If you’re researching here for your London move, let me just say in advance that I’m not going to provide the answers here to whether to go public or private. Rather, I will first kindly direct you to previous posts about NHS such as:
I will next address the topic from the anecdotal expat perspective as well as the factors to consider as you make this decision for yourself. Inspiring this post is a question posed by one of our recent clients at last week’s London Relocation social event: should they keep their U.S. health insurance and obtain private insurance in the UK? The reason why I can’t answer this question is simply because it’s a matter of an individual’s financial ability to do so and frequency of medical attention. In an ideal scenario, I would say, “Yes, do both!” as it would ensure the utmost coverage both at home and abroad. What bursts that little bubble of idealism, however, is cost. Not everyone could afford to do this, nor would necessarily want to pay for it even if they could. If you have a medical condition that requires recurring doctor visits, I think what it really comes down to is which scenario is going to give you greatest peace of mind.
Expats moving to the UK may have an option through private insurance to elect “global” coverage. This comes at a steeper price, obviously, but would expand your medical peace of mind beyond the boundaries of the United Kingdom. My husband and I have private insurance through his UK employer, but we did not elect global coverage sheerly for the cost. This means, though, that we take our chances each time we visit home, which I do frequently enough to be nervous as to what would happen in an emergency. Sure, the U.S. hospitals/doctors will see me, but the upward potential of those costs without insurance is staggering. My backup is simply that I have doctor friends who could write me a prescription for an antibiotic if, say, my chronic sinusitis acts up and leads to infection. That’s something I’ve had enough experience with to self-diagnose, but I wouldn’t dare mess around with an unfamiliar illness or medication.
To tell the truth, however, even with private health insurance in the UK, neither my husband or I have really taken advantage of it in the last two years. Aside from dental care (which we have to pay out of pocket for in full, then mail a form in to later be reimbursed), we have only gone to NHS walk-in clinics when we’ve been sick. I know, shame on us…The hesitation, as it would be for any different city/town you move to whether domestically or internationally, is finding doctors we like and trust. We just haven’t put the legwork into it. Where NHS goes, though, on becoming a UK resident, you will be covered by NHS and assigned a specific GP (general physician) from the outset; you may select a different doctor if you prefer, as long he/she is located within the boundaries of where you pay your local taxes and that you notify NHS of the change.
Sure, I’ve heard the NHS horror stories among my expat friends…of inadequate examination and treatment, of long waits for appointments, of it being more reactive than proactive…of hospitals requiring you to bring your own towel and soap, of a severed finger put on ice for two days before it could be sewn back on, of going in with squeezing chest pain and being sent home with an aspirin (that last one was me). Yet I’ve also heard their horror stories of private practice…of misdiagnosed eye infections, of misdiagnosed cysts, of being refused a mammogram until the age of 40, and so forth. And I’ve also heard the success stories of friends who have given birth here in London (using private insurance) and one of my colleagues who has had successful surgery through the national healthcare and has used nothing but NHS in his decade living in London.
Bottom line: You’ll hear it all. Do I personally view healthcare standards as higher in the States vs. UK? Yes. Do I prefer to have private health insurance in the UK? Yes. But that’s just me. For every me you’ll find someone who’ll personally see it differently. So, you see, I can’t give you the answers; it’s not for anyone to tell you what to do, but for you to gauge your needs, your peace of mind, and to do your research to learn more about NHS, your employer’s private health insurance options, and others’ anecdotal perspectives of either prior to your London relocation.