HEALTHCARE IN THE UK Healthcare in the United Kingdom is provided free at the point of delivery to all UK residents by the National Health Service (NHS) but also to some expats whose countries have reciprocal arrangements with the UK such as Australia, New Zealand and members of the EU. However, even those who are not able to benefit from these arrangements are entitled to free emergency treatment at all NHS hospitals within the Accident and Emergency Department, although they may then be liable for any charges for in-patient treatment. Expats coming to work in the UK may be able to access the NHS as following their registration for a National Insurance Number, which involves an interview and completion of the necessary paperwork, they may be assigned an NHS number. Once this has been received it is then possible to apply at a local General Practitioner (GP) Surgery to be attached to a Doctor who will look after their primary care needs including prescribing medicine. This is usually ok for the “worker” but may leave their spouse and family without provision. The expat worker within a larger organisation, especially in London, and particularly the larger law firms, accountants and banks, is also likely to be looked after by their employer with access to primary care either on site or at a local private GP practice. This is done to assist the employee with rapid access to a doctor as it can sometimes be difficult to get a timely appointment within the NHS. A patient requiring a specialist referral from their GP either to a Consultant or for investigations within the NHS, will have no control over who they will see, or the timing of their appointments, as these will be allocated by the hospital. This leads us on to the provision of private healthcare to assist those patients who are unable to access the NHS other than for emergency treatment. There are some GP’s who run their practices outside of the NHS and charge on either a subscription or per consultation basis. These can be researched either through expat networks or the fount of all knowledge “google” for recommendations. Most
expat families will have private medical cover as part of their package to compensate for not being able to access the NHS but it is unlikely that GP visits are covered. It is possible for a patient to refer themselves to a Consultant or Specialist without being referred by a GP, although a GP referral is normally a prerequisite to use medical insurance. The British Medical Association (BMA) also advises that in most cases it is best practice to ensure it is an appropriate referral. When seeking a GP referral to a specialist the desire is normally to see the “best of the best” for the patient’s condition. These days it is also necessary to consider the financial implications of the referral, as doctors and hospitals may have differing price lists and the cover on the policy may have capped limits or be restricted to certain hospital/clinics. The terms/restriction would normally be explained to the patient by the insurance company when they are contacted to authorise the referral, but it would be prudent of the patient to contact the Consultant who they have been recommended to and ascertain: • Consultation fees • Charges for routine investigations • Level of surgical fees if surgery likely to be involved and where they operate. This information is also of importance to those patients without medical insurance who will be paying for their own treatment. Consultant searches, biogs and feedback are now widely available through Consultants' own websites or other private healthcare portals. The patient might also need to consider if a Consultant is affiliated only to one hospital group or has the ability to refer for investigations across a wider network. Armed with information it should make the conversation with the insurers easier, and also ensure that there are no financial surprises once treatment is underway. For further information on the NHS please visit www.nhs.uk 24
