So you’re getting ready to move to Scotland yourself, eh? That’s great! If you don’t already, I hope you come to love it as much as I do. But obviously if you’re hopping countries, there’s bound to be a few differences. That’s why I created the Scotland Bound section of the Scottican in the first place: to help provide advice for fellow Americans moving to Scotland. This entry should help give you some insights as to differences in healthcare in Scotland versus the States.
Fears and Concerns
There is a lot of propaganda regarding the state of public healthcare and the National Health Service (the NHS) in America. In the US, we’re very much tied to our private healthcare and many of us believe that a public healthcare system is not a good thing. There are a lot of scary stories about severely long waiting periods and not being seen… I’m surprised we haven’t made a horror film on it yet!
But the reality isn’t that scary.
I have never had to wait that long for an appointment. I’m here in Scotland now in the midst of the COVID-19 recovery and I’ve not experienced issues with my doctor. The first check-up I needed, I was seen within 2 weeks. In times when I felt I needed to see a doctor, I received an appointment within 2 weeks; after speaking with the doctor, they’d decide if I needed to come in and my next appointment was scheduled at earliest convenience.
These are for very basic check-ups and treatments. For something bigger, this may change.
Start With Your GP
As an American, I think we get very comfortable doing things our own way. Whether it’s cooking, shopping, or even getting medication, we’ve become used to “it’s my way or the highway.”
I had gotten to scheduling appointments with different doctors depending upon my needs. Here, I need to start with my general practitioner (GP). If I go elsewhere, that’s up to them.
Sometimes, it works this way in the States. If I start noticing different issues and don’t know where to start, I head to my GP and get a referral. But in other instances, I schedule my appointments with doctors I feel I need to see. In the States, I wouldn’t go to my GP for a pap smear. When I was in the US, I would just go to a dermatologist if I was having skin issues.
My point being: often in the States, I didn’t always start with the GP. Here, with the NHS, that’s more common. If you need to go on further, they’ll let you know.
You Get What You Go For
Something that Americans need to know about public healthcare: it is very straightforward. You get exactly what you go in for. No extra bells and whistles. You go with one purpose and nothing else.
After years of getting used to private healthcare options in the States, this was an adjustment. I’m used to being able to chat with my doctors about different issues. If I go to my doctor with one issue, I may talk to her about other things that are on my mind. A visit to the dermatologist might just be for acne issues, but if I have a mole or skin tag, I might still bring it up. A trip to the gynecologist is just for a check-up, but I may have other questions about my personal healthcare.
Moreover, with private healthcare, they may happy to help with all these other issues and questions you find. Sure, they’ll do an extra test if you want it. Here’s face wash and we’ll look at that mole. Just here for a cervical screening? Let’s throw on a full sexual health screening with blood work.
But with the NHS, whatever you’re there for, that’s what you’re there for. If you go for a cervical screening there, that’s all it is. You may be able to ask for something else if you want it. Or you can easily get that sexual health screening at another time.
The NHS is publicly run and funded, and it supports every single person living in the United Kingdom. It’s available to everyone. Not just those with specific jobs where they gained healthcare access. It’s available to young, old, homeless, students—anyone who needs it and is a registered citizen (or you’ve paid your fees along with your visa; see below).
This means it can be very heavily loaded. Know what you’re there for and don’t expect extra. If you get extra, wonderful, but don’t expect the red carpet treatment. You will get your healthcare. You will be seen and taken care of. But you don’t get special treatment. Go for what you need; don’t abuse the system.
As an international student, you will pay a fee for the NHS along with your visa application. Current information shows that the fee is £470 per year if you are applying as a student and £624 per year if you are applying for any other visa or immigration status (NHSinform.scot). This fee is separate from your visa application form, but in paying it, it does entitle you to enroll with a GP and receive treatment. You will also be able to enroll with a dentist and receive basic treatments (cleanings and check-ups, etc) if you have a Biometric Residence Permit.
With this fee to the NHS, which you should pay along with your visa application, you will be covered healthcare wise. You can register with your nearest GP and set up appointments. Further, if you are moving to Scotland, prescriptions are free.
Private healthcare options are still available, but are obviously expensive. This might not work well for you if you’re on a limited budget. But there are private options if you feel you need it.
Also consider that some dental treatment options might not be available on the NHS. Cleanings and basic treatment like that will likely be covered, but more extensive care may not. While I don’t have personal experience with dentists over here yet, it’s something to consider. If you want more information, check out What dental services are available on the NHS?
If you’re getting ready to move to Scotland as an American, you will have options for healthcare. So long as you pay your NHS fee, you will have access to a GP. If you’re moving for work, options for private healthcare may be open to you. No matter what, you should have the ability to be covered.
But be aware of the differences. As Americans, we’ve gotten used to having things our way and getting special treatment. That is not how public healthcare works. As I said above: you will be seen and you will be treated, but know what you’re going in for.
And also: do not abuse this system. I stress: know what you’re going in for and don’t abuse it by treating it like a private healthcare system.
Does public healthcare work? Yes, absolutely! I love knowing that my health is covered and I can see a doctor when I need to. A system like the NHS is something I feel America lacks. But there was an adjustment period after so many years of private healthcare in the States. I am still very happy to have the NHS and know that I’m covered even as a student.
So if you’ve been caught up in fears surrounding public healthcare, I can tell you it’s nothing to worry about. And as long as you’ve paid your fee, you no longer need to fret about what to do if you get sick living in Scotland as an American.