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Healthcare in the UK
NHS: Coverage and Upcoming Reforms
The National Health Service (NHS) is the public healthcare provider in the UK. Established in 1948, it has been the cornerstone of healthcare in the UK ever since. The largely tax-funded NHS offers universal healthcare coverage to Britons, as well as legally resident foreigners and expats.
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Signing Up with the NHS
Signing up with the NHS is fairly easy. As a rule of thumb, you are entitled to free NHS services if you legally reside in the UK and usually live here. This includes, for instance, expats who have come to work in the UK and their direct family members; foreign residents who have been granted indefinite leave to remain; refugees and asylum seekers; international students enrolled in a course that lasts at least six months, etc.
If you are a newcomer to the UK, you will be issued a number the first time you sign up with your local GP. Your personal, unique ten-digit NHS number is mostly used for purposes of identification and documentation of your health records. Any treatments you have received, medication you have been prescribed, health tests you have had, and chronic health conditions and allergies you suffer from are contained in the health records.
Apart from this, your number does not have much of a purpose or significance – you don’t have to remember it by heart or be able to even give it to NHS staff in order to receive healthcare. You should nevertheless make sure to have your number stored safely in your documents, at the very least. In case you should ever forget your NHS number, you can call up the GP practice you are registered with.
Please keep in mind that you will also be issued a number if you are only visiting the UK for less than three months and are in urgent need of healthcare services. However, as you are not a resident, you might have to pay for some of the services you receive, for example, if you need to be hospitalized. Primary care from a GP is free if he or she decides to accept you as a temporary resident. If you have a travel health insurance from your home country or an international provider, you will probably be reimbursed for your NHS costs later on. Visitors from the EEA who have a valid European Health Insurance Card can get many services and treatments free of charge, as can nationals of countries that have a bilateral healthcare agreement with the UK. At the time of writing, those countries are as follows:
- Anguilla, Australia, Bosnia and Herzegovina, British Virgin Islands
- Falkland Islands, Gibraltar, Isle of Man, Jersey
- Macedonia, Montenegro, Montserrat, New Zealand
- St Helena, Serbia, Turks and Caicos Islands
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The Future of the NHS
In April of 2013, after years of hot debates and criticism from many sides, the controversial Health and Social Care Act, a healthcare reform of unprecedented magnitude, was put into place. The act mainly brings about changes in the infrastructure of the NHS. It puts the responsibility for funding into the hands of the newly formed clinical commissioning groups, partly staffed with GPs.
This reform caused great concern over a possible fragmentation and loss of coordination within the NHS, which might lead to a considerable drop in the quality of healthcare. Nowadays, it is not unthinkable to some that a GP might not offer a patient costly treatment so as to save money.
The act also introduces the possibility of the private healthcare sector being much more involved with the NHS and the services it provides. This could abolish the guarantee of healthcare provided by the NHS and potentially open up the public healthcare system to the competition of the free market. The fact that NHS England have estimated that, if no changes are made, there could be a 30 billion GBP cash shortage in NHS funds, only further highlights this possibility.
However, going into full detail would be beyond the scope of an article such as this. While some measures have already been put into place at the time of writing, others are still to follow. Still, in the short term, aside from a shortage of doctors and longer waiting times, the actual changes for patients seeking healthcare will probably not be all that noticeable. While there is consensus about the fact that this is the largest reform in the history of the NHS, many things will stay as they are for locals and expats alike.