or by individuals) in the US is dramatically higher than anywhere else in the world. Oddly, this isn't all that effective.

I'd be interested to see the table for lower and higher earners, and how those figures were calculated - and it may be worth nothing that a pound in the UK has roughly the same buying power as a dollar in the US. The actual exchange rate doesn't seem to matter.

And yes, the cost of healthcare in the US is insane, or seems to be from where I'm sitting. I owe the NHS a debt I can never pay, and to watch it being sold off is heartbreaking.
 

crunchyblanket

the Juggernaut of Imperfection
Super Member
Registered
Joined
Feb 18, 2011
Messages
4,870
Reaction score
766
Location
London's grey and pleasant land
What others have said, in the UK access to healthcare is a right and provided to all (mostly) free of charge. There is no fee to access a doctor, and nobody is denied care. Some groups may have to pay for prescriptions, but that's a fixed cost.

People living in the UK can purchase private healthcare if they want to supplement the care they receive on the NHS, but they get the same doctors and nurses (usually after finishing their NHS shifts) and old NHS equipment, so I've never understood why anyone would choose to do that.

working in both private and NHS hospitals,.I've found the NHS better-equipped (on the whole) despite a lack of funding. We also have more than one consultant at the private hospital who was very nearly kicked out of his NHS role - rumour suggests he jumped before he could be pushed.
I've experienced both behind the scenes and would go NHS every time.
 

Cath

The mean one
Super Member
Registered
Joined
Mar 23, 2006
Messages
8,971
Reaction score
2,298
Age
50
Location
Here. Somewhere. Probably.
Website
blog.cathsmith.net
We actually don't pay much more tax, on average, than in the US. See this table of effective tax rates (including direct and indirect taxes).

We certainly pay less in tax than the average American would pay in tax + health insurance. The cost of healthcare (whether paid via taxation or by individuals) in the US is dramatically higher than anywhere else in the world. Oddly, this isn't all that effective.

Total tangent, but there was a study done in the UK -- the Black Report -- in 1980 showed that the bigger the difference in quality of life between the richest and poorest in society, which is directly influenced by health and social care, the lower the life expectancy for all people in that society. The report was buried for years but emerged again after three further studies in the 1980s and 90s came to the same conclusion. Michael Marmott, who conducted the final study, wrote a fascinating book called "The Status Syndrome" on the subject.
 

evilrooster

Wicked chicken
Super Member
Registered
Joined
Dec 8, 2010
Messages
3,082
Reaction score
888
Location
Where eggs are small and dear
Website
www.sunpig.com
I loved the NHS when I lived in the UK. Had two babies in NHS hospitals, one by C-section. Wonderful care throughout the pregnancy; really good after-birth care from the health visitor, too (she came regularly for the first month or so to weigh the baby and check on both our health).

Total marginal cost (as in, the difference between what I would have paid had I not had a baby and what I did pay) to me: zero. Total marginal cost to an unemployed person: also zero, for the same standard of care.
 

aruna

On a wing and a prayer
Super Member
Registered
Joined
May 14, 2005
Messages
12,862
Reaction score
2,846
Location
A Small Town in Germany
Website
www.sharonmaas.co.uk
It's a universal right that I'm entitled to as a British citizen. Some high-powered employers offer additional private healthcare benefits, but 99% of the time you can get along just fine with free public healthcare.

You don't have to be a British citizen to get NHS free treatment. I and my two kids, and later my husband, all lived for years in the UK as German citizens and we got free NHS treatment. They don't even ask if you pay taxes in the UK (my husband didn't and I only paid Class Two National Insurance).

People living in the UK can purchase private healthcare if they want to supplement the care they receive on the NHS, but they get the same doctors and nurses (usually after finishing their NHS shifts) and old NHS equipment, so I've never understood why anyone would choose to do that.

You don't get the same doctors and nurses. The one drawback of the NHS is that it can take months to see a specialist; you are put on a list and then are given a date and summoned to the hospital. At least, that's how it is in Eastbourne.

Unless, of course, it's an emergency.

My husband's German private insurance was valid in the UK, and he was able to see specialists of his choice right away, ie within a few days. There is a private hospital in Eastbourne that caters to such people. Also, my daughter wanted to see a gynecologist and I knew it would take months on he NHS. So I found a private UK one through google and she got an appointment the next week. We then paid it privately, submit it to husband's private provider, and voila. 100% refund.

So that's the benefit of private health care in the UK: quicker service, and choice of specialist. You don't seem to have many doctors (specialists) with their own practice on the high street.

However, when we went to one specialist, I was surprised to see our own NHS GP had a brass plate with his name on it in the same building --- obviously, he was operating as a private GP after hours!
 
Last edited:

mirandashell

Banned
Joined
Feb 7, 2010
Messages
16,197
Reaction score
1,889
Location
England
That's really the only advantage the private section has over the NHS. As far as emergency medicine goes, the NHS rules. And for ongoing chronic conditions such as CFS or arthritis, it's really good. It tends to be non-urgent operations and such where it falls short.
 

Cath

The mean one
Super Member
Registered
Joined
Mar 23, 2006
Messages
8,971
Reaction score
2,298
Age
50
Location
Here. Somewhere. Probably.
Website
blog.cathsmith.net
Correction: you don't get the same doctors and nurses. The one drawback of the NHS is that it can take months to see a specialist; you are put on a list and then are given a date and summoned to the hospital. At least, that's how it is in Eastbourne.
Actually, in many cases you do. Many NHS staff also work as private doctors/nurses, etc. You many not see the exact same person, but it's highly likely that they also work for the NHS. I worked in healthcare in the UK for a long time and not so very long ago, so I do have some experience here.
 

aruna

On a wing and a prayer
Super Member
Registered
Joined
May 14, 2005
Messages
12,862
Reaction score
2,846
Location
A Small Town in Germany
Website
www.sharonmaas.co.uk
That may be the case, Cath, but certainly, in my experience using private insurance in the UK, we always had the choice and got appointments quickly. So I can understand why some people like to have it.

The lack of which was the one thing I didn't like about the NHS!
 

clee984

Bearded and serious
Super Member
Registered
Joined
Feb 20, 2013
Messages
884
Reaction score
61
Location
France
The NHS is amazing, amazing, AH-may-zing. When my mother was terminal, the level of care she received was unbelievable, and didn't cost anything (except for her prescriptions, which cost a token amount, I think it was 6 quid).

Here is the great Tony Benn dicussing the NHS in the Michael Moore documentary 'Sicko'. He's right, if the NHS were to be dismantled, there would be a revolution. That's how great it is. (Ignore the mawkish Michael Moore bits).

EDIT: No, I take it back, now I think about it, my mother's prescriptions didn't cost anything - I've just remembered, I applied for a refund of the money I'd paid for her pain medication, and I got it.
 
Last edited:

crunchyblanket

the Juggernaut of Imperfection
Super Member
Registered
Joined
Feb 18, 2011
Messages
4,870
Reaction score
766
Location
London's grey and pleasant land
However, when we went to one specialist, I was surprised to see our own NHS GP had a brass plate with his name on it in the same building --- obviously, he was operating as a private GP after hours!

Nearly every consultant/doctor (and a good proportion of the nurses) in the private hospital I work at also work for the NHS. The same is true of most private hospitals in the UK. It's very rare to find a private doctor who doesn't also do NHS work - often, they're older doctors who've retired from the NHS and continue to work privately.
 

aruna

On a wing and a prayer
Super Member
Registered
Joined
May 14, 2005
Messages
12,862
Reaction score
2,846
Location
A Small Town in Germany
Website
www.sharonmaas.co.uk
That makes sense, I guess. I can't imagine it would be easy to make a living ONLY as a private doctor in the UK.

It's similar here in Germany. Doctors work for both public and private insurers. Very few are exclusively private.