- 89,355
- Rule 12
- GTP_Famine
Okay, I shall attempt to lay out the UK's healthcare structure...
General Practitioner (GP)
It isn't required to be registered with a GP but you'll find that, even if you aren't registered, you'll be entitled to treatment with your local GP's practice (they'll "ask" you to register when you ship up ill). There is no "choice" with GPs - you may only register at a practice that covers your postcode (Zip code for the US). Rarely you'll find that one postcode is in an overlap of two or three practices and then you have a choice, but it isn't common. You'll be assigned a doctor at the practice arbitrarily.
This means that when you move, sometimes even if it's just a few streets, you have to register with a new practice and you get a new GP. They, obviously, won't know you, but your health records will be transferred from the previous one.
Generally if you're unwell at all, the GP is your first port of call. GPs are qualified to diagnose, prescribe drugs, carry out minor surgeries and refer you to specialists if you have a problem they cannot treat (this covers pretty much everything that isn't a common disease). There are usually no specialists on-site, you might not see "your" doctor (you might in fact end up seeing a "Nurse Practisioner", who is a nurse) and it's rare to be able to get prescribed drugs on-site.
Accident & Emergency
These are, usually quite large, departments in hospitals (often called "Casualty", familiar to Americans as "ER"). If you've had an accident or require emergency treatment you ship up here - not if you're just ill. There is no requirement to be registered (your health records are accessible by computer, so they can call them up anywhere) or even for you to go to a local one, though you'll find no more than 2 in a city (more in metropolitan areas).
A&E deals with all manner of woes, from alcoholic misadventure to actual heart attacks. Since you're in a hospital, if your accident or emergency requires specialist treatment you may find that you're kept in hospital and transferred to a ward with that specialism - for instance if you turn up with a broken leg, you'll be assessed by an A&E nurse/doctor and transferred to an orthopaedic ward if it's not a simple case of casting it. If you turn up with a broken face, you'll probably end up on a maxillofacial ward. If you're having a heart attack, you'll end up on a coronary care ward (once you're out of Intensive Care).
Specialists
Specialists are, as the name implies, individuals with a particular specialism. In the case of serious medical issues they will probably be consultant-grade doctors, or they could be trained physio/occupational therapists and suchlike.
You must be referred to a specialist through another medically-trained person - either a GP/NP as above or a doctor/nurse in A&E (or, rarely, another specialist). You cannot self-assess and book an appointment with the specialist you think you need to see.
Once you are seeing a specialist, they will continue a treatment plan as and when the two of you choose. However, the specialist will deal with only the issue for which you have been referred - say you turn up to a physiotherapist appointment for the shoulder issue you've been seeing them for, but also have a wonky knee that week. Though you and they both know you have a wonky knee, they will not be allowed to treat it until you have seen a GP and been referred to a physiotherapist for it.
If you have an ongoing health issue for which you have been seeing a specialist (or series of them) for ages as with FK's cardiac issues, there is no need to reinstigate a referral procedure every time you need to see them - it is, after all, the same condition, just with varying severity.
Dispensing Chemists/Pharmacists
Usually on-site in hospitals, occasionally on-site at GP's practices, commonly found roaming the wild (well... in specific "shops"). These are the people to whom you take a prescription for any drug. With the exception of A&E or a hospital ward, who can administer any controlled drug, any prescription must be made by a doctor and supplied by a pharmacist.
Dentists
Dentists are a peculiarity. Most dental practices are both NHS and private, but very rarely will a dentist take on new NHS customers. I am extremely baffled by dentists because they are supposed to be part of the NHS, but you pay for them anyway, regardless of their "free healthcare" status. I would explain further but I don't understand it myself. Sorry.
Private Healthcare Provision
There is no compulsion to use the NHS, though there is no get-out clause for it. If you wish to use private healthcare - and all of the above save for A&E are available privately - you must either pay for it or pay for private healthcare insurance (which essentially means you pay for it and the insurers pay you back).
Costs
GP - Free at point of use.
Drug prescription - £7.20 per course of drugs; Free at point of use for children, elderly, unemployed.
Dentist (NHS) - £16.50 per appointment up to £198 for bridging/crowns/dentures; Free at point of use for children, elderly, unemployed.
Dentist (Private) - At the dentist's fiat; £40 for an appointment is normal
A&E - Free at point of use
Specialist treatment (NHS) - Free at point of use
Specialist treatment (Private) - At the specialist's fiat; Cannot give "normal" figure as there is no such thing!
I think that about covers it...
General Practitioner (GP)
It isn't required to be registered with a GP but you'll find that, even if you aren't registered, you'll be entitled to treatment with your local GP's practice (they'll "ask" you to register when you ship up ill). There is no "choice" with GPs - you may only register at a practice that covers your postcode (Zip code for the US). Rarely you'll find that one postcode is in an overlap of two or three practices and then you have a choice, but it isn't common. You'll be assigned a doctor at the practice arbitrarily.
This means that when you move, sometimes even if it's just a few streets, you have to register with a new practice and you get a new GP. They, obviously, won't know you, but your health records will be transferred from the previous one.
Generally if you're unwell at all, the GP is your first port of call. GPs are qualified to diagnose, prescribe drugs, carry out minor surgeries and refer you to specialists if you have a problem they cannot treat (this covers pretty much everything that isn't a common disease). There are usually no specialists on-site, you might not see "your" doctor (you might in fact end up seeing a "Nurse Practisioner", who is a nurse) and it's rare to be able to get prescribed drugs on-site.
Accident & Emergency
These are, usually quite large, departments in hospitals (often called "Casualty", familiar to Americans as "ER"). If you've had an accident or require emergency treatment you ship up here - not if you're just ill. There is no requirement to be registered (your health records are accessible by computer, so they can call them up anywhere) or even for you to go to a local one, though you'll find no more than 2 in a city (more in metropolitan areas).
A&E deals with all manner of woes, from alcoholic misadventure to actual heart attacks. Since you're in a hospital, if your accident or emergency requires specialist treatment you may find that you're kept in hospital and transferred to a ward with that specialism - for instance if you turn up with a broken leg, you'll be assessed by an A&E nurse/doctor and transferred to an orthopaedic ward if it's not a simple case of casting it. If you turn up with a broken face, you'll probably end up on a maxillofacial ward. If you're having a heart attack, you'll end up on a coronary care ward (once you're out of Intensive Care).
Specialists
Specialists are, as the name implies, individuals with a particular specialism. In the case of serious medical issues they will probably be consultant-grade doctors, or they could be trained physio/occupational therapists and suchlike.
You must be referred to a specialist through another medically-trained person - either a GP/NP as above or a doctor/nurse in A&E (or, rarely, another specialist). You cannot self-assess and book an appointment with the specialist you think you need to see.
Once you are seeing a specialist, they will continue a treatment plan as and when the two of you choose. However, the specialist will deal with only the issue for which you have been referred - say you turn up to a physiotherapist appointment for the shoulder issue you've been seeing them for, but also have a wonky knee that week. Though you and they both know you have a wonky knee, they will not be allowed to treat it until you have seen a GP and been referred to a physiotherapist for it.
If you have an ongoing health issue for which you have been seeing a specialist (or series of them) for ages as with FK's cardiac issues, there is no need to reinstigate a referral procedure every time you need to see them - it is, after all, the same condition, just with varying severity.
Dispensing Chemists/Pharmacists
Usually on-site in hospitals, occasionally on-site at GP's practices, commonly found roaming the wild (well... in specific "shops"). These are the people to whom you take a prescription for any drug. With the exception of A&E or a hospital ward, who can administer any controlled drug, any prescription must be made by a doctor and supplied by a pharmacist.
Dentists
Dentists are a peculiarity. Most dental practices are both NHS and private, but very rarely will a dentist take on new NHS customers. I am extremely baffled by dentists because they are supposed to be part of the NHS, but you pay for them anyway, regardless of their "free healthcare" status. I would explain further but I don't understand it myself. Sorry.
Private Healthcare Provision
There is no compulsion to use the NHS, though there is no get-out clause for it. If you wish to use private healthcare - and all of the above save for A&E are available privately - you must either pay for it or pay for private healthcare insurance (which essentially means you pay for it and the insurers pay you back).
Costs
GP - Free at point of use.
Drug prescription - £7.20 per course of drugs; Free at point of use for children, elderly, unemployed.
Dentist (NHS) - £16.50 per appointment up to £198 for bridging/crowns/dentures; Free at point of use for children, elderly, unemployed.
Dentist (Private) - At the dentist's fiat; £40 for an appointment is normal
A&E - Free at point of use
Specialist treatment (NHS) - Free at point of use
Specialist treatment (Private) - At the specialist's fiat; Cannot give "normal" figure as there is no such thing!
I think that about covers it...
I know this will vary from state to state, but roughly. Top tax rate here is 40%, soon going up to 50% iirc.
