Entering my local NHS doctor’s surgery it resembled a news report on the latest strain of bird flu. There was an air of ailing disarray. The waiting room packed with patients, children squealing, clinging to their parents. When registering I was handed a pile of reading material, mainly rules and regulations, an extensive list of circumstances under which I was not to attend the surgery as well as a detailed guide on (if it was absolutely necessary for me to set foot in the surgery) the various degrees of abuse and/or assault I was expected to not carry out on the attending staff. As I took a seat an irate patron demanding to see a doctor bashed at the thick glass panel (presumably bulletproof) between them and the rather jaded looking receptionist… welcome to the NHS.
The GP was a portly woman sat at her desk as I entered the room. “Hi”, I greeted her. “Have a seat please” she replied. “Alright?” she continued. I faltered a moment; “alright?” as in the greeting/inquiry employed by Londoners to assess whether someone is in good shape or humour? Or was this the first step of her diagnostic technique? Much the same thing, I supposed. “Alright,” I replied hesitantly. Seeming to have picked the right reply she smiled, “what can I do for you? I explained that I had recently developed an intolerable pain in my right hip. “Oh, so you can’t walk right innit?” She exclaimed. I confirmed that yes, yes it was… or is..or...? After a brief investigation it was established that I should visit a radiologist to have an x-ray to ascertain if there was any mechanical damage to the area, because as she explained “you is too young to have hip pain”. The whole process had consumed no more than three minutes and left me baffled as to what service, if any, I had just received. I took my referral and limped home to ponder how I felt about the experience.
As it turned out, I, perhaps based on a little prejudice towards a doctor who uses terms such as “alright” and “innit” decided to let further investigation in to the situation slide for a while. I would, I decided, see how I pulled up over the next week and then decide whether I would let a “radiologist” employed by the “NHS” point their ray-gun at me. Some time passed and I decided the pain was in fact tolerable enough, for the time being.
I am no stranger to the doctor’s surgery, nor am I for that matter unacquainted with the emergency room. My travels have seen me hospitalised from amoebic dysentery in Bangkok, Salmonella in Beijing, and disc prolapse in Kyoto, but I suppose something was different at those times. I was more or less unable to communicate with the doctors and nurses on any real level, some due to my waving consciousness and the others to language barriers. I had surrendered myself to these doctors in far away exotic lands previously and had walked away relatively unscathed… In fact, in at least two cases they had saved my life so, what was my problem with seeing a doctor in the UK!?
The matter has been one that has preoccupied me for some time now so I decided to put a little cursory research in (thanks Google). This combined with a few subsequent visits to the doctor (I seem to get sick in this country), as well as compiling anecdotal evidence from family and friends’ visits to the service I am starting to form a better understanding of how I really should feel about the services available here in the UK.
Recent data taken from a range of sources including The World Health Organisation and The World Bank published by Bloomberg in 20013 ranked the UK as 14th most efficient health-care provider in the world showing the population to have an average life expectancy of 80.8 years, the cost of this care as a percentage of GDP came to 9.4% and the total cost per capita in US dollars was $3609. This is actually not so bad an outcome when you start to compare this with outcomes in other western countries. Canada for example ranked 17th with an average life expectancy of 80.9 years but a greater spend from GDP at 10.8% and a total spend USD$5630 per capita, a significant rise in expenditure and a poorer total outcome. These figures are then trumped by the US who with a ranking of 46th and an average life expectancy of 78.6, spend a whopping 17.2% of GDP and a total per capita of USD$8608. The only former British colony that outranked the UK was Australia, coming in 7th with a life expectancy of 81.8, spending 8.9% of GDP and a total amount of USD$5939 per capita. As I am no expert on anything really, I wont begin to speculate on how or why one country is doing their job better than the other, but with a significantly lower total spend in the UK, it suggests that the money spent is going to the right places and is being used well when it gets there, at least in comparison to some other countries.
From my own more tangible experiences, I have found that the common complaints about the NHS have a basis, yes you do need to wait a long time to see a doctor by appointment, in my own experience as long as 3-4 weeks just to see a GP and depending on which hospital you choose to attend just as long to see a specialist, but these services are without extra cost to what you pay in your taxes. You can of course get a “walk in” appointment with your NHS GP quite easily and always have the choice to pay to see a private specialist. As with anywhere, money talks. Other common complaints include a lack of privacy and a poor bedside manner, but this I see as one of the side effects of having a socialized health service that attempts to bring care to a large population while not taxing the population at such high levels as for example in the Scandinavian systems. In addition to this and most likely to the surprise of most non-Britain’s there is a standardised cost of £7.85 for scripts issued by doctors, if you do not already qualify to get them for free. For a country where the tax-free threshold is for the majority of the population around £10000 and the average income is £26500 for 2014 it starts to seem like a pretty good effort and not a bad deal for the everyman.
As it stands I am yet to have a truly terrible experience within the NHS, in fact I am quite pleased. Sure the experience here is not quite as comfortable as that in Australia but lets face it, this is proving to be a great exercise in understanding how privileged I have been in my life and a fine lesson in how different countries and cultures choose to provide health-care.
My next move will take me back to China (ranked 37th) later this year, where I gear up to deal with a system that left me basically pooping myself on a camping chair in a crowded hall of a Beijing hospital for 15 hours. While I am ready to take on this challenge again it does make me wonder what it is like to be part of the system in the US, ranked another 9 places below, let alone the rest of the world with systems less efficient than that... In the mean time I will count myself lucky and remember that the NHS just ain’t that bad.
