The NHS

I have been very curious about the NHS since moving here, because I hope to practice within it and also due to my interest in natioanized care. The English people with whom I have discussed the NHS seem to either abhore it (one lady said she would rather starve than go without her private insursance) or think that it is "fine." No one has been too enthusiastic in a positive way. I have had my own frustrations, such as not being able to get either the swine flu nor the influenza vaccine for Aaron and Linnea, as they do not fall into the high risk groups.

Unfortunately, when Meade's parents arrived for their visit, Meade's dad, Don, was very sick ("unwell" as they say here). He intermittently has episodes of persistent nausea and vomiting, which at times require hospitalization to resolve, and this one was pretty severe. So, after a while, we decided he needed to be hospitalized and he and I went off to find a hospital that had an open A & E (ER). We ended up at the West Middlesex University Hospital and because his diagnosis was "hematemesis" or vomiting blood, we did not wait long. We went through the usual exhausting experience of telling the history to 18 different people (no difference from US system), he was evaluated by an awkward intern (to whom I was probably a very annoying patient advocate), and after only about seven hours or so, he was admitted (not bad I thought). He was in a six person room with a few men; one who Don describes as "the crazy guy," who would hide from the nurses in the linen closet and run around naked with a catheter (sounds like Harborview), a crochety old englishmen who constantly complained about the tea and wrote his son out of his will due to his inattentions, and a few other interesting characters.

Overall, the care was a little weird but probably average and definitely adequate. He survived the night and after some custard and tea in the morning headed home. And here is the one difference from the U.S. system- he walked out of there with no questions about his finances, where to send the bill, etc. We think that that was it. Completely free, even for a non-resident of England. Crazy.