Mix and Matching NHS and Private Care

[Ginger84]

Hi all,

firstly, I am so glad to have found this forum, since it is helping me think better about my choices, especially as an expat in London.
I have been exploring very many different options to get an elsc and was wondering about the following:

1. Can I for example pay a consultant to perform the c-section on the NHS? There is one consultant I really like and his fees aren't too bad. I am happy to pay it if the hospital agrees to an elcs. In other words, if the hospital agrees, can I get my own consultant who works at that hospital or this doesn't work?
   
2. Can I contact consultants in a few hospitals and ask them if they are willing to approve a c-section for me before I do a referral to this hospital? I don't want to don't want to jump from one hospital to the other and try my luck in each. I was more thinking about having a meeting with the ones I had in mind to inquire if they would approve me first.
   

I know my questions may be a bit naive, but I am really trying to explore every option out there so that I have a plan on how best to proceed.
Many thanks in advance to any helpful answer!

[Roseandharry]

Hi I work for the NHS and unfortunately the system doesn't work like that. You would need to either be approved for the ELCS fully on the NHS or pay for the whole process privately. There is no 'mix and match' so to speak.

You say you are an ex-pat living in London, could you not have the CS in your home country on their heath service ?

[laptopdisaster]

No, it's nhs or private. Some hospitals let you have NHS care and upgrade to a private room, that's all.

[Babytalking]

Hi,

I do know that at St thomas you can have a delivery only package, so see a consultant for antenatal care then have the actual delivery done privately. You would have to call their private maternity for more info.

[Farahilda]

There is no 'mix and match' and no co-paying.

You may well have to pay for antenatal tests privately, irrespective of what had been done on NHS. You will also have to pay, in addition to obstetricians fees, theatre fees, anaesthetists fees, fees for all tests and lab work, fees fro baby check and any treatment the baby requires.

If you opt for a private hospital attacjhed to an NHS one, then emergency care can be transferred, which would save money.

[NotARegularPenguin]

I’m confused about being an expat in London. Are you entitled to nhs care?

[scaevola]

'upgrade to a private room"

Only if available - single rooms are allocated according to need, and a typical way to prioritise would be: those whose babies were still born, those with infection control reasons, serious medical issues, those ith super-multiples, those whose babies are in NICU but whose mothers are not yet fit to join them, other medical issues, twins, anyone willling to pay, anyone else.

[scaevola]

Actual childbirth is considered an emergency procedure, so is free to anyone and everyone. Full antenatal and postnatal care however are not.

[PaddyF0dder]

Basically as others said.

There would be huge ethical issues if people could basically contract privateers to use MHS hospitals. It would mean essentially bribing the hospital to give you preferential treatment over poorer people! It’s jot just the doctor that’s needed. You’d need the anaesthetist. The midwives and nurses. The aftercare. Even simple things like the cleaners and porters that support the running of the hospital. You’d be jumping a queue based on no justification, except the force of your money.

So that’s a no.

[NotARegularPenguin]

scaevola

Childbirth is not free to people who aren’t entitled to nhs care. Believe me I’ve been working on the ward when people have been presented with a bill.

[scaevola]

That's interesting, NotARegularPenguin though it should not happen, for the actual delivery (other things may well be chargeable).

(Just as A&E is free, but other aspects of treatment for whatever landed you there might not be).

[theSFclub]

No, if there is no medical need then a c-section on the Nhs is highly unlikely to be approved. You would need to pay privately at the Portland for example.

[eurochick]

You can have nhs antenatal care and then pay for a private delivery. I did this and the consultant used the nhs operating theatre (I was in a private wing of an nhs hospital). However I had to pay for my drugs, anaesthetist, room, etc as well as the consultant's fees. I think it was around 15k four years ago.

[Ginger84]

Hi all, thanks for your replies. In the meantime I was able to also come to the same answer that everyone else gave. No mix and matching, which is fine. I simply wanted to explore all the options out there and understand the system better.

NotARegularPenguin, being a foreigner in the UK does not mean you are not entitled to the NHS. The NHS is not nationality-based, but based on your legal status and whether you are contributing to the NHS. I have been for years and have been using the NHS since I arrived as a spouse to an EU citizen. We have both been contributing to the NHS as everyone else and have therefore the right to use the NHS. Also those on Tier 2 visas at my work and pregnant are entitled to the NHS as long as they are paying into the system. So I don't think this is the issue here, as again the NHS is not discriminating on the basis of whether or not you are British or European but on whether you are contributing to the system.

Roseandharry, I thought about giving birth elsewhere (my husband's home country in the EU or even my own outside the EU), but it would be impossible with work commitments plus I am not entitled to the national health service elsewhere where I am not contributing to the system. I have been living here for years and haven't been paying in any other system hence this is the only system that allows me to access the national health service. Also, for reasons that are very complicated for this thread I am unable to travel to my home country for years now. So the only option would be somewhere in the EU, but with work commitments up until week 38 and having to go privately there anyway, I might as well pay privately here in the worst case.

Thanks again for all your replies, which have been really helpful as they confirmed what I found out in the last few days.

[Catsandkids78]

Many people get elective c sections on the NHS - let’s not pretend

[BlueBug45]

@Catsandkids78 no one is pretending that women don't get elective C-sections on the NHS. However some women have to fight harder than others to have one especially if it is their first child.

[Roseandharry]

@Catsandkids78 the issue isn't about getting nhs elcs - they are fairly common when a consultant has recommended they are the safest option for delivery, the issue is here whether a woman has a choice of delivery, funded by the NHS, regardless of any medical need.

[Catsandkids78]

Ultimately you have to say it’s a mental health need. I’m sure most people have done enough reading to know that .

[Catsandkids78]

Also in Leeds it is possible to see a private consultant who you then get to sign you for a C section on the NHS.

[Catsandkids78]

• I don’t live in Leeds but this was what my school friend recently did .
  
  It’s all such a farce , if you want a C section you should be able to have one . They argue on cost but it’s far cheaper than to have to fund post vaginal birth repairs and therapy for traumatic births .

[Ginger84]

I agree that in the end it is far cheaper to go the elcs route than to have to treat a woman for postnatal depression and mental health issues if she had to go down the VB route forced, especially that the difference between an elcs and a VB is around £1200 on the NHS. That said, I personally have a long family history of android pelvises, which have made it impossible for women in my family to give birth vaginally. My gynaecologist back home recommended a c-section and here they are making me fight for it. So I decided to weigh all the options I have, because honestly with my mother's experience that broke her for life (she never wanted to have kids again), I am determined to fight for what I personally believe will be best for me and my child. I even told the consultant that I am happy to "donate" the cost difference between both options to the NHS (of course they won't accept that, but I would gladly do it). Going all the way private though is expensive and they tend to exaggerate the costs. But if it is the only option, I will have to close my eyes and bite my lips and go for it...

[Catsandkids78]

Don’t bite your lip and go for it , push for the elective that you are entitled to and deserve .

I’d happily pay them the full cost for any elective I have - it’s the only way I’d give birth .

[Catsandkids78]

Sorry I misread your post - private is a great option if you can afford it . Something I will potentially be doing too if I can’t get NHS elective pushed through in a timeframe I’m happy with .

I’m not happy to get to 30+ weeks without having it signed off

[Ginger84]

Indeed! My MW who seemed quite supportive of my choice after realising how well I understand the risks and how determined I am for an elcs told me that they will make me fight for it past 30 weeks, but eventually if I am strong enough they will not force me into VB. I am also asking my consultant back home to send his recommendation. I personally believe it is my right to try to avoid potential risks given an ugly family history (in addition to my very strong feelings against forceps so there is an added psychological element to it). I would have loved to have a family that had happy birth stories, but up to my great grandmother children just got stuck in the birth canal and had to be surgically taken out. I for one got so stuck that I almost died and my mother ended up with a very dangerous c-section. If the costs of a c-section privately were a little less exaggerated and wouldn't have to go out of our house savings, I would have spared myself the headache and just gone privately, but I am giving it a good fight first

[Catsandkids78]

I just don’t think they understand the level of anxiety I would face getting to 30 weeks without it booked . I was told if I see a therapist pre conception and have a report written I can work with HCP to get this booked . I cannot enjoy being pregnant knowing that I’d have to go ahead and face 30 weeks of not knowing or stress.