An American expat living in the U.K. has reacted to backlash online after revealing that she uses the country’s National Health Service.
Ally McGuinness has been in the U.K. for just over a year on a spouse visa since she married her husband. With thousands of followers on TikTok, she started sharing her experience of being an American living in Cambridgeshire, England.
“I started documenting my experience because at that point I hadn’t seen many others going through it in real time,” McGuinness told Newsweek.
Making videos about taking the English driving test, the cost of living in the U.K. and building credit in a new country—she quickly noticed that one topic seemed to get more attention than all the others.
“Anything I make about the NHS always gets a lot of views because it seems to be quite controversial. People always have something to say one way or another,” said McGuinness.
The NHS or National Health Service is the publicly funded health-care system in the U.K. It was established in 1948 as one of the major social reforms following World War II and is funded by citizen taxes. The NHS provides health care for all U.K. citizens based on their need for medical care rather than an ability to pay.
Because it is government-funded, the NHS means that anyone living in the U.K. can access services including visiting a doctor, getting hospital treatment, seeing a midwife if you are pregnant and getting urgent help if you have serious or life-threatening injuries—including transport to hospital.
Often referred to as “free at the point of access,” health care through the NHS can be used with no payment required at the time of treatment. However, the government allots money to the health service via taxes that are paid throughout a person’s lifetime in the U.K.
McGuinness fell pregnant and is expecting a baby with her husband in May 2023. As she is living in the U.K., she has started receiving maternity treatment through the NHS.
But, as she shared videos discussing her experience, she started to notice comments from people who slammed her for using the service.
“Some people in my comments told me to go back to America and accused me of being here just to get care,” said McGuinness. “I felt the need to address that because I would never want myself misrepresented.”
Being open and honest about her experiences, in one video she responded to comments saying that she should be paying for the NHS care. In the video with more than 540,000 views, she explains that she does financially contribute to the health service. When you are given a U.K. visa, part of the process means paying an NHS surcharge.
“It is £2,000 ($2,442) for the duration of your visa, which is two-and-a-half years for me,” McGuinness said in the video. When that visa expires, she will need to renew it and pay another surcharge for the new one.
On top of this, McGuinness is also working in the U.K., which means that money is automatically deducted from her income through taxes and a system called National Insurance. Both go to the government, and this money is used in various places, including to support the NHS. “So yes, I do contribute,” she said in the video.
But some TikTokers still took issue with McGuinness’s use of the health service. One commenter wrote: “Stop acting like you wouldn’t be paying far more than £2,000 in your own country for healthcare during your pregnancy.”
The state of the National Health Service in the U.K. has been a much-debated topic for decades, and this week, both ambulance staff and nurses have announced an intention to strike for better pay and working conditions.
On Wednesday, U.K. news outlet The Independent reported a “crisis” in the NHS as patients were unable to get the help they needed as staff struggled with the volume of patients in an overstretched system.
But it is unlikely that stretches to the healthcare system are as a result of expats utilizing the service—in fact, between 2009 and 2019, NHS budgets rose on average of just 1.4 percent each year, compared to the average 3.7 percent rises in the previous years since the service was established.
Alongside a backdrop of an increasing and ageing population that is still handling the backlash from the COVID-19 pandemic, many British people are angry that they cannot get the care they need.
While McGuinness was prompted to respond to the backlash from some commenters about her using the NHS, she also found that the majority of people were supportive.
“People always have something to say one way or another,” she said. “I feel, as an immigrant, many people don’t know the process we go through to get here and get access to care. Most people have been so kind and welcoming—it’s been nice to feel so supported.”
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