Adventures with the National Health System

It was inevitable. In 2011, none of us ever needed to visit the doctor, as none of ever got sick enough to warrant professional medical care. This time around, we weren't so lucky. As you know, Leah was sick over the weekend, running a fever and covered in some kind of rash. She didn't seem to get any better by Monday, and so we kept her home from school. The rash was worrying me, and I kept checking her tongue to make sure it didn't look like scarlet fever. Finally, I bit the bullet and started to look into how I could take her to a doctor.

St. Andrews has a local hospital, and I pass it every day on the way to Leah's nursery. It's small but always looks very busy, and there's a large pharmacy in front of the building as well. I had a look at the website, and it seemed that there were three general practices at the hospital, called Strathcairn, Feddinch, and Blackfriars. Very Hogwarts! Interestingly, the website implied that new patients register with one of the three practices based on the first letter of their last name. I'm not sure if that's been the practice for some time, or if, when one is registered, one can switch back and forth between the practices. It did seem odd, though of course no stranger than the way we do this in the U.S., where you choose a doctor based on the financial agreements of your insurance carrier. When I explained our particular situation (U.S. residents in the UK for six months, not permanently, affiliated with the university, with a toddler with a fever and a rash) she decided not to transfer me to one of the practices but to have me speak with a nurse at the hospital. She put the phone down, and a nurse was on the other line in about 10 seconds. I repeated all of Leah's symptoms, and she suggested that it was probably just a virus and that I could go to the chemist to have a wee look at her. This seemed like a curious idea, and so I sent David (who comes from a family full of medical doctors and pharmacists) to the Morrison's pharmacy with Leah.

They came back in about 45 minutes with two bottles of medicine and some fruit pouches from the grocery store. David said that when he arrived, the chemist had come around the counter to have a look at Leah and they registered her for the "NHS Minor Ailment Service." He had a pamphlet from the NIH that described this service, and it really sounds brilliant. It's a free service for children (anyone under 16, or 19 if you are still enrolled in school) and those over 60. It provides, through a pharmacist, advice and FREE treatment for a whole list of things, like cough, headache, nasal congestion, sore throat, hay fever, cold sores, indigestion, etc., but also things like acne and head lice. The literature states that it may be the case that the chemist will refer you to a general practitioner, but still...what a great idea this is! What a shame that we don't implement this in the United States! I'm imagining all of the ailments that could be treated by those Rite Aids and Walgreens that are on every street corner in America, rather than in more expensive facilities like the doctor's office, or sometimes even the emergency room. It would really reduce the burden on our medical system, and it would mean that those who can't afford a doctor's visit or an ER trip for a minor ailment could have it taken care of at no expense, before it turns into a larger problem.

Unfortunately, this wasn't the end of our story. Leah seemed better by the evening, and so I went off to my Italian class at the university. As the class let out, I saw a text had come in from Emma saying I should come home because Leah was asking for me. When I got there, she was crying and holding her ear. So, we bundled her up and headed back to the chemist. This time, they said it was probably an ear infection and they couldn't help us, and that we should call the doctor in the morning. Leah was really in a lot of pain, and it was hard to get her to sleep. We had been in this situation once before last summer, and it ended in a ruptured eardrum, so I knew what was coming. In the morning, sure enough, when she woke up, her ear was full of puss, and so we knew that her eardrum had ruptured overnight. So, I called the hospital again and explained this new development. They told me to come in.

To make a long story short, we spent the best part of the day going back and forth between desks at the hospital and our house, with passports, medical records, and copies of our lease, in an attempt to register Leah with a practice. The staff at the hospital were incredibly helpful, and kept apologizing that this was difficult. In actuality, it was not that hard, but it was complicated by the fact that Leah was sick and I was trying to get her in to see someone at the same time that I was registering. (Note to future Colgate study group directors: best to register with a doctor here BEFORE one is needed). Through the whole process, I noticed that the UK system is generally just a little more flexible, and a little less legalistic, than in the U.S. I have a good bit of experience dealing with doctors, hospitals and insurance companies, and it just seems a lot less complicated here. Of course, I was just trying to deal with an ear infection this time, and I know I can't really compare it to the process of having an infant undergo major surgery at a children's hospital...(plus, that is the subject of another blog!)...but overall it did seem just easier. In the U.S, the first thing one deals with when trying to access medical care here is an insurance company, and matters of billing and co-pays. Here, none of that exists. Once we were in the NHS system, we had no problem getting in to see a doctor that day. The doctor visit was free, the antibiotic was free, the lab work that the doctor ordered for Leah was free, etc. Now that we are registered, I'm sure that none of us will actually need to visit the doctor again, but I did learn something in the process. Plus, Leah seems to be on the mend and was back at nursery today!