Healthcare in the UK

Posted by: Justin on 14 July 2004

Folks,

I read and hear from prepubescent medical students in the US who are scared shitless of universal heathcare that countries that have such a system are in shambles. One person said that she had to wait years to have her tonsils removed.

I tend not to believe a word of it, given that you all seem a happy lot and, in any event, your enjoyment of healtcare seems every bit as technologically advanced and proficient as that in the US.

But I want the truth. For those who live in the UK (and Canada), what has been your experience?

By way of comparison (in case you don't know), in the US a typical course of treatment for chronic tonselitus would look something like this for a person with private insurance:

January 1: Call to make an appointment with primary care physician for sore throat. Because it is an accute condition with possible bacterial infection, appointment would be scheduled for same day or next day. Say 2:00pm next day.

January 2: Arrive at 2:00pm and wait for 45 minutes to be called back into examination room. Wait additional 15 minutes in exam room. Doctor comes in, looks at throat, ears, etc. declares tonselitus and infection. Prescribed antibiotics. Then looks in chart and notices this is 7th time in two years for the same complaint. Suggests tonselectomy and writes referal to see ENT.
On checkout patient presents his insurance card, pays "co-pay" (average about $25 for an office visit). Insurance company will be charged $90 for the visit. They will "write it down" to $67, subtract the $25 patient just paid as the "co-pay" and pay the doc $42.
The patient goes to the drug store (pharmacy), waits 20 minutes for the scrip to be filled and pays about $10 for the anti-biotics (because it is generic and/or common).
Patients calls ENT's office and schedules earliest consultation for 45 days out.

Feb. 17: Patient arrives at ENT's office at scheduled time and waits 45 minutes to be called back to exam room. ENT prescribes tonselectomy and schedules it three weeks out at the local outpatient surgery center. Patient pays $25 copay.

March 6: Have surgery. Outpatient surgery center bills private insurance $1400 for use of the surgical suite, nursing staff and recovery supplies. Insurance "writes it down" to $650. ENT bills seperately for the surgery and bills insurance company $900 for the procedure. Insurance company "writes it down" to $450. As is typical, the patient has an "80/20" plan with a $250 deductible. Hence, the insurance company pays (in total) ($650 + 450 - $250)x.80 = $680. The surgery center (or ENT) charges the patient the addition $250 "deductible" and the 20%.

After all is said and done, it took about 2 months (give or take) to have her tonsils removed and cost her about $470.

Walk me through how this might go in the UK.

judd
Posted on: 15 July 2004 by Tim Jones
quote:
Originally posted by bob mccluckie:
Tim said
'The British NHS has always been extremely good at very serious conditions and emergencies'

Sadly this myth is continually regurgitated by the British press. Have you seen our cancer survival rates compared to The US or Europe? We have a third world health service with third world funding.


I've only just spotted this. Bob - there are counter-examples in anything as big and complex as a health service. But the quality of NHS clinical care in emergency and very serious cases is not a myth - it is a fact.

In ten years of working in and around it, I don't think I've ever heard anyone say the NHS is the 'finest healthcare in the world' (and certainly not in the media). But I have heard the media endlessly spout that tired line about "third world" this and that. It's just a sad cliche. Have you ever been to a third world hospital? I have - and it doesn't bear any relationship to the NHS. As for 'third world funding' where do you get that from? It consumes massive amounts of money - probably getting on for £80bn a year by now.

Of course I don't know the detail of what happened to your daughter - just delighted that she's OK. But you shouldn't jump from what may have been a wrong clinical conclusion in a complex case to a blanket condemnation of the NHS as a whole.

On some interpretations our cancer suvival rates are in the process of improving dramatically - and part of the problem in this country isn't necessarily the treatment, it's the public health issues that lead to cancer in the first place.

Tim
Posted on: 15 July 2004 by Bruce Woodhouse
Be cautious comparing healthcare statistics between countries. Lots of comparing 'apples and pears' for a start.

Crude yearly survival rates for malignancy are especially confusing. An example. If you make earlier diagnoses because patients present or are detected earlier in your country they appear to live 'longer' but in a number of malignancies early diagnosis makes no great difference to survival so the patient just lives 'longer with the disease' and dies at the same time as if detected later.

Not making apologisies for some of the UK malignancy stats, just reminding people about lies, damn lies etc.

Bruce
Posted on: 16 July 2004 by JeremyD
quote:
Originally posted by Tim Jones:
But I have heard the media endlessly spout that tired line about "third world" this and that. It's just a sad cliche. Have you ever been to a third world hospital? I have - and it doesn't bear any relationship to the NHS.
The last NHS hospital I visited was the one where my father was having a hip joint replacement. The conditions were terrible, with filthy toilets and open urine bottles left beside beds for hours. As for the nurses, they seemed not to have come across the word "hygiene" and appeared to be more interested in chatting among themselves than in attending to patients' needs. More than once, my father was offered pain killers that he was allergic to, and only with reluctance did the nurses produce a tag to remind themselves not to offer him them again.

I've only been to one Third World hospital [India, 1986] but on that basis "Third World" would be an improvement, at least in terms of hygiene...
Posted on: 16 July 2004 by JeremyD
BTW, as I understand it,private hospitals here don't generally have the resources that NHS ones have. Apparently it's safer to have operations in NHS hospitals. The only advantage of private medicine is that you can get a quick diagnosis if you're prepared to pay - then by virtue of having a diagnosis you get to jump the NHS queue. This is what most people I know do.
Posted on: 16 July 2004 by John C
BTW, as I understand it,private hospitals here don't generally have the resources that NHS ones have. Apparently it's safer to have operations in NHS hospitals. The only advantage of private medicine is that you can get a quick diagnosis if you're prepared to pay - then by virtue of having a diagnosis you get to jump the NHS queue. This is what most people I know do.

Jeremy, if you don't know what you are talking about why post?


Tim, Bruce and Matthew are right.
Posted on: 16 July 2004 by Tim Jones
quote:
The last NHS hospital I visited was Leicester General, about two years ago, where my father was having a hip joint replacement. The conditions were terrible, with filthy toilets and open urine bottles left beside beds for hours. As for the nurses, they seemed not to have come across the word "hygiene" and appeared to be more interested in chatting among themselves than in attending to patients' needs. More than once, my father was offered pain killers that he was allergic to, and only with reluctance did the nurses produce a tag to remind themselves not to offer him them again.

I've only been to one Third World hospital [India, 1986] but on that basis "Third World" would be an improvement, at least in terms of hygiene...


We have had a problem with (a) 'hygiene' and (b) some aspects of nursing. One of the last thing I did before I left the Department was try to get people to do something about hygiene and infection control policy, which frankly were a joke. They are getting there - albeit very slowly.

There's more to healthcare than hygiene though, and in terms of clinical quality and clinical outcome, anyone who thinks the NHS is 'Third World' is frankly weak-minded enough to swallow a right wing press lie.

Tim
Posted on: 17 July 2004 by Derek Wright
Tim

THe UK two years ago had the lowest number of MRI type scanners per head of population than comparable and lesser countries in the EU

Derek

<< >>
Posted on: 17 July 2004 by John Channing
BTW, as I understand it,private hospitals here don't generally have the resources that NHS ones have. Apparently it's safer to have operations in NHS hospitals.

Most don't have intensive care units (ICU) so you are safer in the NHS for major operations. For minor operations, the 3 star hotel service you get on a private ward is clearly preferable.
John
Posted on: 17 July 2004 by Berlin Fritz
Privately financed initiatives provide all new funding for NHS etc, in UK, how these monies are spread out is another thing ! UK Gov is now in more debt than ever in its history, just well disguised, private patients within the NHS as before will be to its advantage in many ways, paradoxically enopugh, ask a Doctor (not a manager or adminstrator of targets) a fully trained (experienced Doctor or Comsultant if you can find one ?

Fritz Von Hardmedicinetoswallow Eek
Posted on: 17 July 2004 by Berlin Fritz
quote:
Originally posted by Berlin Fritz:
Privately financed initiatives provide all new funding for NHS etc, in UK, how these monies are spread out is another thing ! UK Gov is now in more debt than ever in its history, just well disguised, private patients within the NHS as before will be to its advantage in many ways, paradoxically enopugh, ask a Doctor (not a manager or adminstrator of targets) a fully trained (experienced Doctor or Comsultant if you can find one ?

Fritz Von Hardmedicinetoswallow Eek


An imaculately sterile enviromment is paramount for producing chips a'la silicon, also I would suspect Naim's own labs etc, are similar to a lesser degree ? I'm afraid my thoughts regarding Hygiene² within medicine (layman) are excatly the same, what's the point of even starting expensive, extensive life saving brilliant operations, etc, etc, if they are put immediately at illogical, stupid, MAD, risk (financial & Human) by mindless petty amateurism, and blind apathy.

Fritz Von Itbeggersbelief²

P.S. There's a rat in the kitchen what I'm a gonna do ?
Posted on: 17 July 2004 by Kevin-W
Justin

To answer what I think is your original question: I fortunately have had little experience of the NHS because I'm reasonably healthy.

I had to have emergency treatment in the 1980s after a serious assault and I thought the NHS was wonderful. That's the limit of my personal experience.

But i will say this: on this issue compared to us (despite crumbling infrastructure, waste and all manner of managerial crises), you Americans are living in the stone age. Surely free health care at the point of treatment is a fundamental human right, a mark of a decent, civilised society? I have never understood why so many Americans (especially on the right) seem so opposed to universal free health care.

One of the few things we can be proud of in Britain is the NHS. For all its faults, it is almost universally held in affection (and has been copied in many parts of the world), and is probably our greatest post-war acheivement. And, as Matthew said in another post, it is probably the most important institution in this country, along with the BBC.

What greater tribute can there be to those who died fighting in the war than the establishment of free universal health care? And I wonder when the world's most powerful nation will move into the 20th century (let alone the 21st) on this important matter?

This is why attempts by the likes of Thatch, Blair and other rightist ideologues to do away with the NHS either by the front or back doors will (and must) be resisted.

Kevin (Gil Scott Heron: Spirits)
Posted on: 17 July 2004 by andy c
Hi,
Read this thread with interest re the comparison re the US and us. Also noted several comments re keeping the NHS and I totally support that. It makes me smile that people bash the health system, until I see the sterling work the A & E Dept's do (regularly) with crash victims - and the subsequent follow up work such people require.

Its also usual in this instance to quote the one where then person was well badly done to - at the expense of countless others who have been properly and correctly treated.

In answer to the original thread - went to the do'cs with a knee ache - referred me to the local hospital - two weeks later x-ray then one month after that gets to see the consultant who reccomends surgery. Two months after that day case for arthuroscopy (not sure if this is the correct spelling). so 3 1/2 months from start to finish for what for me was not an urgent job.

regards,

andy c!
Posted on: 17 July 2004 by matthewr
"And, as Matthew said in another post, it is probably the most important institution in this country, along with the BBC"

Actually to give credit where credit is due it was John C who originally said (to me) that Post Imperial Britain is defined by the NHS and the BBC and it's the only two things we ever got right.

"Gil Scott Heron: Spirits"

Did you watch the re-run of Don Letts excellent documentary on him last night? Marvellous stuff.

And was it just me or is he beginning to look rather bizarrely like Arsene Wenger?

Matthew
Posted on: 17 July 2004 by cunningplan
Mrs CP, who is a GP in the NHS, spent a few days visiting a prestigious American teaching general practice unit in 1998.

She was pretty disappointed with things there overall. There were lots of "professors" supposedly teaching even more junior doctors - what this meant was that the juniors saw the patients and then discussed them with the professors, and agreed a treatment plan. It was very medically orientated - lots of investigations, not much consideration for the psycho-social aspect of the patients's problems (often the most important bit in determining recovery) and over-use of antibiotics and generally more expensive drugs.

There was literally no audit of their results, except a printout at the end of the year, telling them how much work they had done, from the insurance company. No consideration of whether the work was appropriate, or the standards were high. They didn't even know how many diabetic patients they had, never mind the percentage that had normal blood results, screening for eyes disease, and all the other things that Mrs CP has at the tip of her tongue and can bore one continually with.....

There was also no continuity of care, so no-one knew how the patient had coped with their previous problems, or what their feelings and expectations were. She sat in with one of the professors for an afternoon, and felt that his communication skills were less adequate than the GP registrars that she teaches over here - he didn't look at the patient, use understandable language or show empathy with their problems. Eg; professor explains results to patient, then leaves room to take phone call. Patient asks Mrs CP "So, doc, do I have heart disease or not".

The NHS has a difficult job to do, but mostly it does it well; not always quickly, but the vast majority of the time, the delays relate to less serious or distressing conditions, and if we want free health-care, there has to be a compromise somewhere.

Regards,

Clive (and Mrs CP)
Posted on: 17 July 2004 by Berlin Fritz
Having been born into the NHS, and subsequently having enjoyed German medical
care since 1981, I can compare the two, as well as when I return to UK on
occassion. A large percentage of our income here goes towards medical insurance
(national) which secures also when unemployed etc, the same quality of care. Mr
Parry will agree with me on this one (I expect ?) that British Military prisons,
along with RSM's offices are probably the most sterile places on earth,
strangely enough BMH's are not. In UK, many hospitals, clinics, etc, do not fall
into a catogary compelling them to reach required hygiene & safety standards
that other institutions do.
Seagull will no doubt be aware that Gosports famous RN Hospital, Haslar, since being open to public patients as well, and like the
afore-mentioned set ups recieving large amounts of public dosh from the health
budget, must also improve thier act. Anecdotal sayings of the past about a being
a good hospital etc etc, are in today's world not relevent, pudding must be
proven to be good by the eating and opinions of experienced neutral proffessionals must be allowed to prevail and acted upon without too much Government interference.
My ex was for many years a nurse here in Berlin as
well as Düsseldorf, once having turned down a position at Berlin's BMH (turned
down not refused) after telling the senior matron she could not work in such
filth and disorder, she was not one to mince her words, and if her comments had
been libeless etc, strangely enough no follow up was ever made, she put them in
writing too, though it didn't exactly help my own career along at the time. I
think the bottom line is a change in mind-set UK has become spoilt, and know's
not where it is going in this direction, I personally prioritise the hundreds of
senior citizens that are dying unnessessarily early through daft closure of
homes, and inhuman overnight movement, creating fear and new illness, all
burdens on the health service that can so easily be prevented, ie, save money.
Prevention rather than cure, put yer rubbish in a bin, or is it infringing on
your freedom to be fined for littering ? (the concept is the same).

Fritz Von Twaddle.

P.S. I'm sure the average Israeli cares no more about the 40 million poor Americans without medical insurance than they do about them, and I would put it also to the British powers that be that if they're not very careful the essence of the NHS could very well soon become just a maze of low quality choices³ depending where one lives naturally, a point that has seemingly escaped most of us until now ?

P.P.S. Will Bobby Fisher apply for Croatian/Serbian Nationality ? Big Grin
Posted on: 17 July 2004 by Bob McC
BerlinFritz said
'the NHS could very well soon become just a maze of low quality choices'

Pray tell me what these 'choices' would consist of?

Bob
Posted on: 17 July 2004 by ejl
quote:
What greater tribute can there be to those who died fighting in the war than the establishment of free universal health care? And I wonder when the world's most powerful nation will move into the 20th century (let alone the 21st) on this important matter?


Unfortunately Kevin, basic principles of social cohesion, such as helping others with medical problems even if they are poor, has always been in tension with the old American fantasy of the self-made individualist, solely reponsible for his own success. Many people in this country sincerely believe that they ought not to have to help others with their medical bills on the grounds that, since they made it without help (they think), others can too.

A current case in point is Mississippi, which under a new Republican Governor has initiated the deepest cuts in history in Medicaid. Medicaid is the state and federally funded care for the very poor -- the "last ditch" saftey net. Rather than raise Mississippi's cigarette tax (one of the lowest in the nation), the Governor gutted Medicaid by reducing the income eligiblility cut-off to under $800/month. This means that if for exmample you make $800 month, you must pay for your own health care, including prescription drugs -- an obviously insane proposition. 65,000 people, mostly elderly poor, are affected, and it is certain that many will die soon as a result of this change. Links

In a bit of Stalinesque cynicism, the Mississippi Governor's office tells those impacted to ask the prescription drug companies to give them their medicine for free.

To my mind, this is little different from selective genocide by omission, aimed at killing the poor.

I think we can all agree that even a lengthy NHS cue is vastly better than nothing, which is what a lot of Mississppians now have.

Eric
Posted on: 17 July 2004 by Berlin Fritz
quote:
Originally posted by bob mccluckie:
BerlinFritz said
'the NHS could very well soon become just a maze of low quality choices'

Pray tell me what these 'choices' would consist of?

Bob


Delta Blues makes some excellent points there, and choices can be whatever you wish them to be ? use your imagination. This picture kind of defines the fine wastage of precious NHS recources as I see it.


Fritz Von Carryonnursing:

P.s: Here in Europe (West) it's basically normal for a woman to stay in hospital for 5-7 days after giving birth for general well being and unforeseen problems as well as giving her confidence etc, etc. In UK my sister recently was privelaged to enjoy just under 24 hours at London's King Georges, maybe she'll have the choice in future to stay longer, or maybe not have the feeling that she couldn't get out of there quick enough, and that she was a burden on the staff.
My mother, and both sisters have worked previously in UK as nurses in various branches, so I take their word for it.
Posted on: 17 July 2004 by matthewr
Eric said "basic principles of social cohesion, such as helping others with medical problems even if they are poor, has always been in tension with the old American fantasy of the self-made individualist"

I have conversed online with Americans who seem, genuinely, to be able to both marvel at how wonderful it is that I get free insulin without insurance and then bristle at the notion that America should have free universal healthcare. My favourite comment was "that sounds like Socialism and all it will get you is shitty hosipitals like they have in Spain".

It is a peculiuar thing as they seem really pleased on my behalf and yet, oddly, slightly insulted if you suggest they might enjoy the same.

Matthew
Posted on: 17 July 2004 by Berlin Fritz
This may be of interest to some ? (Basic Health Insurance Breakdown)

An Average Wage Packet (single person) Berlin 2003: 38.5 Hour Week:

Gross Pay € 1396,00
Income Tax € 118,16 -
Health Insurance € 108,19 - (Rest paid by Employer)
State Pension € 136,11 - ( As Above)
Dole Insurance € 45,37 - ( As Above)
OAP Care Insurance € 11,87 -
Church Tax € 00,00 (Optional when in work)
Solidarity Tax € 6,49 - (Still covering unification costs)

Net Take Home = € 969,81

The immediate Dole / Unemployment money calcultated on above worker.
2003 = 60% of last wages: ie.

Weekly Total = € 320,00 or € 19,18 per day. (net) Broken down as follows:

Income Tax (yes !) € 25,97
Solidarity Tax € 1,41
Church Tax (auto) € 2,08
Health Insurance € 22,40
OAP Care Insurance € 2,72
State Pension € 31,20
Dole Insurance € 10,40 (even when on dole)

Based on a legal financial performance of € 223,82

So the recipient recieves monthly € 575,40 (30 day month) cash.

So basically the state pays out in the region of € 18,000 a year total, and
on the same money whils't working the employer pays the difference depending
on it's síze & type etc, as I imagine is the case in UK & elsewhere ?

On each quarterly visit to Doctor / Dentist (as of 01.01.04.) one has to pay
a practice fee of € 10,00 if still being treated for the same ailment and sent
to a specialist from ones own GP a cover note excempts further fees of this
kind. Also as of (01.01.04.) all persons who previously recieved free
prescriptions via their insurance company now have to pay a percentage at the
chemists (about 10% I think). Seriously poor folk (on the Social, rather than
the dole as they are presently different) (come together as of 01.01.05)still
get it free, plus specs etc, via fair means testing.
There are a ridiculously
large amount of private health insurance companys at present (some 80 I believe)
but one main State one "AOK" which is also the most expensive covers vitually
85% of the population, the others are job, income related, but back up the main
system through high paying extras, etc (like BUPA or HSA in UK).



Fritz Von Notalotovpeopleknowthis ! Wink
Posted on: 17 July 2004 by throbnorth
Well, Matthew - quite..... universal being the operative word rather than free, [which of course it isn't as a glance at anyone's payslip shows]. As you might imagine, I've had some interesting transatlantic conversations as well, in my case about respective levels of HIV/AIDS care. Late Partner had haemaglobulin replacement therapy [£200 per bottle x 32] a couple of times, [I only found out when a nurse dropped some and looked worried]]. I can't even begin to imagine what the cost of his total care from diagnosis in 1984 until the inevitable sad conclusion was. Chronic and acute care does seem to be where the NHS shines, and if anyone doubts this just ring NHS Direct and mention a couple of things about tightening in the chest and irregular heartbeat, and see what happens.

throb
Posted on: 17 July 2004 by JeremyD
quote:
Originally posted by John C:
Jeremy, if you don't know what you are talking about why post?
Mr. C. You are obviously not aware of the fact that what you said is neither a polite nor a constructive way of expressing your opinion. If you have a serious criticism of what I said then you are welcome to express it politely. Otherwise, I suggest you keep your opinions to yourself.
Posted on: 17 July 2004 by Justin
quote:
Originally posted by cunningplan:
Mrs CP, who is a GP in the NHS, spent a few days visiting a prestigious American teaching general practice unit in 1998.

She was pretty disappointed with things there overall. There were lots of "professors" supposedly teaching even more junior doctors - what this meant was that the juniors saw the patients and then discussed them with the professors, and agreed a treatment plan. It was very medically orientated - lots of investigations, not much consideration for the psycho-social aspect of the patients's problems (often the most important bit in determining recovery) and over-use of antibiotics and generally more expensive drugs.

There was literally no audit of their results, except a printout at the end of the year, telling them how much work they had done, from the insurance company. No consideration of whether the work was appropriate, or the standards were high. They didn't even know how many diabetic patients they had, never mind the percentage that had normal blood results, screening for eyes disease, and all the other things that Mrs CP has at the tip of her tongue and can bore one continually with.....

There was also no continuity of care, so no-one knew how the patient had coped with their previous problems, or what their feelings and expectations were. She sat in with one of the professors for an afternoon, and felt that his communication skills were less adequate than the GP registrars that she teaches over here - he didn't look at the patient, use understandable language or show empathy with their problems. Eg; professor explains results to patient, then leaves room to take phone call. Patient asks Mrs CP "So, doc, do I have heart disease or not".

The NHS has a difficult job to do, but mostly it does it well; not always quickly, but the vast majority of the time, the delays relate to less serious or distressing conditions, and if we want free health-care, there has to be a compromise somewhere.

Regards,

Clive (and Mrs CP)


What you are describing is the typical "teaching" hospital in the US - a so-called "accademic" facility normally associated with universities and medical schools. They are, moreover, taughted at the best America has to offer in terms of technical medical care. Hospitals like Mass General, Johns Hopkins and the UCLA medical center fall into these catagories.

The complaints voiced my Mrs. CP are indicative of the debate we have been having about medical education (and the medical treatment incident to it) for decades. There's little doubt that the system works fairly well in the training of young physicians in the science of medicine. But there is also a feeling that the patients are treated merely as "vehicles" for this training. The argument that the US system pays insuffient heed to socio-economic aspects of its patients is an old one. The reality of it all is simply this: The real problem in medicine is poverty.

That said, there's little doubt that these teaching hospitals are the very best places to be treated for life-threatening illnesses in US. Two reasons for this: First, this is where all the cutting edge medicine in the US takes place because these are where the academic-type physician practice and do research. Mass General, for instance, receives something like $600 million a year in NIH research money. The situation is similar for all the top hospitals. The second reason is that in a teaching hospital the care and diagnosis is more likely to delve into the minutia in order to serve the pedegogical purpose. This means you get seen by interns, resdidents, attendings, etc. etc., repeated over and over again.

It's a double edged sword (as you well know) because while you get a thourough going over, there is little in the way of continuity of care in these types of places, and the patients is treated as a lab dummy rather than a person.

finally, in the US, like everywhere, we have our share of good doctors and bad.

judd
Posted on: 18 July 2004 by John C
Jeremy it is true I was impolite, sorry. However you made an ill-informed blanket assertion with no accompanying evidence about private vs NHS diagnosis. It is exactly this sort of ignorance of the facts that makes the NHS debate so frustrating. I assume what you mean is it sometimes takes longer to get tests done on NHS. This is true to some extent and would possibly delay diagnosis in a few conditions. Similarly if you had a skin rash and were able to see a dermatologist privately rather than wait on NHS when the rash would have disappered anyway, you might get faster diagnosis. In almost everything that counts the NHS delvers timely accurate diagnosis.

Every healthcare system in the world faces the same problems as the NHS. Aging population, accelerating cost of medicines/diagnostics etc. The simple fact is we have a system which for 50 years has delivered world class health care and universal coverage. I have worked in major teaching hospitals in the US and London and while resources are far less in the UK standard of care is equal and often better. Now if you compare an inner city VA hospital with a DGH in an British city with similar levels of poverty, the standard of care in the UK is light years ahead.
Posted on: 18 July 2004 by Berlin Fritz
As an afterthought for general information regarding UK & Europe medical cover.
I suspect we all know about the famous E111 form (for those who don't it's an
agreement between member states usually for holidays to prove you're insured in
your own country of residence). These forms have in the past been missused and
abused by mainly building workers´in member
states, but generally they work like
this. I go on holiday within Europe & some other specific countries (UK inc), my
insurance company sends me the form (which is printed in the relevent language
(luvvy jubbly) so far !
Even though I am British, when I now visit UK I need
said form, which I must then change into a cover note at a local SS office, then
visit Doc or Hospital, in practice it can be very problematic, and in the past
I've actually had to pay cash first, then try to recover it later (nightmare).
The original pricinpal of the NHS is excellent but it naturally was never free,
no more than emergency services, schooling, etc, etc, are, but it's a nice dream
shattered on most British peoples 16th birthday upon recieving their National
Insurance Cards, which guides their dosh for the rest of their lives, innit.

Fritz Von Keeponrockininafreeworld

P.S. Mathew, it's naturally excellent that you get yer insulin for nowt, I hope
that applies to all in UK though irresspective of their means ? including many
other daily required drugs naturally such as Beta-Blockers etc, etc.

P.P.S. It's a nasty old political trick when discussing the NHS or Military matters to immediately tar those positively critising with the brush of being anti patriotic, anti soldiers & doctors, they are merely the brilliant tools we need to make these services possible, and are always there, irrespective of what wankers are suppossedly democratically seated at numer 10 ( or Penn Ave for that matter too) Big Grin

Obviously in the real world of business where CEO's get jailed and the shares go up 37% overnight as a sign of support, internal regulation and natural selection can also apply (without managers etc)to waste precious recources (Public I may add)