I am thinking of moving to London from Canada for work, but am worried about the health care situation. Your NHS website drives me mad: I can’t find anything about eligibility for services, or how to enrol. As I understand it, if I am ‘ordinarily resident’ (again, no definition of the term anywhere) or have a UK-based employer, I am eligible. Correct me if I’m wrong.
Once one is enrolled, is everything free? Including drugs? (I will be starting Tamoxifen soon, so this is a concern.) What is the standard of care like? (Here in Canada, it’s great but sometimes you have to wait, e.g. getting a mammogram/ultrasound/MRI.) Is there any need to resort to private health care?
Dear MsDainty
Ordinarily resident means that you actually live in this country - have your main home/residence here. I am not aware that there is any minimum requirement as to how long you would need to have been ordinarily resident. If you are employed in the UK and paying tax + national insurance contributions here, then you are eligible for free NHS treatment / health care. The care on the NHS is usually of a good standard - the consultants are often the same whether you choose to go private or not… quite a few NHS consultants have jobs in the private sector as well. Private health care can be very costly - and with a bc dx you would be lucky to be able to find private health insurance, which would cover you for anything cancer related.
Re prescription drugs - if you are working then you would need to pay a contribution for your meds (apart from the ones received as NHS in-patient) - many pharmacies offer different rebates and you can buy discount vouchers, which could keep your yearly prescription fees below £100.
Practices should manage an application for registration from an overseas visitor who is in the area for a period of more than six months in the same way as any other applicant. The practice may accept the patient as an NHS patient but, if unwilling to do so, must give reasons which are not related to any form of discrimination. A practice may, of course, decline to accept the person as an NHS patient, inform them of their eligibility to NHS services and treat the patient privately. Dependents who accompany those who are working or are students in the UK for more than six months are entitled to NHS services based on the eligibility of the student/worker.
If you are working in London, and plan to stay for longer than six months, then you are eligible for registration with the NHS.
What is your current status? You say you are about to start Tamoxifen [which is one of the cheapest drugs, so is no problem for GPs to prescribe]; are you likely to need other intervention soon?
Thanks for the info, ladies. I haven’t been told I need any other therapy besides Tamoxifen (*cross fingers*). There is a possibility of radiation but that will be a short treatment. I had a mastectomy for the DCIS. I intend to get the implants swapped for the expanders before I move anywhere. So, the Tamox is likely the only thing that will be on-going in the future. Of course, I will need constant medical monitoring for the rest of my life.
So, is everyone here on this forum using NHS for their treatments? I just want to ensure the UK system is not like other countries, where public health care is to be avoided (as private care is vastly superior), or that there is public coverage only for certain treatments and not others.
The NHS in general can be hit and miss depending on where you live in the country with regard to standard of hospital, waiting lists etc. Everyone is registered with a GP and that is the first point of call for any medical consultation. The GP would then decide on referral.
In terms of bc, there is a protocol about how quickly people should be seen after presentation with a breast problem but, as some of the ladies on this forum will confirm, that has not always happened.
People can choose to be treated privately. Many people, like me, have private medical insurance provided by their employers. For me, it means that my treatment so far (chemo) has been in a private room in a private hospital. Again, when I have my surgery next month, I will be in my own room rather than a ward with other patients. In general, it means that for non-urgent medical problems, the wait to see a consultant is very much shorter.
Private medical insurance is significantly cheaper here than in North America because of the access for all to the NHS. Many employers offer private medical as part of a remuneration package. The rationale behind this is said to be that if an employee has a medical problem they can be treated more quickly and be back to work using private care. You can purchase it as an individual but it would be more expensive than under a group scheme. You may also find that pre-existing conditions will not be covered as Anneli said above
I have private med care as part of my employment package and I work in the hospital where I am treated so it works very well for me… convenience.
The NHS in my area gives the same standard of treatment but you may have to wait… like having chemo can be all day if things get held up… I f I need scans and things being private doesn’t mean I jump the queue it is on med/clinical need and I join in the NHS queue using the same machine as my private hospital doesn’t have all the facilites and differnet types of scanning/radiotherapy equipment.
Private med care for your bc would most likely not be covered unless you already have cover in Canada which was taken out before your dx. The private health here does not cover anything that you’ve had in the last 3-5 years. The NHS is great but can be patchy in some areas, although BC is one othe dx which seems to be very well regulated with protocols.
If you are fortunate to get private medical insurance as part of your remuneration package from your new employer, be aware that there is likely to be a “pre-existing conditions” exclusion, so breast cancer treatments may not be covered. It will however, be nice to be covered for any new problems!
“Ordinarily resident” is a tax term, rather than an NHS term, which is why you have had problems getting a definition. For practical purposes, if you are paying the usual UK income tax and national insurance contributions, rather than being treated as an overseas visitor, you will be treated as “Ordinarily Resident”.
Thanks everyone for your input. As Holeybones said, I suspected that once I disclose I had cancer, the insurance will either be too expensive or the insurer will decline coverage. That’s why it’s reassuring to know that there is a public system and it’s not too terrible. I shudder to think what would have happened to me if I were living in the United States right now.
My sister is here from Canada and availing herself of various NHS treatments. She left the UK returned in 2002 for “a change of scene”. She goes home in 2 weeks, for good. She’s had no issues about getting treatment but then, born here, she has always kept her UK passport current as well as her Canadian one so can flit about to her heart’s content!
I am being treated under the NHS I do have private cover as well but the treatment I have received under the NHS has been second to none. No expense has been spared. I’ve been treated amazingly. I have to say the treatment I have received under the NHS is better than any private treatment I have ever received. I have so much confidence in my consultant, oncologist, my GP, the breast care nurses etc. It is important however to still do your own research and speak to people etc etc to ensure you are getting the best treatment possible for your situation.
I want to say the same. I lived in London for 20 years and was always covered by medical insurance through employers. Any treatment for anything I had was always done privately. However, when I moved back to Scotland permanently in 2004 we decided medical insurance was too big an expense for us to take out on our own as we were trying to go self employed and as we had not claimed for 7 years we allowed it to lapse. Then I found out last year I had BC!
I have to say the treatment I have had on the NHS has been second to none, everyone I have dealt with has been a consummate professional and every stage has been explained in the fullest of terms. It has made me feel very safe despite the circumstances.
I shudder to think what would have happened to me if I were living in the United States right now.>> Absolutely! The NHS when it works is wonderful.
Yes, yes, three cheers for the NHS from me too. I think this is a treatment area that has been prioritised and they are doing so many things right. It is a real shame that this positive feeling for the NHS is not what hits the headlines.
x
Jo
I agree entirely on the good comments on the NHS. I do have private cover through my husband’s employment, and have used it for minor problems (eg bad back) but would never have considered it for BC. I cannot fault the treatment I have received so far -apart from long waits in the chemo suit every three weeks! But that does not affect the drugs etc I have received, it’s just an inconvenience… My original dx was very swiftly dealt with.