Intended for healthcare professionals


The NHS through American eyes

BMJ 2000; 321 doi: (Published 23 December 2000) Cite this as: BMJ 2000;321:1545

A different perspective

I too am an American with an 'inside' view to the NHS. Unfortunately
part of my view is built upon my experience as a patient while the other
part is formed from my employment by a NHS Healthcare Trust over the last
three years.
First, from the perspective of a patient, apologies but the standard of
care in NHS is appalling. I have a congenital kidney disorder that reared
its ugly head last year for the first time in 12 years. This is not the
place to provide explicit detail I will only say I have never experienced
a lower quality of care, with inefficiency the rule, and unprofessional
practice the norm. In addition the conditions of the hospital were
filthy, rundown, ill equipped, and 'unclinical'. I am afraid to have to
depend on the NHS should I incur further problems. So I am a member of a
private scheme because one must be in order to ensure medical provision is
Yes the mission of the NHS is admirable but it is not functional. It
proposes to be free healthcare for all. But it is not free. The bulk of
moneys being drawn from NIS contributions. This means that my husband and
I pay just under £400 a month for healthcare, this includes £50 a month
for the private scheme. Contrast this to the US where as a public sector
employee I never paid more than $50 a month for a MUCH higher standard of
care, in which the latest technology was available to my doctors who were
specialists. I am sure that I could purchase health insurance in the US
for the equivalent of £400 a month that would be of this higher level of
care in much better facilities.

As an employee of the NHS there is the constant problem of
underfunding, short staffing, lack of support, shortages of equipment,
etc. I have beeen stunned by the task before me as I go out to train in
primary care as well as in the hospitals. The great majority of GP's I
have met are not people I would trust with my health.

I do think the mission of the NHS is admirable but it is not
achieved, perhaps unachievable. I do not think the NHS is a model the US
should be looking to. I say that as a patient and as an employee.

Competing interests: No competing interests

22 December 2000
Karen Lee
Training Coordinator
Trafford SMS