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Friday, February 15, 2013
On Tuesday, the 22nd I went to the Soho NHS Walk-In Clinic of London and was able to experience the difference between the US healthcare and that of London first-hand. Since my arrival in London I have had this cold that I just could not kick. It seemed to be getting worse and I feared a sinus infection, so I eventually went to the Soho NHS Walk-in Medical Clinic. First, let me note that Soho is a fantastic part of the city; my favorite part thus far. I like to think of it as a combination of Times Square and the North End of Boston. The clinic I visited was at the end of this narrow side street by a little park called Soho Square.
The clinic was exactly how you would imagine a clinic to look. You walk into a large waiting room of sick people and a line, or “queue” as they call them here in the UK, along the back wall leading up to the reception desk. This clinic is for individuals that have not registered with a General Practitioner (GP) (a Primary Care Physician as we call them,) or are here for “holiday” that is less than 6 months. Before this clinic, I visited the clinic that I am supposed to go to just outside of the Regent’s College campus. I am supposed to register with a GP there and complete paperwork before-hand so I can make an appointment. I had not done this ahead of time so I was forced to go to this clinic in Soho.
All residents of England receive healthcare coverage from the National Health Service (NHS). This service is run by two divisions of Parliament, the Secretary of State for Health and the Department of Health. The NHS covers preventative services including physician visits, screenings, immunizations, vaccinations, and inpatient and outpatient care. It also covers inpatient and outpatient drugs, some dental care, some eye care, palliative care, rehabilitation, some long-term care and mental health care including most care for those with learning disabilities. Learning disabilities are not taken lightly here since the Equality Act of 2010. Even at Regent’s College the disability services are much more involved than at UNH. The paperwork for UNH’s disability services is quite invasive which is to be expected, but here at Regent’s there are just a couple papers that need to be filled out. Plus there are specialists on campus that hold tutoring sessions to help individuals with dyslexia for example. They are very accommodating.
Some things are not covered by the NHS. Outpatient prescription drugs cost 7.65 pounds which is what I ended up paying for the amoxicillin that the doctor ended up giving me. Dentistry costs 209 pounds per course of treatment. Individuals such as myself, who are not covered by the NHS obviously do not have these services available to them, however emergency services and some infectious disease treatments are free. Wealthier people can opt out of the NHS coverage and get private healthcare usually from their employers. Only about eleven percent of the UK opts out and is covered privately. This private insurance is not regulated by divisions of parliament like the NHS is.
Financially the system is more cost-effective than the US healthcare system. In 2010 England spent 9.6% of their GDP on healthcare while the US spent a whopping 15.2% in the year prior. Today the US spends closer to 18% of our GDP on healthcare. The English NHS receives 76% of their funding from general taxation, 18% from payroll taxes and some from copayments and privately insured patients.
From a patient’s point of view, not a tax payer’s point of view, I thought the system was great! You wait in a short line to speak to the receptionist who takes down your information and sets you up to speak with what they call a triage nurse. These nurses are there to speak with you to determine what the next step should be. I assume this is a type of gatekeeper to be sure that you indeed should speak with a doctor as to not waste the doctor’s time and tax payer’s money. After they decide the best course of action you wait in the waiting room for a short while and the doctor calls you in. From here no time is wasted. The doctor immediately asked me what my symptoms were. She determined right away that I had a bacterial infection in my sinuses. She then explained that she would give me an antibiotic, amoxicillin, to treat the infection. In America when I went in for a cough and the physician offered to give me an antibiotic which is ridiculous because the common cold is caused by a virus therefore an antibiotic would be completely useless. This is a perfect example of how doctors in America just want to give you a pill and send you on your way, even if it doesn’t help. This is not the case in England. Also, in England the doctor physically gives you the medication. You do not need to go to a pharmacy to pick it up which is nice. She also explained what medications and foods I should be cautious of when taking this antibiotic, (another thing American doctors are not very good at doing). She then gave me some home remedies of how to limit my coughing so I would get better. One time my doctor in America prescribed me steroids for a cough I’d had, and after taking them I still had the cough. She never mentioned anything that the English doctor had mentioned. Upon noticing how thorough and helpful she was I asked her if she and most of her colleagues treated their patients this way. She affirmed that many but not all doctors share the same idea that “patients are not like potatoes” they are all different and require attention. She told me that she would rather have someone else in the waiting room wait an extra five minutes than have me come back in a week still feeling lousy.
Visiting this clinic was one of the most interesting things I have done thus far. I learned a lot, not only about their healthcare but about the healthcare of the United States as well. If you would like to learn more about England’s National Health Service, this website is exceedingly helpful. Nothing compares to first-hand experience though!
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