Welcome to the online diary of the “London Ziegs,” as they journal their experiences relocating from the balmy climes of sunny Orlando, Florida to the more chaotically cosmopolitan environment of London, UK!

Monday, December 29, 2008

Special Investigative Report: NHS

I know that one of my friends in the States has a particular interest in anything our family can share about NHS, the UK's National Health System (yes mec, I'm talking to you!), especially as America seems strongly headed toward nationalized healthcare ourselves. Therefore, as a special investigative report, I cleverly engineered a chance to "go underground" and experience the full spectrum of NHS services. Gads, the efforts to which I will go to please my readers :-)

I won't go into the boring details of my specific malady, as there's nothing so tiresome as listening to someone else run on about their physical ailments; suffice to say that the greatest pain came at checkout when they ripped off the electrodes, taking with them a goodly portion of my chest hair -- yeooch!

Thinking Christmas night to be an ideal time to catch their responders unaware, we dialed 999 at 1am on Boxing Day, in the wee hours of Christmas Night. Impressively, an initial responder arrived within a few minutes, who began subjecting me to all manner of questions, pokings and proddings. After establishing that mine was no clever ruse, he radioed for an ambulance whilst we tried to force him to accept a cup of tea. His greatest laugh was when I tried to shove a handful of Amazon insurance papers at him; chuckling, he waved it all away, saying "You're in Britain now, mate -- there's no need for that lot!"

The ambulance driver and paramedic were a pair of women who repeated his questions, efficiently downselecting my symptoms into a coded category. Executing the associated protocol, they stuck me with an IV, popped me some pills, then bustled me into their flashing wagon. As the Maidenhead hospital is not equipped for nighttime emergencies, they whisked me off to the larger Wexham Park in northern Slough -- still in my checkered PJ's and slippers, thank you very much!

After being wheelchaired in, I was parked on a bed and subjected to the usual litany of doctors, stethoscopes, X-Rays, yada-yada-yada. You're all familiar with this part of the story, whether on the receiving end or accompanying a family member. So the question is, how is it different in the UK?

For my part, it went exceedingly well; I had no complaints at all, and was quite pleased with the quality and quantity of professional care and friendly service I received. All the doctors seemed highly competent, the nurses friendly and merry, the staff helpful and prompt. The physical layout and contents of a British ER was comfortingly identical to the US version -- it was pretty much all the same equipment from the same manufacturers, with all the same abbreviations glowing green on the readouts. For better or worse, given our many experiences with Jonathan, I felt instantly at home. As far as the medical care goes, there were no surprises or disappointments at all -- I could have been in a slightly more careworn version of Osceola Regional or Arnold Palmer as far as that went.

Not that there were no changes at all -- this was Slough, after all! Far and away, the most interesting part of the whole experience were the panoply of colorful characters who similarly decided to avail themselves of the emergency services on Christmas night. I was in ER or the neighboring observation ward for the better part of 14 hours, so given the high turnover such a wing sees overnight, I got to see quite a few fellow convalescents flow by, including...
  • an inebriated football fan of indeterminate nationality, escorted in by an exasperated woman constable, who declared, "He seems to be afraid his willy's going to fall off -- he hasn't let it go since we picked him up!"
  • the sweetly sad type of dementia, where an elderly lady needed to be reminded how she fell and hurt her arm, promptly forgetting the whole thing again every three minutes. "Oh dearie dear, dear me...I am hopeless, aren't I? Now...who are you, and what have you done to my bedroom?"
  • the freakishly disturbing type of dementia, in which an unseen female, possibly in her teens or possibly in her 70's, kept shrieking "keep them ON! keep them ON!"...every ten seconds...all night. The staff appeared not to even hear it, to the point I began wondering if I was the person hearing voices in my head!
And finally, the biggest change of all was the remarkable absence of paperwork. They asked my name and street, and that was it. I didn't yet have a home phone number, to which they just shrugged and said that didn't matter; they didn't bother taking down my mobile or work number. I didn't remember my NI (like US SSN), but that's okay 'cause they never asked for it. Although Amazon provides supplementary private insurance, they never asked for that either. Even at checkout, I didn't have to sign a single form. Basically, it was just "oh you don't feel well? 'ere, we'll take complete care of you, and when you're done, feel free to walk out with a friendly wave, and it doesn't really matter to us who you are or where you came from."

Between the paramedics, ambulance, tests, night in ER, and physician consultations, I can't see such a episode occurring in the US without the bill reaching $5k-15k, which would then be kicked around between various agencies and payers to squabble over line-items for the next 120 days, probably with a final deductible of a few hundred finally landing with the actual patient. It really felt weird walking out of the hospital without a signature, like some accountant was going to come barreling out and rugby-tackle me with a pen. At the end of the day, the only thing I paid for was the £15 taxi fare back home, and I don't even resent that because once the cabbie realized I was new to the area, he took me on a same-rate backroads route where he could point out all the interesting places I couldn't easily see by rail.

What did I take away from all this? Well, I'm sure to feel slightly less resentful when paying our UK taxes this year, as we've already gotten some clear value out of them. If this is be the dank hell into which Democrats plan to drag the US, I can't say as it seems so very terrible from the inside. We'll see what new observations repeat ventures warrant.

Oh, and hospital lunch on Boxing Day? Roast beef, mashed potatoes with gravy, peas, carrots, cauliflower, Yorkshire pudding, apple pie and cream, and piping hot tea!


  1. Thanks for giving us this glimpse into NHS--been very curious to hear about it. Love your blog. Happy New Year!

  2. Another expat noted that you can sometimes get better response from NHS on the phone if you adopt a fake British accent :-)