Home » United Kingdom » A Guide To The NHS For New Expats In The UK

A Guide To The NHS For New Expats In The UK

When talking about the United Kingdom, some of us will be immediately reminded of grey skies, glum weather, bland food and high costs of living. Yet, there is of course much more to the country than this. Immigrants of all ages from around the world are drawn to this diverse European destination for a number of very compelling reasons, which include its rich culture, high living standards, career opportunities, quality of education, and advanced infrastructure.The UK has therefore become a popular expat hotspot for students, entrepreneurs, professionals, businesspeople and retirees of all nationalities. However, when it comes to healthcare, you are likely to get mixed reviews from the locals as well as from foreign residents living in this country.

In the last few years, surveys conducted by a couple of global entities to assess the overall standard of healthcare across this nation have been inconclusive, to say the least. For example, the Commonwealth Fund assessment of global healthcare systems ranked the UK at number 1 but the country did not fare well in the Europe-wide survey of a similar kind that was conducted a year or so later. So, does the UK offer attractive healthcare options for expatriates or not?

Contrary to what many people believe, the healthcare system in this country is of a fairly high quality; it is at par with, if not better than, some of the other developed western nations. Residents have access to public and private medical care facilities all across the nation. While both sectors offer the same service, you are likely to see a huge difference in their cost and quality. Like in most other places, public healthcare is available at a much lower price; however, waiting lines can be long and the quality is inconsistent. On the other hand, private healthcare is far superior but comes at a premium. A majority of residents in the UK avoid undergoing treatment at private medical facilities, unless they have a private health insurance plan. A majority of the expats residing in this country rely on state-run healthcare for most of their medical needs. So how does public healthcare in the UK really work?

Introduction to the National Health Service

The National Health Service (NHS) is the provider of public healthcare all across Great Britain. Its network consists of state-run facilities, General Practitioners (GPs), specialists, dentists, pharmacists, optometrists and ambulance services. It has been recognized as one of the most robust and comprehensive medical care systems across the globe.

The NHS was launched in 1948; the main idea behind it was that medical services of good quality should be easily accessible by all the residents of the UK, regardless of their social status and income. The primary objective of this service was to provide medical care for no cost at the point of use to all the people living in the country, even the foreign nationals who have moved from other countries, as long as they are legal residents, pay taxes and make contributions towards the national health program.

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The number of individuals from across the UK who are covered under NHS currently stands at 64.6 million. According to statistics, the system handles an average of 1 million patients within a short span of 36 hours for a range of different services, which includes routine physical exams, antenatal tests, emergency care, treatment for chronic conditions, transplants, surgeries, and end-of-life care. The complete responsibility of medical care in Scotland, Northern Ireland and Wales has been devolved to the Scottish Government, the Northern Ireland Assembly and the Welsh Assembly respectively.

Not too long ago, in 2014, the National Health Service was declared the most impressive public healthcare system, in comparison to 10 other developed countries. The UK ranked higher than places such as Canada, the US, Australia, New Zealand, Germany, France, Norway, Switzerland, Sweden and the Netherlands. The main reason for its high rating was effectiveness, efficacy, safe care, coordinated care, patient centered care, and cost related issues of the NHS. In terms of quality too, the UK ranked quite high, coming in at second place.

NHS-provided healthcare services are further divided into 2 areas: primary care and secondary care.

Primary care can be described as the initial or first point of care for most users. You can visit a range of independent contractors, such as general practitioners, pharmacists, dentists and optometrists for this service. Almost all patients in the UK have to opt for primary care when they first decide to undergo any kind of treatment.

Secondary care, often referred to as acute healthcare, could be an elective or emergency service. Elective care can be described as a service that is planned, like specialist medical care or even an operation. Emergency care, as the name suggests, makes provisions for immediate medical attention and offers outpatient care for treating any illness, injury or chronic condition. You can opt for secondary care after being referred by a primary health professional, like your general practitioner or family doctor.

The Primary Care Trust or PCT is in charge of primary care in the UK. However, this entity also plays a key role in the commissioning of secondary care and for providing community care services. The trust is of key importance to the NHS and has control over 80% of the budget.

As an expat, it is possible for you to use the public health service for all your medical needs, but you should be aware of how the system functions. This is because you will have to meet certain criteria in order to be eligible for discounted or free treatment under the NHS. Read on to find out more about the system.

The NHS for outsiders

In order to be eligible for public healthcare and get subsidized or free treatments in the UK, you should belong to one of these categories:

– A person with the right of abode in Great Britain
– A legal resident of the country
– A student who has signed up for a course that is at least 6 months long
– A working professional on an entrepreneur or work permit
– A citizen of a foreign nation that has a reciprocal agreement with the UK

There is no specific qualifying period after which you will be eligible for free medical care. If you are entitled to it, you can use the service without any delay. Some expenses, like dental treatment, will have to be borne by you. However, you may be eligible for help from the NHS for these charges too. Any of the complementary treatment you receive from the NHS will have no impact on your immigrant status in this country.

Do bear in mind that not every type of medical service that is provided by the NHS will be free of charge. If you are eligible for public healthcare, you will not have to pay for medical consultations, hospital treatment, and ambulance services. However, you can get subsidized prices for your tests, prescriptions, glasses, and dental treatment. Under certain circumstances, you may also be exempt from paying for these services.

Every legal foreign resident is entitled to receive emergency treatment at any NHS medical facility for free, regardless of their nationality. However, depending on the situation, you may be asked to pay for in-patient treatment. As an expat, you can also make use of free NHS treatment for many other illnesses and conditions, depending on the duration of your stay and the purpose of residence. Fortunately, the official authorities in the UK have reciprocal agreements with a number of countries, which include the EU member nations, Australia and New Zealand. If you are a citizen of these places, you should be exempt from making several types of healthcare payments.

Fortunately, if you are eligible for free treatment under the NHS program, your dependents (civil partner or spouse and children under the age of 16) will also be entitled for receiving free medical services. However, this is only applicable for those who live in the UK with you (the main beneficiary) on a permanent basis.

While the services offered by the public healthcare sector are of a fairly good quality, you should prepare yourself for a long wait. This is because only a limited number of specialists across the UK accept NHS patients. You may find it very difficult to get an appointment with the doctor of your choice.

If you do not fall into one of the categories listed above and are not eligible for the NHS cover, you will have to bear the cost of your medical treatments on your own. Of course, even if you don’t qualify for public healthcare, you will not be refused treatment that helps stabilize a life-threatening condition. The medical staff will deal with the emergency. However, once the critical phase has passed, you may be asked to return home and complete the rest of your treatment. In a situation where there is no real emergency but your treatment has to begin without any further delay, the care givers may ask you to sign an “undertaking to pay”. Before agreeing to anything, it is essential to find out how much the treatment is likely to cost. As a patient, you do have the right to delay or even refuse treatment in the UK until you have raised the money, as long as there is no medical emergency.

How to get an NHS Number

In order to make use of the public healthcare system and undergo free consultation with a general practitioner or a dentist, you will need to be registered with the NHS and obtain your unique 10-digit code.

For this, you will have to set up an initial appointment with a general practitioner who accepts NHS patients. You can access the list of all NHS doctors in an area on the NHS website, and choose the one you plan to register with. During your visit, you will go through an interview and will be asked to fill out some paperwork. You will then be assigned an NHS number within a couple of weeks and will receive it by post once the process is complete. Alternately, your doctor should be able to give you the number when you next visit.

It is also possible for you to get your NHS number without registering with a general practitioner. Contact the NHS Local Area Team to find out your unique code. Depending on your situation, you may be asked to get in touch with the patient registration service in your area.

Funding of the NHS

When it was launched in 1948, the NHS had a budget of £ 437 million (around £9 billion in today’s value). In 2008-2009, it received over 10 times that amount, which came to more than £100 billion, with an average contribution of £1,980 per person. This is equal to an average spending rise of approximately 4% each year, taking inflation into account. However, investments of much higher amounts have been made in the last few years, in order to fund a more modernized medical program.

The main funding for the NHS comes from general taxation and the National Health Insurance contributions that are made by the public. Each year, small amounts come from patient charges. These include services like dental care, optical care and prescriptions. The decision of how much money will be given to the Department of Health from the parliament for spending on the NHS is made during the Spending Round process.

Though the NHS has never been completely funded by the public, the percentage it receives from the general taxation and National Insurance is presently at an all-time high. In 2001, there was an increase in National Insurance rates. This move was designed to boost NHS funding; it changed the balance between general taxation and National Insurance funding. Taxation still accounts for about 80% of all the NHS funding.

Sources: [1], [2]

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