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What a Brit Thinks of the NHS

My interest in social and cultural politics extends from my interest in genealogy and history and how they project into today's societies.

Air Ambulance in Essex, England

Air Ambulance in Essex, England

What Is the NHS?

The NHS is the National Health Service in the UK:

  • It’s free to all at the point of use (for all UK citizens).
  • It provides a full and comprehensive healthcare system.
  • It’s paid for by the Government from taxes.
  • The Doctors and Nurses are Government Employees.

The NHS Explained in Simple Terms

Culture Clash Between USA and UK

In spite of the politics and the bad press, the British people love their NHS because:

  • “It is free for all at the point of use”

So as a Brit I find it incomprehensible why Americans don’t want free health care, and instead prefer to pay for their expensive medical insurance.

I’ve discussed this at length with several American friends on social media. Each time they’ve vehemently supported the principle of paying expensive medical insurance; and rubbished the NHS.

When I ask the simple question:

  • “What happens to those who can’t afford medical insurance”

I never get an answer?

I confess I don’t understand American’s passion for their medical system, but then again it seems most American’s don’t understand the NHS. Albeit (as evident on YouTube) some American’s who have visited Britain and used the NHS do speak positively of it.

British People Appalled By USA Health Care

Free Health Care vs Medical Insurance

Bad Press and Propaganda

You only need to Google Search the NHS to find the web littered with bad press, which if you don’t understand the system gives the distinct impression that it’s a failed system. Whereas in fact it’s the reverse; because of its popularity it’s a victim of its own success.

As a Brit, I am passionate for and biased in favour of the NHS. That being said, I aim in this article to cut through some of the myths and propaganda objectively (rather than subjectively) and show the NHS for what it really is.

American Explains Difference Between UK and USA Health Care

The Origin and Politics of the NHS

The NHS was born in 1948, in the aftermath of the 2nd World War. Set up from scratch and fully operational in just six months; in spite of fierce opposition from the medical profession and the Conservative party. The Conservatives being politically akin to the Republican's.

In 1945, having won the war for Britain, it had been expected Churchill (leader of the right-wing capitalist Conservative party) would also win the General Election. However, to everyone’s surprise, the left-wing socialist Labour party were elected into power on a landslide victory; and during the course of the next five years pushed through major social reforms, including the birth of the NHS.

Since its formation, as the NHS is a Socialist ideology, there’s always been friction between consecutive Conservative Governments and the NHS.

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During the 1980s Maggie Thatcher (as leader of the Conservative Government) over a number of years tried hard to dismantle the NHS and introduce an American-style private health service. In the face of opposition from the medical profession and the public, she failed miserably.

In spite of the fact that ‘Free Public Health for All’ flies in the face of Capitalism, it’s a vote winner. So ever since Maggie Thatcher’s failed attempt to dismantle it, the Conservative slogan in General Elections has always been:

  • “The NHS is Safe in Our Hands”.

To pacify the public in General Elections, protecting the NHS is now part of the Conservative’s election manifesto, and government policy; and as such its funding is ‘ring fenced’ to guarantee its protection when a Government is looking to cut Public Expenditure.

However, whenever in power, a Conservative Government will always tinker around the peripherals of the system, trying to make it more in the image of ‘Capitalism’ rather than ‘Socialism’; which invariably causes friction and bad press.

Nevertheless, the NHS, now 70 years old and thriving, is as popular with the voting public as ever.

Below is a full-length documentary on the birth of the NHS, which from the start is engaging, albeit it’s not a short video so you may want to grab a coffee and make yourself comfortable before watching. Alternatively, just watching the first few minutes is enlightening.

The rest of this article highlights just some of the aspects of what is an all-encompassing, and therefore sophisticated health care system.

The NHS: A Difficult Beginning

Healthcare Options

Free healthcare is wide-ranging in the UK, with numerous options when needed; one of the most popular being the controversial A&E (Accident and Emergency).

If you feel you need medical help or advice, some of the main options (all free) include:

  • Making an appointment to see your local GP (Doctor).
  • Going to A&E (Accident and Emergency).
  • Use the NHS website (Your Choice).
  • Phone 111 if it’s not an emergency,
  • Phone 999 if it is an emergency.
  • Walk-in centres, and
  • Minor injury units.

How Public Healthcare Works in England

Seeing Your Doctor

Everyone should be registered with one of their local surgeries. A surgery being a team of local General Practitioners (GPs) aka doctors. Where I live there are at least three local surgeries to choose from when registering. If you don’t like the doctors in one surgery you can change your registration to another practice.

When you want to see your Doctor you can make an appointment either online or by phone; if it’s non-urgent you may have to wait a few days. On making an appointment you can insist on seeing a specific doctor (which might mean waiting longer for an appointment) or see any available doctor in the surgery.

A Day in the Life of a GP

Accident and Emergency

This is the most controversial part of the NHS. Most main hospitals have an A&E Department, which is partly a walk-in service and also where Ambulances bring patients.

The Ambulance service is quite straightforward; if you get taken to hospital in an Ambulance then you receive immediate attention.

The controversial aspect of A&E is that no one who walks in, regardless of how minor their complaint might be, will be turned away. Lots of people walk in with minor complaints when they could have gone to their doctor instead; which can clog up the system, especially at busy times.

Complexities and Controversial Use of A&E Explained

Using the NHS Website

The NHS administers a comprehensive self-help website, called NHS Choices (Your Choice). Alphabetically listed on their website is just about every known medical condition, complete with details of symptoms, remedies, and advice, including when you should consult your doctor.

On the website is also a large section on healthy living and what care and support the NHS offers, with a full list of all local services near where you live.

NHS Choices Website

Phoning for Help or Advice

If you just wish to speak to someone then phoning 111 will take you through to the 24-hour non-emergency call centre, staffed with fully trained nurses and doctors for specialist advice. The call centre will give you good sound advice and recommend whether you should see your doctor.

If during the conversation the nurse concludes you need emergency care they will automatically call an ambulance on your behalf; and invariably within minutes, an ambulance will be pulling up outside your house to rush you to the hospital.

Alternatively, if you think it’s an emergency you can just dial 999 and wait for the ambulance to arrive.

NHS 111 None-Emergency Phone Service

Full Insight

Unlike the USA, the NHS does not put profit before people, and neither is it funded by private insurance companies that cream off fat profits for shareholders and CEOs.

Consequently, as complex as it may appear, the NHS is far more cost-effective than America’s private health; while providing a fully comprehensive service that’s free for all at the point of use.

Detailed Overview of the Complexities of the System

© 2017 Arthur Russ

Your Comments

Arthur Russ (author) from England on March 20, 2017:

Thanks Jean, I know exactly what you mean; I’ve faced the same arrogance from Americans, over the past couple of years, when I’ve tried holding what should be sensible discussions on similar matters. Not just American’s on Hubpages but also others I’ve established contact with via email as part of my genealogy research.

Unfortunately they’ve all been middle class white Americans who vote Republican and think Trump is the best thing since sliced bread. I wouldn’t mind so much if they showed some curtesy and had respect for my views; but when they start criticising Britain and Europe for being sympathetic towards refugees, and then criticise Britain for its welfare state (including the NHS) it gets personal. Even more so when they dispute just about everything I say, as if they live here and know better than me what British Society and British Life is actually like.

It doesn’t help matters in when trying to hold a friendly social chat with an American Republican that I’m a Socialist with humanitarian views, an atheist, and consider myself ‘working class’ (albeit technically, as I’m a retired government employee, I am classified as lower middle class). On all these fronts I just get ridiculed by them; and then they can’t understand why British people are increasing losing respect for Americans.

I just wish I could meet a lot more Americans like you and Jo on HubPages and elsewhere .

Jean Bakula from New Jersey on March 19, 2017:

Thanks for an informative hub. I see you wrote on the forum I'm arguing and getting accused of being disingenuous because of the richest people in the US not even paying taxes hide their money in offshore accounts. They have 1% of the wealth in the country, while many people in the US live at poverty level. And now with Trump, he's putting more financial burden on the backs of poor and the disappearing middle class. There's no talking to these people. I believe we should try a system as you describe.

Arthur Russ (author) from England on February 14, 2017:

Thanks Jo, you’re the first American I’ve seen on HubPages to talk positively about the ACA (Affordable Health Care). It’s something which I know nothing about, but being a Socialist the idea naturally appeals to me.

I guess ACA is linked to Obamacare and is something Democrat supporters’ sees as being positive, while Republicans don’t? If so then in some ways it’s very much like the bitter battle between the Conservatives and Labour, when Labour launched the NHS back in 1948. Fortunately for Britain, Labour won the General Election in 1945 with a landslide victory; so although the Conservatives tried to argue that Britain couldn’t afford it, the Labour Government was able to prove them wrong.

I do empathise with your struggle, and I hope (with all the protests) that something can be salvaged.

Jo Miller from Tennessee on February 14, 2017:

Many of us prefer a system more like yours, but money controls. One of the things many of us are protesting about is saving the ACA, the system created during the Obama term.

Arthur Russ (author) from England on February 13, 2017:

Thanks Dora, yes you are right; the people who are best placed to make an informed decision on which system is better are those who experience both e.g. Brits living in America, and Americans living in Britain.

In that respect, before writing this article I spent ages viewing videos on YouTube specifically from Americans who’ve used the NHS and from Brits living in America. From those videos, although some had some criticisms of the NHS, more often than not both British and American people who had experienced both systems generally spoke highly of the NHS.

Dora Weithers from The Caribbean on February 13, 2017:

Arthur, individuals may want to experience both before they change their opinions. You're surely giving us some good British education. Thanks.

JON EWALL from usa on February 13, 2017:


Nope not a R or D an independant who understands right from wrong, believes in the US Constitution and laws of the land

Dem Party replaced by New Democrat Socialist Party Big LABOR UNIONS RADICALS & SOCIALIST Obama Clinton Soros

Candidate Clinton Obama 2/6/11 SHARED AGENDAS SOROS OBAMA


2/8/17 ANTI-TRUMP ACTIVISM google protest july 2012 Google sought to help insurgents overthrow Syrian President Assad

11/15/16 Big Labor Radicals & Socialist marching in cities in US D’s big story1020/16 What’s Wrong with Civics

You britts are well aware of George Soros Democrats running the show are financed by Soros

Trump '' the peoples president '' will work hard to make healthcare work fairly for all Americans

STAY TUNED have a great day!

Arthur Russ (author) from England on February 12, 2017:

Thanks Jon, I understand that you are a Republican, and don’t like the Democrats; so I guess because of your politics you would disapprove of a Socialised Healthcare, like the system in Britain.

Therefore, in your own words, what in your opinion do you think the answer is for America e.g. the status quo, or a single not for profit insurance company to cover most people’s healthcare, similar to the schemes in many countries; where their cost of healthcare is a lot cheaper than in America, but not as cheap as in Britain.

I would appreciate your own personal thoughts.

JON EWALL from usa on February 12, 2017:


The American people have been lied to for past 8 years not to say even before President Obama and 2009 2010 Democrat controlled Congress

2/27/10 HOW DID BARAK OBAMA CLOSE THE HEALTHCARE SUMMIT big story ACA … R's health plan rejected by BO DEMS No compromise fact 2016

Healthcare reform abortion … Healthcare Summit … Obama Health Reform … a FRAUD

2/10/17 Trump’s new health secretary already planning changes to Obamacare’’ doesn't crumble’’

11/21/13 How Obamacare Became LAW #1 big story Senate Leader Harry Reid cut a deal with Pelosi:’’ reconciliation

2007 2008 D’s control 2/3s gov 2009 2010 100%control 2011 2014 D’s 2/3s 2015 2016 D’s 2/3s with D Senate filibuster BO D’s RULE

*12/23/16 Thank You Mr. President video really big story Obama

1/19/17 Top 10 Ways Obama Violated the Constitution during His Presidency

Trump has only been in the whitehouse jan 20 feb 13 the attacks on our elected president by the Democrats is REVOLUTIONARY

Arthur Russ (author) from England on February 11, 2017:

Thanks Jon, from the information you provide it does strongly suggest that Obamacare isn’t the answer.

Given that the present American healthcare system is in desperate need of change (assuming you agree with Caleb’s comments above); what do you think the answer is?

Also, given who the current President of the USA is, what do you think the odds are of any changes to the American healthcare system in the near future, that’s going to benefit the people rather than corporations?

JON EWALL from usa on February 11, 2017:

Caleb H'

just a few links for your reading pleasure one can decide ??

12/29/14 ACA plan deductibles vary wildly. Challenging consumers big story k mc carthy

10/8/14 Nonprofit health insurance pioneer closes it’s doors due to Obamacare costs

GAO reports $619B missing from 302 federal programs For more than 22% of federal awards, the spending website literally doesn't

4/9/15 Health care coalition demands better data from Obamacare big story difference

9/9/16 Documenting citizenship an added hurdle to ACA big story

the US government is the largest healthcare provider medicare medicaid veterans administration just to name a few

the record speakes for itself !!

4/15/16 Insurers warn losses from Obamacare are unsustainable big story aca

10/28/14 For Some Obamacare patients, the doctor is not in big story

Contrary to goals, ER visits rise under Obamacare

8/27/15 How Doctor Obama keeps the premiums down

the law has neither improved care nor lowered costs.

Americans are waiting to see the changes !!

Arthur Russ (author) from England on February 11, 2017:

Thanks Caleb, a very informative and passionate reply. I think I understand the American system a little more now; and from what you are saying, although Obamacare isn’t the answer something radical needs to be done.

We were facing similar problems in Britain over 70 years ago; although we didn’t have health insurance, doctors were ‘Private’ so the poor couldn’t afford them. The healthcare of the poor (which was millions of people) was dependent on charities that helped to fund a small number of doctors and hospitals.

For things to change something radical had to done; it was at this time (in the 1945 General Election) that Labour came to power on a landslide victory. It gave Britain a Socialist Government who had the foresight and the ‘Will’ to do the impossible against all odds, and against fierce opposition from the doctors themselves and the Conservative opposition party (Winston Churchill).

Back in 1948, in just six months from making the announcement in Parliament, the Labour Government managed to persuade the medical profession (doctors and hospitals) to give up their private practices and become ‘public employees’ as part of the new National Health Service. On the 5th July 1948 the NHS took control of 480,000 hospital beds, 125,000 nurses and over 5,000 Consultants.

The whole of this is explained in great detail in the above video ‘The NHS, a Difficult Beginning’.

As regards your comment disputing the fact that ‘everything the NHS provides as free’; the key wording I use in this article; and which is used elsewhere is “The NHS is free, at the point of use”; in recognition that its paid for from the taxes. The whole point of the NHS philosophy is that everyone who’s working and earning enough to pay taxes contributes towards the cost of the NHS, so that everyone (including the poor, the elderly and the unemployed) are entitled to the same free healthcare at the point of use.

If back in 1948 the Conservatives had won the General Election (as was expected) we wouldn’t have the NHS today; and we would be in the same position as every other country, where health is paid for through insurance; which like in America, can chastise the poor.

Caleb H on February 11, 2017:

Thought I might throw in my two American cents about our system: It's an atrocious example of a market/capitalist system. It is, by far, the least free market of our industries. There is government regulation and red tape covering every inch, and the FDA (Food and Drug Administration) actually enforces some company's monopolies by not approving competition (Milan's EpiPen is a recent example). In addition, since everyone basically has to have insurance, high price tags rarely affect if someone gets a drug/treatment or not, so the providers will artificially raise the prices further to milk the insurance companies. This all drives costs way, way up and generally removes all of the benefits of a market economy while keeping the bad bits. A big reason that Obamacare has been such a disaster is that (to generalize a bunch) it was government interference trying to fix problems caused by government interference, without addressing the source of the problem.

tl;dr the American healthcare system is not actually a free market in the slightest, and is a terrible example to compare to a socialist economic model.

Also, one of the things I noticed is that you kept referring to everything the NHS provides as free.

Which is a lie.

It isn't. You just don't pay directly for what you use. (As you do point out) In the end, the bill still needs to be payed by taxpayers. The "It's all free!*" shtick used by advocates of a socialized system tends to get on my nerves. Especially because you didn't really address the economics of the NHS (which is the part I am more interested in personally), only its services.

(Well, that wound up being more long winded than I'd expected. I did like your article, I don't know much about the NHS myself and it was informative, even if missing in some details I'd like to see.)

Oh! And as to your question about what if people can't pay for health insurance: Right now, thanks to Obamacare, you get a few thousand dollars' worth of fines. Which is stupid. Normally, you'd just pay for healthcare out of pocket. Which is sometimes (oftentimes? I don't have statistics) cheaper than insurance anyway. Also, if you just can't afford care, hospitals will generally give it to you anyway. Especially if it's an emergency. The cost then gets passed on to the people who can pay.

Richard Haigh on February 11, 2017:

Very clear…thank you.

Arthur Russ (author) from England on February 11, 2017:

Thanks Jon, although not like the UK healthcare system, I would have thought that Obamacare would have at least been a step in the right direction. With reforms I’m sure it could have been made to be more like the single payer systems adopted by most industrialised countries across the world.

The NHS is unique in being the only truly socialised healthcare system in the world e.g. the NHS is funded from taxes rather than insurance.

It seems almost criminal that Trump is so intent on destroying Obamacare, without any attempt of reform. Especially when the existing USA healthcare system is by far the most expensive in the world (17% GNP, double the world average), which seems to me to be largely due to insurance companies CEOs and shareholders creaming off fat profits, at the expense of the people.

JON EWALL from usa on February 10, 2017:

Larry R

A recent debate regarding US healthcare and a single payer system 2/8/17 CNN Sanders, Cruz debate Obamacare big story ACA

the discussion is on Obamacare not th euk system

Larry Rankin from Oklahoma on February 10, 2017:

Great read!

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