Is Healthcare Free in the UK?

Roman Danaev

19 December 2024

The UK is known for having one of the top healthcare systems in the world, with high-quality services, especially when it comes to care and fairness. Other countries often rely on contributions to fund healthcare, but the UK operates a bit differently. If you’re curious about whether healthcare is really free for everyone in the UK, this guide will answer that. We’ll cover which services are free, if all of them are, and touch on private healthcare, too.

Why Is Healthcare Free in the UK?

The National Health Service (NHS) was established by the National Health Service Act in 1946 with one clear goal: to provide healthcare to everyone. It was part of a wider welfare reform to address issues like unemployment, poverty, and poor health.

The NHS is built around the idea of offering high-quality care to everybody. To uphold this, the Care Quality Commission regulates health and social care services, which makes sure all providers are registered and monitored. The National Institute for Health and Care Excellence (NICE) also helps maintain high standards by setting clear guidelines for treatments. They manage waiting times for services like cancer care, elective surgeries, and emergency services, and they collect data to track the quality of care at every level.

In the UK, healthcare is seen as a basic right, not something to be bought. Even though it’s not truly “free” — it’s funded by taxes — the NHS makes healthcare accessible to everyone.

Who Can Access Free Healthcare in the UK?

If you were born in the UK and live there, you’re eligible for free healthcare through the NHS. To qualify, you need to be “ordinarily resident,” which simply means living in the country legally and on a long-term basis.

Immigrants with indefinite leave to remain can also access free healthcare. Even if you’re an expat or a new resident, you’re still covered by the NHS.

While many NHS services are free when you use them, some people may need to pay a surcharge. This applies to immigrants before they move to the UK. Short-term visitors or anyone staying for less than six months will also need to pay for most NHS services.

What Free NHS Care Actually Means

The UK’s healthcare system, the NHS, is funded through taxes, so people don’t need to buy health insurance. This setup allows UK residents to get healthcare for free when they need it, but the cost is really covered by the taxes everyone pays.

The funding works through something called national insurance. This is a type of tax that’s based on your income. If you’re working, a portion of your wages is automatically deducted by your employer and paid into national insurance. These payments help cover the cost of healthcare for everyone. So, while you don’t pay directly for healthcare services when you need them, your contributions through national insurance help make sure that free healthcare is available to all.

What Is the NHS (National Health Service)?

The NHS includes NHS England, NHS Scotland, NHS Wales, and Health and Social Care in Northern Ireland. It’s made up of three key areas: general practitioner and dental services, hospital and specialist care, and local health authority services.

GPs, or family doctors, are the first point of contact for most healthcare needs. They provide care to anyone who registers with them. These doctors and dentists run their own practices but are paid by the government based on the number of patients they see. Their services are managed locally, and they have the option to work privately while still being part of the NHS system.

Hospital and specialist care is provided by professionals working in government-run NHS hospitals and clinics, which are overseen by regional hospital boards. These healthcare workers are salaried employees.

Local health authority services focus on community care — services like maternity and child health, post-hospital care, home nursing, vaccinations, and ambulance services. They also manage programmes like family planning clinics and day nurseries.

Which Healthcare Services Are Covered?

Some of the key medical services covered under free healthcare include:

• Routine consultations, health checks, and preventive care
• Hospital services:

• Emergency care (A&E)
• Inpatient and outpatient care
• Surgery and specialist treatments
• Diagnostic services like X-rays, MRIs, and lab tests

• Maternity services:

• Antenatal and postnatal care
• Birth-related services (home births, hospital births)

• Assessment and treatment for mental health conditions, including therapy and counselling.
• Routine childhood immunisations, flu vaccines, and other preventive immunisations
• Emergency ambulance transport and care
• End-of-life care to provide comfort and manage pain

In addition to the core healthcare services, the NHS also covers tertiary care and community health services.

• Tertiary care includes highly specialised treatments like neurosurgery, transplants, plastic surgery, and secure forensic mental health services. These services are provided in specialised centres for complex conditions.
• Community health services include support like district nursing, health visiting, child health services, and sexual health services. These services focus on providing care within the community and helping manage health outside of hospitals.

Which NHS Services Do Patients Need to Pay For?

The NHS provides a lot of free care, but some services do come with a cost. You may need to pay for:

• Prescriptions
• Eyecare
• Dental care
• Wigs and fabric supports
• Travel to and from NHS facilities

However, some groups of people can avoid these charges. For example, anyone under 16 or over 60 gets free prescriptions. If you’re not exempt, you’ll pay £9.35 for a prescription. People with partial blindness also get free eye care and may receive optical vouchers to help cover the cost of glasses or contact lenses.

Cost of Healthcare When Visiting the UK Temporarily

If you’re visiting the UK, you’ll have to pay for most NHS services. For example, hospital treatment usually costs 150% of the normal NHS rate. However, depending on your situation or if you qualify for certain exemptions, you may pay less.

To keep costs manageable, you can get health insurance. This will cover the treatment you need while in the UK, and some insurers may reimburse you for NHS charges. If you already have health insurance from home, check if it covers healthcare abroad. Many policies don’t unless you have an international plan. In that case, you might want to consider getting a UK-based health insurance plan.

Is Healthcare Free in the UK for Foreigners?

Healthcare can be free when you need it, but there’s one important step: you’ll need to pay an immigration health surcharge if you’re a student or migrant staying in the country for over six months. This fee is paid when applying for your visa.

Here’s how much the surcharge costs:

• £776 per year for students, youth mobility scheme participants, or anyone under 18
• £1,035 per year for everyone else

This surcharge applies to anyone applying for a visa or immigration status, whether you’re applying from inside or outside the UK (if staying more than six months). Even if you already have private health insurance, you’ll still need to pay this fee.

However, there are some exceptions. If you’re applying for permanent residency, you won’t need to pay the surcharge. Children under 18 in local authority care are also exempt, but they’ll need an IHS reference number. The same applies to civilians working for NATO or the Australian Department of Defence in the UK, as well as their dependents.

How to Access Treatment in the UK

If you’re visiting or moving to the UK and need medical care, you’re still entitled to treatment.

• For emergencies, call 999 to reach Accident and Emergency (A&E) services, or go directly to an A&E department if one is nearby.
• For non-urgent medical needs, dial 111. They’ll help you find the right care and tell you what to do next. You can also visit an NHS walk-in centre or healthcare facility for quick treatment.
• If you need a prescription, a pharmacist can advise you and may offer over-the-counter remedies. However, not all hospitals have A&E departments, so it’s good to check before going.
• Always carry your health insurance details with you. If you need care, having this information ready will help. Just keep in mind that your insurance might not cover everything you need in the UK.

If you’re moving to the UK, you’ll pay a health surcharge as part of your visa application. This will give you access to free healthcare once you arrive.

Once in the UK, it’s a good idea to register with a local general practice clinic. You’ll need to complete a registration form and show proof of your immigration status. If your chosen GP isn’t taking new patients, you can find another nearby.

Who Should Consider Health Insurance?

Even with the NHS around, you can benefit from private health insurance if you:

• Want faster access to care
• Prefer more choice and flexibility (access to private hospitals and the ability to choose your doctors)
• Have specific health needs (for example, infertility treatment or ongoing specialist care like physiotherapy)
• Are interested in elective procedures (covers treatments like cosmetic surgery or dental work)
• Are a foreign resident (provides coverage if not eligible for NHS)

The private healthcare system isn’t a replacement for the NHS — it’s meant to complement it. By using both, you can make the most of each system. You’re covered for primary care with the NHS, and if you need private treatment, you won’t have to worry about huge healthcare costs.

Final Words

The NHS provides healthcare for everyone in the UK and makes it available at no direct cost when you need it. However, healthcare isn’t completely free because it’s funded through taxes. Also, even though most people rely on the NHS for their care, some may also choose private health insurance to cover treatments or services that aren’t included in the NHS.

Overall, everyone can get the care they need, with extra options available for those who want them.