Basic Levels of UK Healthcare

Real heroes and heroines stopped wearing capes. They wear uninspiring scrubs and dangle stethoscopes from their oversized pockets.

The time is 1430hours. I have been checking the world clock on my screen every minute. Partly because I can’t sleep and partly because I have no headphones. I left mine at home and the airline is not providing any.

The couple next to me are having a beautiful moment together watching whatever it is they are watching. The man is American and the lady is Spanish. I have become a connoisseur at telling accents. Before, all whites were ‘mzungu’ but nowadays I appreciate their different backgrounds.

They look so sweet together and I suddenly miss being in a situationship of some sort. It is a fleeting thought and I banish it as soon as it appears. Because it is liberating to not have to share my bed, yes? Yes I’m joking Karen.

I am aboard KQ Flight 0390 to Heathrow, London. We taxied off at Jomo Kenyatta International Airport (JKIA) at 0930hrs. I have no idea where we are but I see clouds outside my window seat. Fat clouds. Wispy, feathery clouds. Clouds that look like a hybrid of a cat and an eagle. Small clustered clouds. Undecided clouds.

This is the second time I’m leaving Kenya for UK. The difference is that this felt like an actual goodbye. This time, I could taste the colours of my light face powder in the tears that streamed down my flushed cheeks. I still could smell my elder sister’s love on my shoulder when she embraced me that morning inside Paul Caffe Coffee shop at JKIA.

My sister has always looked out for me. She is older by two years or thereabouts but we grew up together. Fraternal twins of some sort. She is the brains where I am the muscle. She strategizes, I execute. She thinks before leaping, I leap then think later. We are complete opposites of each other and maybe that is why we are so intertwined.

Shii (my sister) is not one to show emotions. She cries and laughs in silence. The ultimate prim and proper EnglishLady. I display my emotions. All barrels out. That is until I jeed a recharge where I withdraw into my cocoon of silence. Shii is witty as a housewife’s bucket and takes a backseat wherever I’m involved. Allowing me to rush ahead and knock my head off.

It came as a shocker then when I came from the lavatories at the said coffee shop and found her in tears. That is the first time I saw my elder sister unashamedly break down in my presence.

At first I thought it was her eyes. Her eyes have recently decided to be wee devils and they tear up. It wasn’t. I pushed away my suitcase, crossed over the hard, cold table and sat next to her. I am the queen of public display of affection. She loathes it. Ha ha.

Nestling her dreadlocked head on my left shoulder, she cooed up amidst sobs,” I will miss you.”

I may have heard many warm things in life but those words chewed me up raw. My insides trembled and the pieces came out as hot tears that soaked onto her white and red-striped cardigan. “Me too Toto, me too.”

Father calls all his children Toto. It is a contraction of Mtoto meaning Child in Swahili. We have adopted it as a family.

I would miss her. I do. I always will. But I had to leave Kenya and fast. My Endocrinology appointment awaited and I had a follow up interview with a Trust in the National Health Service(NHS).

This departure was emphatic because I had finally tied all the loose ends in Kenya and I was ready to settle down in Edinburgh, United Kingdom.

Even as I formed shapely images of the clouds that rose invitingly in the skies, I knew I had made a definite decision. That decision involved me missing my elder sister more than anything in this world.

The NHS is a government funded public medical and health service anyone living in the United Kingdom can access. This is without being asked to pay upfront. What they don’t tell you however is that as an immigrant worker, you pay an Initial Health Surcharge (IHS) of about 500 Sterling Pounds for every year you’ll be in the UK. This is at the Visa application stage. Last I checked the current government plans to increase that fee.

It baffled me the first time I came here. My appointment with the endocrinologist had been occasioned by a referral from my general practitioner.

Health systems in UK are tiered up into different levels. At the most primary one is the community. That is equivalent of community health nursing in Kenya. It however is very formal and organised unlike anything I’ve ever witnessed.

In hot pursuit are the health centres. Only that they are not called health centres. They are know as General Practitioner’s (GP) medical practice or GP surgery. Why someone in Britain thought it is cute to call a health centre a ‘surgery,’ I will never comprehend. Just like I’ll never understand people who don’t eat avocados. What is your problem guys?

The interesting thing about health centres, is that they have a GP (a medical doctor) in charge as opposed to the health centres I was used to back home. There are imaging services and specialist services like physiotherapy and podiatry. Some clinics are run entirely by Nurse Practitioners.

This is the first place I interacted with a Nurse Practitioner. I always heard of them but I never knew it was a real thing. Stella Donohor (name changed) was her name. She was a Reproductive health nurse practitioner. When I booked an appointment, the medical receptionist sweetly informed me that Nurse Donohor would be the one to see me.

Raised up in a culture where a nurse isn’t really appreciated or viewed as someone who knows her or his trade, I was mesmerized. Coming from a tribe that sees nurses get short changed at the table of opportunities, I was impressed.

She let me call her Stella and because I accused her speculum of being too tight in my lady parts as she did my Pap smear,I tricked her into answering some of my burning questions. Ha ha. Yes I know how to strike up conversations in the middle of uncomfortable procedures.

A nurse practitioner, she told me, had to have a Bachelor’s of Science degree in whatever field of nursing she chose. She also had to undergo a Prescribing Course. I will revisit this topic some day in the near future.

The doctor handles all other cases. Doctors are few (so are nurses) hence the nurse practitioners help the entire citizenry by handling some cases and referring the rest appropriately. The teamwork between the Nurse practitioners and the doctors is to die for.

My GP had handled my other cases and referred me to the endocrinologist. I remember chatting with a nurse friend back home who told me it cost her an arm, a leg and a slice of her liver to afford the services of this highly trained specialist of glands and hormones of the body.

Therefore when I waltzed to The Royal Infirmary of Edinburgh hospital to see my specialist, I was sceptical if I was to cough up some Queen’s pounds. I did not.

As you’ve noted, we have graduated to the hospital. Hospitals are grouped into private and public ones. Private hospitals are not popular in the UK. They are mushrooming like bushfires because the NHS is overwhelmed but still, they are playing catch up. Worthy to mention is a branch of NHS that is the social care. This is where Care homes and home based care fall. They are either privately or run by the government. Majority are privately owned but regulated by the differed Health Care Inspectors of the government.

The inspection and regulation is a serious business and I’m full of praises for the way the UK as a whole has decided to take care of her geriatric population. That and the terminally ill.

NHS hospitals are then clustered into groups depending on the locality they are in. These many hospitals form a TRUST. Why the name Trust you ask me? I’m asking the same thank you very much. Perhaps the most famous one being St. Guy’s and Thomas Trust in London. One of its hospitals, St.Thomas, is where the good Prime Minister Boris Johnson got admitted with and recovered from Covid-19.

My hospital, The Royal as it is colloquially known falls under NHS Lothian Trust. The different Trusts across the UK run under different managements but all subscribe to the guidelines of the UK government. We could classify all these further based on the four countries that make up the UK. I feel doing so would be belaboring the point and akin to a broken record.

After a chat with Dr. Graham the Endocrinologist, I left for home feeling much better. I wished my sister was here. To hear what the good doctor had to say about me and to also accompany me home. She wasn’t. It was just me and my hopes and dreams strapped in a light backpack.

I did follow up with my interview and got the job I desperately needed. It keeps opening my vistas of healthcare in this country. I get to fall in love with a government funded, public owned healthcare without a cheap private option. Ranked as one of the top ten healthcare system by World Health Organisation, the NHS offers so much for a greenhorn like myself.

Chronic diseases are managed at the health centres only being sent to the hospital if and when acute. Community health is the heartthrob of United Kingdom’s healthcare. Without it, all patients end up in the hospital and cripple it. I have had a beautiful opportunity to be part of a community dialysis team. Accompanying renal nurses to deliver services in patients’ houses. This couldn’t get better.

Any emergency warrants a visit to the hospital while a minor concern sees you at the health centre. I can’t bring myself to say ‘surgery,’ sorry Your Majesty. Emergency services work. They are not a suggestion. The ambulance, fire, police departments are not flimsy afterthoughts. They are stark naked realities and I am mesmerized as a nurse.

When I asked Google to show me hospitals in the UK, he didn’t tell me about the mystery of Trusts. Now that it makes sense, it is prudent to think about the area you want to settle in then look for Trusts near that locality. Afterwards you can apply for a job in any of the hospitals mentioned. I think this is where you raise a glass to that.

6 thoughts on “Basic Levels of UK Healthcare

  1. I love that you’re making the most of your new environment and filling us in.
    I’ve become not just your stalker but numero uno fan, cheering you on.
    And yes, I don’t eat avocado {come beat me, hahaha}

    Liked by 1 person

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