Transnational Healthcare Preferences Among EU Nationals in the UK: A Qualitative Assessment

Abstract

This article explores the motivational factors behind preferences for medical care in the country of residence or the country of origin among EU nationals living in the UK. Undertaking a thematic analysis on a large-N qualitative data set, the article aims to establish a data-driven typology of motivations inductively. This provides an intermediary analysis between qualitative depth and quantitative operationalisability, contributing to the existing literature on healthcare location preferences among transnationally connected social groups. This article finds that preferences for medical care in the country of origin are driven overwhelmingly by quality considerations, while preferences for the UK have more to do with convenience and financing. These perceptions result from negative personal experiences, lack of trust, and often concealed cultural differences, and the analysis identifies various nuances and connections between attitudes that previous in-depth qualitative studies could not systematise.

Central and Eastern European Migrants in the United Kingdom: A Scoping Review of the Reasons for Utilisation of Transnational Healthcare

“…Although most CEE migrants within the 16 publications utilised healthcare in their CoO either exclusively or in addition to the NHS, three studies revealed that some CEE migrants used healthcare exclusively in the United Kingdom [ 49 , 50 , 51 ]. Reasons included convenience and cheaper cost.…”

“…Financial considerations were a major factor, as certain migrants could not afford the costs associated with utilising healthcare in their CoO, which usually consisted of purchasing airfare and health services abroad. Moreh, McGhee, and Vlachantoni [ 49 ] described migrants who solely used NHS healthcare had made this decision as part of their perceived identity as United Kingdom residents.…”

“…Two studies contained evidence that Romanians had less trust in the Romanian healthcare system and felt the NHS was more trustworthy in terms of quality [ 49 , 51 ]. Expectations of bribes and gratuity in Eastern European national healthcare systems were another deterrent for travelling back to individuals' CoO for healthcare.…”

“…Mismatched cultural expectations of healthcare services provided in the United Kingdom were the most common theme [ 49 , 50 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ]. CEE migrants were frustrated with the general practitioner (GP) acting as the gatekeeper, with no direct or easy access to specialists in the NHS compared to their CoO.…”

Diagnostic testing: therapeutic mobilities, social fields, and medical encounters in the transnational healthcare practices of Polish migrants in the UK

“…An increase in the flow of patients from the U.K. to Poland since the mid-2000s is mostly constituted of migrants seeking to access healthcare in their home country ( Horsfall, 2020 ). Returning to the country of origin to access medical services is common to other Europeans living in the U.K. ( Moreh, McGhee, and Vlachantoni, 2018 ) and has been found for Poles in several of EU countries ( Mathijsen, 2019 , Migge and Gilmartin, 2011 , Main, 2014 ). By moving from Poland to the U.K., Poles shift between state-funded health systems and lose access to public services in Poland, while becoming entitled to the use of the National Health Service (NHS) in the U.K.. Poles access most of the services in Poland within the private healthcare sector ( Troccoli et al., 2021 ), thus they seek healthcare “on their own initiative” outside the EU institutional routes ( Legido-Quigley et al., 2011 ).…”