Care is free, but patients are asked to contribute towards certain services, as well as towards medicines and dental treatment.

To be treated in England, you must first go through your GP. If they are NHS-registered, the consultation is free and there is nothing to pay upfront. Only this doctor can refer you to a specialist if needed.

Public hospitals are also free when they are NHS-approved and you attend on a GP’s referral.
Prescribed medicines carry a flat charge of £7.65 per item.
For dental costs, three bands were introduced in 2006 and updated in 2012:

– £17.50 for preventive care, diagnostics, examinations, advice and urgent treatment, even where several procedures are required.
– £48 for tooth extractions, fillings and any root work, on top of the treatments in the first band.

– £209 for any treatment requiring crowns, dentures or bridges, on top of the care in the first two bands.

Eye tests are chargeable, as are glasses and contact lenses. Some people, subject to income or age, can receive help in the form of vouchers.

Note that certain groups may be exempt from these charges, such as under-16s, older people, pregnant women, people with disabilities and those receiving non-contributory benefits.

Like any free public system, the English health service is a victim of its own success, particularly in London. It is therefore often hard to get a prompt appointment with a specialist, and the comfort and reception in public hospitals is often disappointing (shared wards). More and more Londoners choose to top up their cover with Private Medical Insurance (PMI) to access private care, which is far more expensive. Even so, this does not avoid the need for a GP referral before seeing a specialist, nor does it provide full cover for maternity, dental or optical care. Some specialists are also not approved. Expats in London generally prefer first-euro cover.