LUCRARE DE ATESTAT - Limba

engleza

“Medicine and healtcare

in UK”

By Iorga Georgiana Denisa

Teacher: Vlad Alina

Milea Oana

Grade 12 D
 2023-2024

Table of
contents

➢
Argument………………………………………………………
………………3
➢ Introduction
…………………………………………………………………4
➢ Chapter 1- History of Medicine and Healthcare
system……………………………………………………………
…………………5
➢ Chapter 2- Important personalities in
Medicine…………..10
➢ Chapter 3-
Hospitals……………………………………………………..18
➢ Chapter 4- Medicine study
……………………………………………27
➢ Conclusion……………………………………………………
……………….34
➢ Bibliography……………………………………………………
……………35
ARGUMENT
I choose to speak about medicine and healthcare in uk
because nowadays it si very good to be informed about the
resources we have,especially in the context of pandemic
and not only.
The United Kingdom provides public healthcare to all
permanent residents, about 58 million people. It’s different
from the system in many countries and a role model for
many more. Healthcare coverage is free at the point of
need, and is paid for by general taxation. About 18% of a
citizen’s income tax goes towards healthcare, which is
about 5 percent of the average citizen’s income. Overall,
around 8 percent of the UK's gross domestic product is
spent on healthcare.
In conclusion,UK is in a continuous evolution, thus
becoming an example for the health systems of other
countries.
INTRODUCTION

In this paperwork I will talk to you about medicine and

the healthcare system in the UK. Nowadays it is very good
to be informed about the resources we have, especially in
the context of the pandemic and not only.
The United Kingdom is a sovereign state located off the
north-western coast of Europe. The country includes the
island of Great Britain, the north-eastern part of the island
of Ireland and many smaller islands. It has a population of
62,262,000 people and a reported GDP of $2.260 trillion
Great Britain Pounds.
 The United Kingdom provides public healthcare to all
permanent residents, about 58 million people. It’s different
from the system in many countries and a role model for
many more. Healthcare coverage is free at the point of
need, and is paid for by general taxation. About 18% of a
citizen’s income tax goes towards healthcare, which is
about 4.5% of the average citizen’s income. Overall, around
8.4 percent of the UK's gross domestic product is spent on
healthcare.
The United Kingdom has a universal healthcare
system called the National Health Service or NHS. The NHS
is responsible for all aspects of the U.K. healthcare system.
Today, the NHS is also one of the largest public health
systems in the world. It serves an average of 1 million
people every 36 hours. Its guiding goals include universality,
free delivery, equity, and central funding. UK also has a
growing private healthcare sector that is still much smaller
than the public one.

CHAPTER 1- History of medicine and

healtcare system

From the last two years, one thing is abundantly clear –

medicine has, and will continue to have, a significant role in
the lives of people worldwide. In Britain, medicine has
drastically changed over the last thousand years, a long
and deep history, but fundamentally has demonstrated
progress and improvement over time.

-Medieval Medicine-

Medicine in medieval Britain was a complex and varied

field that was shaped by a number of factors, including
social, cultural, and technological developments. From the
early days of traditional healing practices to the
development of more advanced medical treatments, the
history of medicine in medieval Britain is a rich and diverse
one.
One of the earliest forms of medicine in medieval Britain
was herbal medicine, which was practiced by traditional
healers, such as Druids and wise women. These healers
used a variety of herbs and plants to treat a range of
ailments, and their knowledge was passed down through
the generations. In addition to herbal medicine, other
traditional practices, such as acupuncture and massage,
were also used to treat a range of conditions.
During the Middle Ages, the Catholic Church played a
significant role in the development of medicine in Britain.
Monasteries and other religious institutions served as
centres of learning and provided care for the sick. The
Benedictine monk, Saint Benedict, is credited with
establishing the first hospital in Britain in the 6th century.
In the later medieval period, advances in medical
knowledge and treatment were made by scholars and
physicians who were influenced by the works of Greek and
Roman writers. One of the most famous medieval
physicians was the Englishman Sir Thomas Elyot, who
wrote a number of influential works on medicine, including
the “Book of the Governor,” which was a guide to health
and well-being.
Despite these advances, medicine in medieval Britain
remained largely ineffective and limited in scope. Many
diseases, such as the plague, were poorly understood, and
treatments were often inadequate. As a result, mortality
rates were high, and life expectancy was relatively low.
 In Britain, the Black Death is thought to have arrived in
1348, possibly through the port of Bristol. The disease
quickly spread throughout the country, killing thousands of
people and severely affecting the economy and social
structure. Many people fled the cities to escape the plague,
but this only served to spread the disease to rural areas as
well. The Black Death had a significant impact on the
population of Britain, with some estimates suggesting that
it may have killed as much as 40% of the population.

The Black Death also had a profound effect on the

culture and society of Britain. It led to a significant shift in
the balance of power between the nobility and the
peasantry, as the nobility lost a large proportion of their
labour force. This led to a rise in wages and an increase in
the bargaining power of workers, which ultimately led to
the development of a more equitable society. The plague
also led to a shift in the focus of the arts, with many artists
turning to darker, more macabre themes in their work.

The history of medicine in medieval Britain was a

complex and varied one that was shaped by a number of
factors. From the early days of traditional healing practices
to the development of more advanced medical treatments,
the field of medicine in medieval Britain reflects the
evolving nature of the field.

-Early modern medicine-

An important development in early modern medicine

was the emergence of the concept of the “miasma” theory
of disease. This theory held that diseases were caused by
unhealthy or contaminated air, and that they could be
spread through the air or through contact with infected
individuals. This theory led to a focus on improving
sanitation and hygiene, as well as on quarantine and
isolation measures to prevent the spread of disease.
 One of the most significant figures in early modern
medicine in Britain was William Harvey, a physician who is
credited with discovering the circulation of the blood.
Harvey’s work revolutionised our understanding of the
human body and laid the foundation for modern physiology
and medicine.
Other notable figures in early modern medicine
include Edward Jenner, who is credited with developing
the smallpoxvaccine, and James Lind, who is known for his
work on scurvy and his contributions to the field of
nutrition.
Overall, early modern medicine in Britain was marked by
significant advancements and the development of many of
the principles and practices that are still used today.
Despite the many challenges faced by medical practitioners
during this time, they made important contributions to our
understanding of the human body and to the field of
medicine as a whole.

-Modern medicine – 20th century-

One of the most significant developments in 20th

century medicine in Britain was the widespread adoption of
antibiotics. These drugs revolutionized the treatment of
infections and greatly reduced the mortality rate for many
diseases. Penicillin, the first antibiotic, was developed in the
1930s and quickly became widely used. Other antibiotics,
such as streptomycin and tetracycline, were also developed
during this time.
Another important development in 20th century
medicine in Britain was the emergence of the National
Health Service (NHS). The NHS was established in 1948 and
provided free healthcare to all citizens of Britain. This
greatly improved access to medical care and helped to
reduce healthcare costs for many people.
The 20th century also saw significant advancements in
surgery, with the development of new techniques and
technologies such as laparoscopic surgery and the use of
anaesthetics. These developments made many types of
surgery safer and more effective, and greatly expanded the
range of procedures that could be performed.
Other notable developments in 20th century medicine
in Britain include the development of vaccines for a wide
range of diseases, such as polio and measles, and the
widespread adoption of imaging technologies such as X-
rays, CT scans, and MRIs. These technologies revolutionised
the diagnosis and treatment of many diseases and
conditions.

-Hstory of UK Healthcare System-

National Health Service (NHS) was founded in 1946, and

is responsible for the public healthcare sector of the UK.
Before this, healthcare in UK was generally available only to
the wealthy, unless one was able to obtain free treatment
through charity or teaching hospitals. In 1911 David Lloyd
George introduced the National Insurance Act, in which a
small amount was deducted from an employee’s wage and
in return they were entitled to free healthcare. However
this scheme only gave healthcare entitlement to employed
individuals.
After the Second World War, an endeavor was
undertaken to launch a public healthcare system in which
services were provided free at the point of need, services
were financed from central taxation and everyone was
eligible for care.
A basic tripartite system was formed splitting the service
into hospital services, primary care (General Practitioner’s)
and Community Services. By 1974 concerns over problems
caused by the separation of the three primary areas of care
had grown, so a drastic reorganization effort was made
which allowed local authorities to support all three areas of
care. The Thatcher years saw a restructuring of the
management system, and in 1990 the National Health
Service and Community Care Act was passed, which set up
independent Trusts that managed hospital care.
Continued reformation has occurred since the time of
the Blair government, including the formation of NHS
Direct, which aimed to improve healthcare standards and
lower costs and waiting times.
Recent changes in the NHS include the dissolving of the
current government management structure by 2014, which
would put some 30,000 administrators out of work. Also,
80% of the NHS budget will be turned over to doctors to
have them spend as they see fit. The purpose of this reform
is to encourage the ongoing privatization of the healthcare
industry in order to give more choices to the patients. The
reforms are put in place to help lower medical costs and
patient waiting times.

-Current Healthcare System in UK-

The UK has a government-sponsored universal healthcare

system called the National Health Service (NHS). The NHS
consists of a series of publicly funded healthcare systems in
the UK. It includes the National Health Services (England),
NHS Scotland, NHS Wales and Health and Social Care in
Northern Ireland. Citizens are entitled to healthcare under
this system, but have the option to buy private health
insurance as well.
The NHS Plan promises more power and information for
patients, more hospitals and beds, more doctors and
nurses, significantly shorter waiting times for appointments,
improved healthcare for older patients, and
tougher standards for NHS organizations.
The UK's health care system is one of the most efficient
in the world, according to a study of sevenindustrialized
countries. The Commonwealth Fund report looked at five
areas of performance - quality,efficiency, access to care,
equity and healthy lives, The Netherlands ranked first
overall, closely followed by the UK and Australia. UK
performed well when it came to quality of care and access
to care. The UK also ranked first in efficiency, which was
measured by examining total national spending on
healthcare as a percentage of GDP, as well as the amount
spent on healthcare administration and insurance.
In regards to access to care, the study states: "The UK
has relatively short waiting times for basic medical care and
non-emergency access to services after hours, but has
longer waiting times for specialist care and elective.

CHAPTER 2- Important personalities in UK

medicine

>John Snow (1813-1858)<

-Innovator in epidemiology and anaesthesia-

John Snow was a brilliant physician who was active in

London in the middle years of the 19thcentury. He is best
remembered for tracing the source of the Soho cholera
outbreak in 1854, but he also made significant
contributions to other medical fields, particularly
anaesthesia.
John Snow was born on 15th March 1813 in York, the first
of nine children born to William Snow, a farmer, and his
wife Frances. The neighbourhood was one of the poorest in
the country, with flooding from the River Ouse a constant
hazard. He was educated in York and at the age of 14 was
apprenticed to the surgeon William Hardcastle based in
Newcastle. He worked as a colliery surgeon and developed
his interest in cholera during the epidemic of 1831-2. From
1833 to 1836 he was an assistant in general practice in
Durham and later North Yorkshire, after which he moved to
London to further his education, travelling to the capital on
foot.
In October 1836 he enrolled as a student at the
Hunterian School of Medicine in Great Windmill Street,
Soho, and a year later he started working at Westminster
Hospital. He remained here until 1838, the year in which he
graduated as a member of the Royal College of Surgeons
as well as a licentiate of the Society of Apothecaries.
Further academic recognition came later with graduation as
MD from the University of London in 1844 and membership
of the Royal College of Physicians in 1850. After graduation
in 1838, he set up a practice at his home at 54 Frith Street
and that year also published his first paper ‘Arsenic as a
Preservative of Dead Bodies’, which appeared in The
Lancet. In 1842 he published his best-known paper ‘On
Asphyxia, and on the Resuscitation of Stillborn Children’.
Snow had a keen interest in cholera, a nasty disease from
which all too often death from massive dehydration
resulted. In 1849 he published ‘On the Mode of
Communication of Cholera’ in which he argued that it was
an intestinal infection. This was controversial, since the
‘miasma’ (bad air) theory had firm advocates. His argument
against airborne transmission was that he attended dozens
of patients with the malady without catching it himself.
Snow’s other main legacy was in obstetric anaesthesia.
During his career he anaesthetised 77 obstetric patients
with chloroform, typically initiating the drug only when the
2nd stage of labour had been reached. He held discussions
with Prince Albert who expressed an interest in obtaining
anaesthesia for his wife, Queen Victoria, and conferred with
her other physicians including Charles Locock. In 1853,
when she was pregnant with her eighth child Prince
Leopold, the Queen submitted to chloroform, which Snow
administered successfully. The Lancetpromptly criticised
him for tampering with nature, but London’s social elite
were captivated and soon followed the Queen’s lead. In
1857 Snow repeated the feat when Queen Victoria gave
birth to her ninth and final child, Princess Beatrice.
By this time Snow had moved to a larger home and
practice at 18 Sackville Street. There has been much
speculation about his own health, for despite the fact that
he was vegetarian and virtually teetotal, he never looked a
healthy man. He contracted tuberculosis around the time
he received his MD, and although he recovered it is thought
that he subsequently suffered kidney disease. He may well
have done some damage by testing anaesthesia on
himself, and rumours of a mental breakdown also
circulated. On 9th June 1858 as he had gathered a small
group of colleagues at his home to discuss a new bi-aural
stethoscope he suffered a stroke. He recovered sufficiently
to pen his paper ‘On chloroform and Other Anaesthetics’,
but following a further stroke he died on 16th June at the
tragically young age of 45. He never married, and his
brother Thomas, who was by his side, registered his death.
He was buried at Brompton Cemetery, where his friends
erected a memorial stone. John Snow rose from humble
origins to become one of the most eminent physicians of
his day and a poll in 2003 named him as the greatest
British physician of all time.
 >Elizabeth Garrett Anderson 1836-1917<

-Britain’s first female doctor-

Today, well over half of all graduates from British

medical schools are female, yet just a century and a half
ago there existed not a single female doctor. It took a
steely Londoner called Elizabeth Garrett to change
centuries of accepted male prejudice.
Elizabeth Garrett was born in Whitechapel, East London
on 9th June [Link] father ran a local pawnbroker’s shop at
the time of her birth, but five years later purchased a corn
and coal warehouse in Aldeburgh, Suffolk. The business
was a great success, and within a decade he became a
wealthy man and was able to send all of his twelve children
to boarding school.
Elizabeth went to school in Blackheath and during her
time in London became interested in feminist issues, her
meeting with Emily Davies in 1854 providing the catalyst.
In 1859 she met Elizabeth Blackwell, the Bristol-born
American who became the world’s first female doctor, and
resolved to become a doctor herself. After initial hostility,
her father, a strong advocate of education, became very
supportive of her aspiration.
 The barriers, however, seemed impenetrable. In 1860
she became a nurse at the Middlesex Hospital and attended
lectures for medical students, but her motive was soon
uncovered and following complaints by male students she
was barred from the lecture hall. She persevered, studying
anatomy privately at the London Hospital, and found
sympathetic tutors at the University of St Andrews who
gave her private tuition. When ready to sit the final
examinations, however, all of the universities, plus the
Royal College of Physicians and the Royal College of
Surgeons, rejected her candidature. She exploited a legal
loophole when she discovered that the Royal Society of
Apothecaries did not specifically bar women. She duly
passed their Licentiate examination in 1865, and they
predictably altered their laws to ban future female
participation.
Having climbed extraordinary hurdles to qualify, she
forged a distinguished career in medicine. In 1866 she
established the St Mary’s Dispensary in Euston, with the
aim of allowing poor women to obtain medical care from
female practitioners and she worked there for 20 years. The
dispensary developed into the New Hospital for Women in
1872, with her mentor Elizabeth Blackwell appointed
Professor of Gynaecology. Now named the Elizabeth Garrett
Anderson Hospital, it continues to provide healthcare under
the NHS today. She learned French and in 1870 graduated
in medicine from the University of Paris.
Garrett continued to be a feminist activist, and in 1865
teamed up with Emily Davies, Dorothea Beale and Francis
Mary Buss to form a discussion forum called the Kensington
Society. A year later the group organised a petition
lobbying Parliament to grant women the vote. The petition
was rejected, but individual support remained from many
Liberal members, particularly Henry Fawcett, the blind MP
for Brighton. Garrett and Fawcett were very close, but she
rejected his marriage proposal, fearing it may harm her
medical career. He later married her like-minded younger
sister Millicent, who was to become leader of the National
Union of Women’s Suffrage Societies.
 Garrett did eventually marry, in 1871. Her husband was
James Anderson, a London ship owner, and she had three
children, Louisa, Margaret (who died from meningitis) and
Alan. Despite her domestic responsibilities she continued to
work tirelessly, and in 1874 created the London School of
Medicine for Women, another institute still thriving today.
Now based in Hunter Street, it has around 200 students
mainly from University College Hospital, which opened its
doors to women in 1877; a year after Parliament passed its
Act opening all medical schools to females. In 1897 she was
elected President of the East Anglia branch of the British
Medical Association.

Alexander Fleming, Howard Florey, Ernst

Chain and the Penicillin story

Medical history is littered with examples of delays and

missed opportunities. One of the most glaring of these is
the half-century gap between the discovery of bacteria by
Robert Koch in 1877 (at the same time that Louis Pasteur
was correctly proposing the germ theory of disease) and
that of the first antibiotic, penicillin, in 1928. Be that as it
may, the penicillin story is a fascinatingly human one,
involving three brilliant individuals, several unsung heroes,
international collaboration and a good deal of raw luck.

>Alexander Fleming<
 In 1928 he was working on the influenza virus and he
had cultured Staphylococcus aureus, which is a type of
bacteria, on a petri dish. A rather untidy man with a
cluttered laboratory, Fleming then left for a fortnight’s
holiday. Upon his return he observed that some mould had
grown in the dish after accidental contamination, and that
this led to a bacteria-free circle around the mould. He
isolated the substance and called it penicillin, and with
further experiments proved that it inhibited the growth
of staphylococcus even when diluted 800 times. He
reported his momentous, albeit accidental, discovery in
the British Journal of Experimental Pathology in 1929.
A modest, slightly dour man, Fleming did not believe that
mass production of penicillin was viable, and made little
further reference to it. It was not until a decade later,
several miles up the Thames in Oxford that the next
chapter in the penicillin story would be written. Though he
received numerous honours including Fellowship of the
Royal Society in 1943 and a knighthood in 1944, his career
as an innovative scientist peaked with penicillin and he
continued with more routine work. His first wife, with whom
he had one son, died in 1949, and four years later he
married Dr Amalia Koutsouri-Voureka, a Greek colleague.
He died from a heart attack in London on 11th March 1955,
and was buried at St Paul’s Cathedral.

>Howard Walter Florey<

 The second strand in the penicillin story involves Howard
Walter Florey who was born in Adelaide, South Australia on
24th September 1898. He was the son of an English
immigrant and his Australian-born second wife. He studied
Medicine at the University of Adelaide. Upon qualification in
1921, he arrived at Magdalen College, Oxford, on a Rhodes
scholarship, gaining a BSc and MA. In 1926 he was elected
a fellow of Gonville and Caius College, Cambridge, and
received a PhD from there a year later.
In May 1940 a classic experiment was performed when
eight mice were deliberately infected with Streptococcus;
the four that were subsequently treated with penicillin
survived whilst the others died. The following year penicillin
was tried for the first time on a human. The patient, Albert
Alexander, a 48-year-old Metropolitan Police Officer,
sustained horrific facial swelling after a thorn scratch
became infected necessitating several abscess drainages
and removal of an eye. He appeared to improve after he
was given the penicillin but due to insufficient quantities of
the drug, he relapsed and died.
In 1943 Florey travelled to North Africa to test the
effects of penicillin on wounded Allied soldiers, and he
discovered that it was remarkably effective, literally saving
life and limb. The clinical benefits having been clearly
demonstrated, the focus now turned to mass production of
the drug. Again using his American connections, Florey
travelled with Heatley to Peoria, Illinois. This was against
Chain’s wishes, as he wanted to patent the drug in the UK.
In America an enthusiastic researcher called Mary Hunt
found that the cantaloupe melon provided a medium for
prolific growth of the mould. By late 1943 several major
drug companies, including Merck, Squibb and Pfizer had
begun mass production. By the tail end of WWII allied
soldiers were to benefit from this, their wound infections as
well as their gonorrhoea cured.

>Ernest Chain<
 Ernst Boris Chain was the third pivotal figure. Like
Fleming and Florey, he was an outstanding scientist who
led a very interesting life. He was born in Berlin on 19 th June
1906, his Russian father having moved there to study
Chemistry at Friedrich Wilhelm University; his mother was a
native Berliner. Chain enrolled for the same course and at
the same university as his father, graduating in 1930.
Realising that he was no longer safe in Nazi Germany, he
moved to Britain in 1933. He began work at Cambridge
University, studying phospholipids under Sir Frederick
Gowland Hopkins. In 1935 he moved to Oxford and
researched a wide variety of biochemical areas before
joining Howard Florey’s team in 1939. He theorised the
structure of penicillin (which was confirmed by x-ray
crystallography by Dorothy Hodgkin) and worked out how
to isolate and concentrate the active ingredient.

A brilliant polymath, Chain was also a fine pianist and spoke

German, Russian, English, French, Italian and Hebrew.
However, he suffered a personal tragedy as both his
mother and sister perished in the Holocaust. In 1948 he
moved to Rome as Scientific Director of the International
Research Centre for Chemical Microbiology. Academic
institutions in Italy at the time were bedevilled by
corruption and nepotism, and Chain was one of several
scientists recruited from abroad to restore damaged
reputations as well as conduct research. In 1964 he
became Professor of Biochemistry at Imperial College,
London, and was knighted in 1969. He retired in 1973 and
moved to the West of Ireland, He died in Castlebar, County
Mayo on 12th August 1979.
In 1945 Fleming, Florey and Chain were jointly awarded the
Nobel Prize in Medicine or Physiology for their momentous
work.

CHAPTER 3- Hospitals

If you are moving to the UK, you will be happy to know

that the country is home to some of the best hospitals in
the world. There are two general types of hospitals in the
UK; those which operate within the National Health Service
(NHS) and offer free healthcare, and independent hospitals
which are run by private companies or charities and charge
for services.
Whichever system you use, it’s important to understand
how hospitals in the UK function.
The UK hospital system includes both public hospitals and
those which are independent and run by private companies
or not-for-profits. Most of the hospitals in the country are
part of the National Health Service (NHS) which is publicly
funded and run by trusts. As an expat living in the country,
you can access free NHS healthcare and choose from a
range of public hospitals, depending on the service you
need and your location.
There are also university hospitals (or teaching hospitals)
that operate within the public healthcare system and are
connected to the NHS and institutions of higher learning.
The medical staff train at these hospitals, which are
considered to have unrivaled expertise and facilities.
In addition, there are 14 NHS children’s hospitals in the
UK, of which the most famous is Great Ormond Street
Hospital in London. It offers 63 clinical specialties, which is
the widest range of health services for children in the UK.
While some hospitals treat a range of conditions on an
elective or emergency basis, others specialize in a field
such as ophthalmology or cancer. One such example is
Royal Marsden, which is the first hospital in the world that
dedicates itself to the study and treatment of cancer.

-The four NHS systems in the UK-

In the UK, the National Health Service (NHS) is the

umbrella term for the four health systems of England,
Scotland, Wales, and Northern Ireland. However, in
Northern Ireland, the NHS was merged with the broader
social care system in 1973 and called the Health and Social
Care (HSC) system rather than the NHS.
 These systems operate independently of each other as
they are devolved and overseen by individual governments.
Notably, most of the information provided in this guide
refers to the NHS in England, which is the largest provider
of healthcare in the UK. So if you need specific advice for
Wales, Scotland, or Northern Ireland, please refer to their
individual websites.

-Services in UK hospitals-

A UK hospital will typically include the following

services, although this list is not exhaustive and it is best to
check the NHS services near you:
• Accident and Emergency services (A&E)
• Women’s healthcare
• Maternity services and family planning
• Ear, Nose, and Throat (ENT)
•Sexual health
• Specialist care such as ophthalmology, oncology,
urology, cardiology, and dermatology
• Oral surgery
• Geriatric care
•Mental healthcare
If you require maternity services, it is worth checking
what your options are with your GP. Notably, you can
choose your midwife team and how you would like to give
birth, depending on your individual circumstances and a
risk assessment.

-Waiting times at UK hospitals-

The maximum time you should wait to start non-urgent

treatment in the UK is 18 weeks, or two weeks if the
treatment is for cancer. This starts from the date that a
hospital receives a referral letter from your GP (general
practitioner) or from when you book an appointment
through the NHS e-referral service after speaking to your
doctor. However, it is important to bear in mind that waiting
times can vary as COVID-19 has put a huge strain on the
NHS and hospital system.
In fact, the number of people waiting for hospital
treatment in England has hit a record high of 5.7 million as
the NHS struggles to clear the growing backlog of care
worsened by the pandemic. If you have been waiting for
more than 18 weeks to start treatment, you have a right to
change hospitals, however, there are exceptions. It is also
worth mentioning that waiting lists for some procedures
can be longer than a year.
Because of this, The Commonwealth Fund, a prominent
think tank in the United States, has downgraded the UK
healthcare system to fourth overall, among 11 wealthy
countries. It had previously ranked number one in two
separate reports, in 2014 and 2017.
To summarize, the UK healthcare system is under a lot of
strain and waiting lists are longer than in previous years.

-How to access hospital treatment in the UK-

Hospitals in the UK are secondary care services,

meaning that your GP typically refers you, except for in an
emergency. Essentially, anyone living in the UK can access
hospital treatment through the NHS, which is free at the
point of use. However, if you have just moved to the UK or
are staying there temporarily, then charges may apply.
Notably, citizens from the EU/EEA and Switzerland can
use their European Health Insurance Card (EHIC) to access
treatment in the UK; be it for an emergency or not.
However, different charges will apply to those who are from
outside these areas.
Before you can be referred to a specialist service at a
hospital, the first step is to speak to your doctor. This
applies to both inpatient and outpatient services. Your
doctor will then write a referral letter to your agreed
hospital, or give you the go-ahead to book an appointment
through the NHS e-referral system. You will generally
receive a letter, phone call, or text to confirm your
appointment.
Notably, while you may not need to know your NHS
number in order to receive care, it will help NHS staff find
your health records. You will get an NHS number and card
when you register with your GP, and this number will also
be on your referral letter.
Services not covered by the NHS
It is important to be aware that while the NHS provides
free healthcare at the point of use, it will not cover all
services; for instance, procedures that are considered to be
cosmetic or some drugs and treatments that are new or
experimental, such as breakthrough cancer drugs.
Of course, you can always choose to see a private
consultant or opt to have private treatment. In this case,
you will need to arrange private health insurance or cover
the costs out of pocket. You can read more about this
further down the guide. Depending on your job, some
employers will also offer private medical insurance as a
staff benefit.
To be clear, if you are going down the private route, you
will likely not need to seek a GP referral first and will cut
back significantly on waiting times.

-Emergency treatment in the UK-

The NHS responds to over 110 million urgent calls or

visits every year. Anyone can receive emergency medical
attention in the UK. And as an expat living in the country,
you won’t need to pay to visit an Accident and Emergency
(A&E) department.
The NHS distinguishes between emergency care and
urgent care. If you or someone you are with requires
immediate, emergency attention, you should call 999. You
will be connected to a team that can dispatch an
ambulance and will assess the emergency. Alternatively,
you can simply show up to any A&E department in an
emergency and wait to be seen.
Notably, it is possible to contact the emergency services
by text if you can’t make a voice call, but you must register
with the emergency SMS service first. You can simply text
‘register’ to 999 to sign up.
If you require urgent care and can’t speak to your doctor,
you should call 111. You will be asked a series of questions
and directed to the most appropriate service for your
condition or problem. You can also go online and contact
NHS 111 for pharmacy advice or urgent refills, out-of-hours
GP appointments, and referrals to urgent treatment
centers.
Hospital stays in the UK: what to expect
If you are admitted to a hospital in the UK, it is likely that
you will end up in a ward that has beds separated by
curtains. In most cases, you won’t have a private room or
bathroom, and you will be given limited meal choices.
That said, visitors are usually allowed to bring in food
from outside and you can also bring your own personal
items, such as toiletries and clothes. You will likely need to
bring your own laptop or device for watching programs or
entertainment. In summary, wards are basic and facilities
will vary based on their location.
Private hospitals in the UK
By contrast, private hospitals in the UK offer better
facilities and are likely to look more state of the art.
Essentially, the main differences are privacy and comfort.
For instance, you will be offered a private room, given more
extensive food options, and generally enjoy a more relaxing
environment.
Having said that, the medical attention that you will
receive in a private hospital is unlikely to be superior to
what the NHS offers. In fact, your private doctor or
consultant may actually work for the NHS. Moreover, NHS
hospitals also perform private procedures and reserve
 some beds for private patients. Your private health
insurance provider may even offer you a cash benefit for
having a private procedure in an NHS hospital. You just
need to check your individual plan.

-Hospital costs in the UK-

There is no cost for receiving care at an NHS hospital as

treatment is covered through the country’s government-
funded universal healthcare system. Therefore, you will not
be sent an itemized bill after your stay, unlike in the United
States.
Prescriptions are also subsidized, and whether you pay
will depend on your age or circumstances. For instance,
those under 16 years of age or over 60 do not pay, as well
as women who are pregnant or have had a baby in the
previous 12 months.
Health insurance for hospital costs in the UK
On the other hand, charges do apply to private hospitals
and private treatment, and your insurance plan will cover
all or some of these costs. It is important to understand
that without having private health insurance, you will need
to pay out of pocket, and these costs can really mount up.
For instance, a consultation can range from around £100 to
£250 and a surgical procedure can cost more than
£10,000.
Healthcare is generally available on both a personal and
family basis, and premiums depend on your level of cover,
lifestyle, age, and pre-existing medical conditions. Notably,
most private policies will not cover emergency treatment,
maternity services, and treatment for long-term or chronic
conditions such as diabetes or arthritis.
Some of the largest health insurance companies in the UK
include:
• Allianz Care
• Cigna Global
• Globality Health
 Of course, it is important to check individual plans to see
what is covered through insurance, whether there is an
upfront cost, and how you can claim back for medical
procedures and treatments. You can discuss payment plans
with your chosen insurance provider.

-The best hospitals in the UK-

>Guy’s and St Thomas’ Hospital in

London<

Coming in at number 44 in the global league table, Guy’s

and St Thomas’ in London is the highest-ranking hospital in
the UK. Renowned for medical research, innovation, and
training, this NHS hospital has several specialties. It is part
of King’s Health Partners, an academic health center that is
based in the capital and is famous for its clinical excellence.

>Freeman Hospital (Newcastle upon

Tyne)<
 Located in Newcastle upon Tyne in the North East of
England, Freeman Hospital has an international reputation
for transplant surgery and carried out the UK’s first
successful baby heart transplant in 1987.

>Royal Berkshire Hospital (Reading)<

Located in Reading, Berkshire, the highly-rated Royal

Berkshire Hospital has earned praise and recognition for its
cleanliness, dementia care, and acute stroke unit. Serving
more than 500,000 people, it is one of the largest NHS
hospitalsr in the UK.
-List of UK hospitals-

London
• Chelsea and Westminster Hospital NHS Foundation Trust
• Great Ormond Street Hospital NHS Foundation Trust
• Guy’s and St Thomas’ NHS Foundation Trust
• Homerton University Hospital NHS Foundation Trust
• King’s College NHS Foundation Trust
• London Bridge Hospital
• Moorfields Eye Hospital NHS Foundation Trust
• North East London Mental Health NHS Foundation Trust
• The Portland Hospital for Women and Children
• Royal Marsden Hospital NHS Foundation Trust
• South London and Maudsley NHS Foundation Trust
• South West London and St George’s Mental Health NHS
Trust
• St George’s University Hospitals NHS Foundation Trust
• University College Hospital NHS Foundation Trust
• University College London NHS Foundation Trust

Birmingham
• Birmingham Women’s and Children’s NHS Foundation
Trust
• Sandwell and West Birmingham NHS Trust
• University Hospitals Birmingham NHS Foundation Trust

Manchester
• The Christie NHS Foundation Trust
• Manchester University NHS Foundation Trust
• Northern Care Alliance NHS Foundation Trust

Sheffield
• BMI Thornbury Hospital
• Sheffield Teaching Hospitals NHS Foundation Trust

Newcastle
• Newcastle upon Tyne Hospitals NHS Foundation Trust

Liverpool
• Clatterbridge Cancer Centre NHS Foundation Trust
• Liverpool University Hospitals NHS Foundation Trust
• Merseycare NHS Foundation Trust

Bristol
• North Bristol NHS Trust
• University Hospitals Bristol NHS Foundation Trust

Cardiff
• Cardiff and Vale University Health Board
• Nuffield Health Cardiff Bay Hospital

Swansea
• HMT Sancta Maria Hospital
• Swansea Bay University Health Board

Edinburgh
• NHS Lothian
• Royal Edinburgh Hospital
• Royal Infirmary of Edinburgh

Glasgow
• NHS Greater Glasgow and Clyde
• Ross Hall Hospital

Belfast
• Belfast Health and Social Care Trust

Private hospitals
• Circle Health Group
• Nuffield Health
CHAPTER 4- Medicine study

-Introduction to Medicine Degree-

Medicine is one of the most competitive courses in the

UK to gain entry to, but every year thousands of
international students are accepted into medical schools
across the UK. The entry standards for any medical school
to study an MBBS are strict and exacting. Interviews for
admission can be tough, and students should expect
questioning on motivation, previous work, and personal
interests, as well as being able to produce evidence of all
previous achievements, including relevant work experience.
A number of medical schools will expect completion of the
clinical aptitude test, UCAT.
If your grades are of the highest standard, and if you can
prove that you have set your heart on studying and working
in this field, then applying to read Medicine in the UK is for
you. 3 As at A-level, including chemistry or biology, an IB of
38 or IELTS score of 7.0 is the academic standard required
for a Bachelor of Medicine degree in the UK.
A strong first degree and a successful career record are
required for graduate Medicine, and work experience of one
day a week for six months in a hospital, care home, hospice
or other caring environment is the sort of evidence of intent
the medical schools will be expecting and looking for.
Understanding the National Health Service and how it
works is also crucial for international applicants.
Admission to medical degrees in the UK is highly
competitive, with many more qualified applicants than
available spots. Students need to have a strong academic
record, as well as relevant work or volunteer experience, to
be considered for admission.
-Medicine Course Duration-

A Bachelor of Medicine in the UK is an undergraduate

degree that typically takes 5-6 years to complete. A
Master's in Medicine typically takes 1-2 years to complete
and requires a strong background in the sciences
and/or healthcare.

-Medicine Degree Tuition Fees-

Medical courses are among the most degrees to study

in the world because medical education requires extensive
training and resources, including access to specialised
equipment and experienced faculty. The cost of
medicine tuition is also higher because of the length of
medical courses, which typically require 4-6 years of study.
Because of this, many medical schools offer
medicine scholarships to students to help with the cost of
their education.
On average, international students can expect to pay
between £25,000 to £45,000 per academic year when
studying MBBS in the UK.

-Medicine Degree Types-

Bachelor of Medicine
A Bachelor of Medicine, also known as an MBBS, in the UK
prepares students for a career in medicine, including roles
such as doctors, surgeons, and medical researchers. To
pursue a Bachelor of Medicine degree in the UK, students
typically need to have completed high school or its
equivalent with a strong academic record, including
subjects such as biology, chemistry, and physics.
A Bachelor of Medicine degree in the UK includes both
classroom learning and clinical experience. In the early
 years of the course, students learn about the basic sciences
and medical terminology, while later years focus on clinical
skills and patient care. Students typically also participate in
clinical rotations in hospitals and other healthcare settings.

Masters in Medicine
A Master's in Medicine is a postgraduate course that
focuses on advancing the knowledge and skills of
healthcare professionals in a specific area of medicine. To
pursue a Master's in Medicine, you'll typically need to have
completed a bachelor's degree in medicine.
A Master's in Medicine typically includes advanced
coursework in areas such as pharmacology,
pathophysiology, epidemiology, clinical research, and
patient care.

PhD Medicine
A PhD in medicine is an advanced degree that involves
conducting original research in a medical field. It typically
takes 4-6 years to complete, and after completing your
PhD, you may pursue a career in academia, industry, or
government. Many PhDs in medicine go on to work in
research, development, and regulatory affairs in
pharmaceutical and biotech companies, while
others become professors and researchers at universities or
work in government agencies like the National Institutes of
Health.

-Graduate Medicine Careers and Salary-

Students graduating from an MBBS course in the UK have

a variety of different options available to them. Many opt
for further study, but common career paths include:
• General Practice: Many doctors choose to work as
general practitioners, providing primary care to patients in
the local community
• Hospital Medicine: In roles such as cardiology,
neurology, oncology, paediatrics, emergency medicine
• Surgery: Surgeons who specialise in performing
operations on patients
• Public Health: Public health doctors work to improve the
health and well-being of entire communities through
initiatives such as vaccination programs and health
campaigns
• Research: Some doctors choose to work in medical
research, either in an academic setting or in the
pharmaceutical industry
• Education: Medical educators work in universities,
teaching the next generation of doctors and other
healthcare professionals

-Average Salary for Medicine Professionals-

The average medicine salary for medical professionals in

the UK varies widely depending on the specific field of
medicine and the level of experience. Based on data from
the National Careers Service and the NHS, here are a
selected number of medical specialities and the average
weighted salary.
• General Practitioner: £72,000 - £105,000 per year
• Surgeon: £79,860 - £149,400 per year
• Consultant: £82,096 - £110,683 per year
• Psychiatrist: £79,860 - £107,668 per year
• Physician: £40,000 - £102,500 per year
• Medical Researcher: £25,000 - £60,000 per year

-Graduate Employability Rate for Medicine-

 According to the Guardian University Guide 2023
medicine subject rankings, the following five universities
have the highest percentage of graduates who find
graduate-level jobs or are in further study at a professional
or higher education level within 15 months of graduation.
1. University of Cambridge (100%)
2. Imperial College London (100%)
3. Durham University (100%)
4. University of Sheffield (100%)
5. Swansea University (100%)

-Medicine Entry Requirements-

If you decide you want to study medicine, you will need

to enrol at a medical school, which is often part of a
university but will have strong links to local hospitals and
medical practices. For undergraduate medicine, students
will need exceptional grades in subjects such as biology,
chemistry, and physics.
In the UK, most medical schools require applicants to sit
for the UK Clinical Aptitude Test (UKCAT) or the BioMedical
Admissions Test (BMAT). These tests assess your critical
thinking, problem-solving, and communication skills.
Some universities may also require applicants to have
work experience in a healthcare or medical setting to
demonstrate their commitment to the field. Shortlisted
applicants will typically be invited to attend an interview,
which can be conducted in person or online, to assess their
suitability for the course as well.
For international students wishing to study Medicine at
the undergraduate level, an IELTS score of no less than 6.5
across all four categories - reading, writing, speaking and
listening – with an overall 7.0 score is generally required at
most universities.
 -UK Clinical Aptitude Test-

The UK Clinical Aptitude Test (UKCAT) is part of the

selection process of some UK medical and dental schools. It
is an online test designed to test cognitive abilities,
attitudes, critical thinking, and logical reasoning. There are
four reasoning tests and a situational judgement test.
• Verbal Reasoning- Assesses ability to think logically
about written information and arrive at a reasoned
conclusion: 21 minutes, with 11 passages to read and 44
questions.
• Quantitative reasoning- Assesses ability to solve
numerical problems: 24 minutes, 9 tables, charts, graphs
etc. as information and 36 questions.
• Abstract reasoning- Assesses the ability to infer
relationships from information by convergent and divergent
thinking: 13 minutes and 55 questions.
• Decision Analysis- Assesses ability to deal with various
forms of information to infer relationships, make informed
judgements, and decide on an appropriate response: 32
minutes, 1 scenario full of information and 28 questions
(basic calculator provided)
• Situational Judgement- Measures your responses in
situations and your grasp of medical ethics: 27 minutes and
67 questions on 20 scenarios.

Where can I study Medicine Degree in the

UK?

• University of Aberdeen School of Medicine and Dentistry

• Anglia Ruskin University School of Medicine
• Aston University Medical School
• Queen Mary University of London
• University of Birmingham College of Medical and Dental
Sciences
• Brighton and Sussex Medical School
• University of Bristol Medical School
• University of Buckingham Medical School
• University of Cambridge School of Clinical Medicine
• Cardiff University School of Medicine
• University of Dundee School of Medicine
• Edge Hill University Medical School
• The University of Edinburgh Medical School
• University of Exeter Medical School
• University of Glasgow School of Medicine
• Hull York Medical School
• Imperial College London Faculty of Medicine
• Keele University School of Medicine
• Kent and Medway Medical School
• King's College London GKT School of Medical Education
• Lancaster University Medical School
• University of Leeds School of Medicine
• University of Leicester Medical School
• University of Liverpool School of Medicine
• London School of Hygiene & Tropical Medicine
• University of Manchester Medical School
• Newcastle University School of Medical Education
• University of East Anglia, Norwich Medical School
• University of Nottingham School of Medicine
• University of Nottingham - Lincoln Medical School
• University of Oxford Medical Sciences Division
• Plymouth University Peninsula Schools of Medicine and
Dentistry
• Queen's University Belfast School of Medicine
• University of Sheffield Medical School
• University of Southampton School of Medicine
• University of St Andrews School of Medicine
• St George's, University of London
CONCLUSION

To summarize, Medicine and the healthcare system

have evolved a lot in the last centuries to offer people all
the necessary conditions they need and a chance for a
healthy life. Moreover, the public healthcare system is free,
to the advantage of the citizens.
The conditions in the hospitals are up to expectations,
offering everything that is essential to be in a hospital plus
more.
 Besides, studies in medicine prepare students to reach
their maximum potential, so that medicine and
the healthcare system evolve more and more.
The UK is in a continuous evolution, thus becoming an
example for the health systems of other countries.

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