The first 15 years of my life in the 1970s and 1980s was spent going in and out of London to various hospitals on trains.

No. Absolutely not. It's much better now. Orders of magnitude better. Every train was late. There were engineering works overruns every Monday and weekend service was so bad you might as well walk.

And no not more expensive. People couldn't afford the train then and regularly took the inferior busses. If you went long distance, it was coach.

Either way you were doomed to a face full of diesel fumes from a Paxman or a Leyland and spend the entire day with your nose running black snot. Incidentally this is what killed my father; he was a bus driver.