Polls show that most Brits would agree with the European Union leader who “reserved a special place in hell” for whoever invented Brexit, but they strongly differ on their attitudes towards it. Young people tend to support remaining in the EU (Remain) in order to retain their free travel within it, while their more elderly relatives lean towards leaving the bloc (Leave) to get Brexit done as soon as possible and to end the bickering over it. Leave’s appeal is stronger in the industrial north and Remain’s in the more prosperous south.

In a recent poll, 59 percent of voters named the crisis in the National Health Service as the biggest issue the United Kingdom faced after a decade of cuts, yet only 18 percent said health care policies would influence their vote. However, the renewed threat of a no-deal Brexit in two months’ time is already casting a shadow over the NHS. Several senior executives fear that many EU staff won’t return after Christmas. While they have the right to stay in the UK, they worry that their families may not be allowed to join them.

Also, Tory leaders have been trying to refute opposition claims that they have been entertaining United States demands for market access to the NHS and higher prices for US drugs during any post-Brexit trade deal.


Personal experience

For two months recently, I experienced this purgatory for myself, neither in nor out of hell (or paradise), after appointments with two visiting consultants at our hospital in Road Town failed to diagnose a troubling medical condition satisfactorily.

I was the last senior to see the consultant from Puerto Rico in Outpatients. He interviewed me for 10 to 20 minutes without any examination, then told me to take some tests before he returned in a month’s time. I took the tests but he didn’t return. Another one, from Miami, did similarly a further month later. When I asked him for advice on exercises, he replied that it was not for him to tell me which to do.

A National Health Insurance official in the Virgin Islands was understandably adamant that the programme would not fund a third opinion, so I resolved to seek one myself during my first vacation in the UK since 2012, at a family home in an English commuter town. It eventually lasted two months.



While in the UK, I was struck by the changes the intervening years of austerity had brought and shocked at the way differences over Brexit were fracturing British society, from families to political parties to the UK itself.

I discovered I could normally only be treated at the nearby NHS hospital if I was “ordinarily resident” in the UK, unless in an accident or an emergency, when I could have been admitted there under the reciprocal heath care agreement between the NHI and NHS. I was advised to register with a general practitioner at the “walk-in centre,” another innovation

Next morning, I walked along the road until I saw a large roadside sign at the entrance to the walk-in centre, open practically 24/7. Inside, I passed several partially occupied rows of chairs before waiting my turn for a receptionist to call me over.

After I told her I wanted to register there, she took my NHS number, pulled up my records on her screen, and gestured me across to another cluster of chairs further in. As I sat there, a patient bobbed into the hall on one knee, in a painful undulating motion, until he hauled himself up before the receptionist. He obviously did not expect anyone’s help.

A nurse directed me to an open door. After the doctor had glanced at my records, he asked me how he could help me. I told him that I wanted to re-register for NHS treatment. I learnt that GP practice managers can accept as temporarily resident any visitor to the UK for under three months, regardless of their regular status, but may charge for certain services.


One visit, one issue

The doctor told me to make me an appointment at reception for a preliminary medical examination, but stopped me when I started to describe my primary medical concern, saying he could discuss only one issue during our ten-minute appointment

When I protested that the receptionist hadn’t mentioned those restrictions, he smiled sympathetically and said that everyone else out there already knew them. As I left, I noticed nearly every chair was occupied.

A few days later, a nurse gave me a routine medical examination and said I was fine, but was uninterested in my worrying medical condition. However, she said I could now make an appointment with a GP, whose name the receptionist wrote down for me.

When I returned to meet my allotted GP, the receptionist told me she was not available (it transpired she prioritises her private practice) and I met the same doctor as on my first visit. After hearing my brief description of my complaint and learning that I would be going away again in a few weeks’ time, he recommended I consult a specialist at a nearby private hospital.


Private hospital

The private hospital’s letter confirming my appointment detailed the specialist’s quite reasonable fee for an initial consultation for a full hour. It also warned of a charge for unauthorised parking.

I relaxed in an armchair until I was told the specialist was ready and directed to his office, but a smartly dressed man met me halfway and greeted me warmly. Within 30 minutes, he had diagnosed my condition without the scans and exploratory procedures called for by the consultants in the VI.

He prescribed a two-month supply of an expensive drug and recommended a local physiotherapy centre. Both the medication and physiotherapy would be free to me as a senior if the walk-in centre’s manager authorised their provision. He promised to ask him to do so, although I may have to wait a week or two for the physiotherapy appointment.

I planned to extend my stay accordingly, but the next day the receptionist at the centre could at first find no message about either the medication or the physiotherapy. It later emerged that after considering my consultant’s request carefully, the manager had approved the free supply of only half my medication, as he kept a tight rein on expenditure. I never heard from the physiotherapy centre.

Back in Tortola, my GP re-wrote the specialist’s repeat prescription for a VI pharmacy, which found its cheapest available source was the UK. My medication arrived within two weeks.