NHS vs Private Care at Chelsea & Westminster

[Confused2011]

I'm pregnant for the first time and currently booked under Chelsea & Westminster Hospital's NHS team. We can easily afford to pay for private care in the Kensington Wing, but I'm unable to justify why we would want to do this.

My husband pays tax at 50%, so paying £10-13,000 for antenatal and birth/c-section fees translates to £20-26,000 of his annual salary. If we don't use the £10-13,000 for private care we could use it for several luxury holidays before/after the birth, pay for a year of day school fees, upgrade our car, etc...

Although I love the idea of being pampered in a private wing with polite staff and delicious food, I would much prefer to spend a few days on an NHS ward and use the money to go on a couple of luxury holidays at a different time!

Can anyone help me to think about this decision differently?

Confused xx

[misty0]

Hi, i didn't want to be the first to reply to this thread - as i couldn't decide if it made me cross or made me laugh.

Not sure if i can help you much - but i just wanted to say maybe it might be nice to give up your place on the NHS ward and feel you're doing something to help the massively under-funded NHS. With out getting into the rights and wrongs of taxation, you are very lucky to be able to choose between slumming it on the NHS and a luxury hoilday!!!

Sorry x

[Sparklies]

You could have an NHS delivery then pay for the Kensington Wing afterwards (think it's somewhere between £700-£900 a night, can't remember now). The only issue here is that you may not be guaranteed a room, but if you're flip-flopping over the idea anyway, you could just leave it up to the universe to decide on the day by virtue of available spaces!

If there was any aspect of antenatal care you were unhappy with, you can add onto your NHS care with private scans e.g. at the Fetal Medicine Centre. That's what we've been doing, although we sadly can't afford a private room post delivery (although I am booked into C&W for an NHS ELCS delivery!)

[YummyMummyBella]

Hi Confused, I have been on the kensington Wing twice (once for a miscarriage and another for a small operation) and I am thoroughly disappointed with both admissions, I asked to be transferred to the Cromwell Hospital. You still have the same moody, overworked staff as on the NHS wards, the food isn't much better neither are the rooms. I am currently on the NHS antenatal team at C&W and am extremely happy. If I were you I would not consider the Kensington Wing at all, complete waste of money. Have you considered the Portland Hospital? I was planning on having my care there however it is a slight drag to get to the Westend. Of course it is a personal choice but mine is don't waste your money there on the KW!

[YummyMummyBella]

Hi Confused, I have been on the kensington Wing twice (once for a miscarriage and another for a small operation) and I am thoroughly disappointed with both admissions, I asked to be transferred to the Cromwell Hospital. You still have the same moody, overworked staff as on the NHS wards, the food isn't much better neither are the rooms. I am currently on the NHS antenatal team at C&W and am extremely happy. If I were you I would not consider the Kensington Wing at all, complete waste of money. Have you considered the Portland Hospital? I was planning on having my care there however it is a slight drag to get to the Westend. Of course it is a personal choice but mine is don't waste your money there on the KW!

[breatheslowly]

I would check out the postnatal care - if as YummyMummyBella says - the KW doesn't have it's own dedicated team of MW and assistants then I don't think that there is much point. The bit of birth that my friends and I thought was worst (not at C&W) was the postnatal care. I am looking to go privately next time, but will want to be somewhere postively overstaffed to ensure that I can get the help I need when I request it, not an hour later or not at all.

[MrClaypole]

I had DS at C&W - NHS branch!

The delivery was absolutely fantastic, could not fault anything so I would not waste my money on private healthcare for that.

The ward afterwards was grim (like all London hospitals I'm sure!) and some of the staff were vile but you should - all things being OK- only be there for a night or so. I would consider paying for a private room though as all maternity wards are a bit noisy.

What I would spend money on is a maternity nurse or Doula to help me in those first few weeks when you don't know what you are doing, are knackered and the baby won't stop feeding/ crying/ waking up!

[lilly13]

Hi, I am booked at the Kensington Wing. I did give NHS a fair chance on all fronts and even went on a tour of facilities. This is my 1st pregnancy and I am in the 50% tax bracket as well... My 1st NHS appointment was not until 12 weeks, although I saw GP at 7 weeks. The whole process was sloppy. The midwife was young and rushed, and I was not impressed with her knowledge of medical conditions (I am highly educated myself and have certain medical issues)... I was assigned to a hospital team which later claimed they were not responsible for me and insisted that I go see another team at a different center 3 weekws later. No one took my bloods or urine at any stage (from 8 till 13 weeks). I did a 12 weeks scan there and no one made sure that my blood was taken at the same time. The equipement was old (not 4D like the private scan) and the sonographer was very rushed. I had some medical conditiions and was not given an appointment with a consultant until 18 weeks, although my 1st appintment with GP was at 7 weeks (too late if you have problems!) That was enough for me, and I proceeded with the private consultant! So far (I am 32 weeks) the private care has been fantastic. The consultant did extra tests immediately (not offered under NHS) and discovered certain other conditions that require additional monitoring throughout pregnancy. I have been having regular visits and scans, and if any issues, communicate with the consultant via email. I don't care about being pampared. What I do care is having a highly qualified medical professionals I can rely on when needed. Unfortunately, I do not feel I got that with NHS. I am not a Brit, and where I come from pregnant women are treated by doctors, rather than nurses. This is normal, and basic medical care is not a luxury unlike in the UK... In conclusion, if you have the means, I would recommend private care. Or you can go test this for yourself like I did...

[TRL]

I've had 4 with C & W (NHS), 3 in the labour ward and one at home with no less than 3 midwives (they all want to do homebirths as they're quite rare ...). I've had fantastic antenatal care every time - once I as diagnosed/operated on for cancer when 20 weeks pregnant there, so pretty dramatic, high risk stuff. I have NEVER had to wait more than 5 mins for a scan, midwives in antenatal dept often run a bit late but not much given how many variables there are in their day. Last time I was assigned to my local team of midwives who came to my home for 2 appts and I saw in their clinic (within 1/2 mile) for the other appts, all running to time. In the course of 4 babies I've met several consultants (only when problems have arisen, not as a matter of course), registrars, midwives, receptionists etc and they've all been helpful/done their job well without any 'fluffy perks'. I spent one night on the Kensington Wing because the antenatal ward was full, and the menu was substantially better but the care was no different at all.
Delivery-wise the NHS side is great. Top people, top equipment - I really can't see how it could get any better. Antenatal ward did have the normal London grim reputation and I hated the continual noise, hence I had the last one at home - apparently there's been big investment in more midwives and so on there but I can't speak from experience.
It's normal not to have your first midwife's appt until 12 weeks at C & W - try to organise your scan for just before so you only have to go in once. The first appt takes about 1 hour, thereafter if everything's OK it'll be much quicker. They'll do scans at 12/13 weeks and 20 weeks as part of the NHS care. They test yr blood regularly and offer you a gestational diabetes test as standard at about 26 weeks.
Some people from overseas are used to a very different system to the NHS and prefer the more medically managed private healthcare in the UK. Myself, I'm more of a hands off girl. C & W NHS is pretty good at being the middle line - hands off if everything's normal and brilliant medical aid if there's a need.

[MrClaypole]

I should have saidin my previous post that the ante-natal care at C&W was great. A few waits to see midwives but nothing too bad.

Unlike Lilly, I found that tests and scans were all done on time and well. All the issues picked up (gestational diabetes, enormous baby, low lying placenta) were followed up and dealt with. Infact I felt at times they were being too careful and got sick of all the appointments! But glad in hindsight that they were keeping a good eye on me.

Agree with TRL, it's normal in London to have first scan at 12 wks although if there are concerns your Dr can refer you earlier (I had a scan at 10 wks with my 2nd PG as was spotting).

Also agree with TRL that the NHS tends to be midwife led and hands off unless here are some risks to you or your baby. My American friends have been horrified by this as they are used to seing their "ob-gyn" for a check up every few weeks and cannot get their heads round the fact that births in the UK tend not to be as "medicalised" as in the USA.

[bemybebe]

I cannot help you choosing between C&W or K Wing as I know nothing about those, but my gut reaction would be to stay off NHS if you can afford it because it is so unpredictable in its performance on the day. I would also go to Portland, in fact I am still pondering it (I have time, I am only 13+ weeks). I have lots of friends and they were over the moon about care and medical attention they received there. My only concern is their ethos of medicalizing the birth but if this is what you are seeking, it may be a place for you. i am also thinking about homebirth, but nervous as it is my first and i may end up going to one of the local hospitals as emergency case anyway. wish it was easier.

[kitstwins]

Confused I'm not sure how you want to look at it differently. You say you'd like to be pampered on the Ken Wing side but equally would rather spend a couple of days NHS postnatal and spend the saved money on a holiday instead.

Only you can know what is a better use of your money. You might have a very straightforward, quick delivery and not need to spend much time on the postnatal ward, in which case the Kensington Wing would possibly not present huge value for money. However, if you had a complicated birth or caesarean delivery and required a postnatal stay of 3 to 5 days (as can sometimes be the case) then things might not be so clear cut. Personally, I'm forgoing my holiday this year and am going down the private route at C&W but for reasons more complicated that just issues with the postnatal care (I want continuity of care from my 'own' consultant following a difficult delivery last time). We're also 50% tax bracket but I'm not sure of the relevance of this in terms of grossing the final bill. If you pay a lower tax band you're still having to find more money gross for your private care and surely it's all relative whatever you earn. On a plus, my experience with private care to date (am a couple of weeks away from my due date) has been great. Fantastic care and the Kensington Wing has its own labour rooms and postnatal rooms and dedicated midwives. I've also had a couple of night's stay there in the last month or so due to minor complications and the food was good and the care excellent - very friendly, polite midwives and people couldn't do enough for you. I've experienced NHS antenatal and postnatal care also during my previous pregnancy,albeit at a different hospital, so I have a point of comparison.

One option, as someone mentioned, is to have NHS care and then transfer to the Kensington Wing for the postnatal period. It costs £850 per night following vaginal delivery and £950 a night following caesarean delivery. You aren't guaranteed a room - these are obviously guaranteed to patients with full private care - and if it's full you'll have to stay on the NHS postnatal ward, but if you're not that bothered about it then it seems a good compromise.

I'm not sure if that helps. Personally if you decide to go down the NHS route I wouldn't book a holiday with the money you save - personally I'd spend some of it on a doula and maternity nurse.

Good luck with your decision.

[sh77]

Delivered at the C&W NHS wing last week. My ante-natal care was equivalent (if not better) to what I would have received privately. I did consider private care but as my preg. was high risk, I was monitored super-closely by Mark Johnson (who I wanted privately) and the excellent high-risk team. The care was faultless. Mark oversaw every detail of my ELCS and visited me before discharge and is following me up in 2 weeks. However, I am sure low-risk pregnancies would not have received this level of care.

The post-natal ward experience was not as bad as I anticipated - ok, so it was not luxurious but there was continuity of care, friendly and knowledgeable midwives (I didn't come across a single rude one), baby was closely observed and seen promptly by the neonatologist . Again, the quality of care was excellent . I spoke to other mothers in my bay, who were also happy.

[Sparklies]

Sorry for thread hijack but sh77 Congratulations on your baby!! I didn't realise you were at C&W.

Relieved to hear the postnatal ward wasn't too bad - that's my biggest fear!

[sh77]

Thanks sparklies - my biggest fear also. I tried to get a side room but glad I didn't as I don't think we would have had as many checks. MWs were very good at helping to change baby, showing me how to BF, bringing water, changing bedding. They actively encouraged me to call them if I needed any help. I think I was lucky as my bay wasn't too loud with screaming babies at night. Do inform the midwives of any concerns as I am sure they will keep a close eye on you. If you are planning to BF, the support is excellent - in addition to the MWs, there are volunteers on hand to advise.

[Sparklies]

Thank you for sharing your experience sh77! I am aiming to get a side room too, but I see your point. I don't mind a shared bay if everyone does their best to be considerate - it's not the screaming babies that bother me as you can't avoid those and I have sympathy, it's the midnight phonecalls and tinny headphones and fifty visitors per patient that do it for me!

Definitely planning on BFing - still BFing DC2 who is two! I'm very glad there is support as although it's my third, it's amazing what you forget when it comes to newborns and every baby is different.

I had a great experience (well, in so far as these things go!) on the gynae ward in November so it's reassuring to hear your experience doesn't sound too much different in terms of care to that one. In other words, miles away from my awful experiences elsewhere!

How many nights were you in?

[Snowfalls108]

Hi there.
I had DS on the NHS and am due with DT's in 6 weeks time on the Kensington Wing.
Purely doing it for the aftercare and guarantee of own room. Sparklies - not sure how you're planning on aiming for a side room. They give them to parents of multiples or those where there has been a problem and they need to stay in longer.

[Snowfalls108]

Hi there.
I had DS on the NHS and am due with DT's in 6 weeks time on the Kensington Wing.
Purely doing it for the aftercare and guarantee of own room. Sparklies - not sure how you're planning on aiming for a side room. They give them to parents of multiples or those where there has been a problem and they need to stay in longer.

[Sparklies]

I'm having a c-section so I'll likely be in for a while (plus a very high risk of PTL so baby may be in longer than usual). I'm certainly not expecting to get a side room and I know I probably won't but figure there is no harm in asking.

[NatzCNL]

Hello, not really talking from a parents point of view, but I used to work at C&W managing the hearing screening team, and also covering the private wing. Just wanted to say that every mother I spoke to gave wonderful feedback with regards to the Antenatal care and the care they recieved on the labour ward. My old manager had all 2 of her children there and could only find one fault on the NHS postnatal wing (she also got a couple of nights on the private wing) and that was the lack of midwives during the night. Unfortunately this is the same in any NHS hospital.
There are side rooms available on Josephine Barnes ward, or there were when I worked there, which you can pay a small fee to go into after delivery - provided thay are available, and there is also the birthing unit on Josephine Barnes which is for uncomplicated pregnancies. All of this I am sure you are aware of already.
As for the side rooms on the Postnatal ward, yes these are usually utilised by multiple births or complications, but not always. Have had many mums in there that have had straightforward deliveries but given the option of the side room if one is available. Usually C-section mums.
I left there in 2006 to have my 1st daughter so things may have changed slightly since then.
There was a health care assistant who worked there called Kaye, an Irish lady, who was wonderful at keeping visitors and any noise disruption to a minimum. And the midwives were quite strict with regards to the number of visitors allowed in to the ward per patient. I was horrified when I had my daughter in Kent to find that the midwives allowed my bed neighbour to have 11 visitors in at one time and past the visiting times too.
I worked with both the NHS midwives and the Private wing midwives as well as on the NICU unit, and as I say this was 5 years ago now since I left, the staff were wonderful. I recal so very few complaints from patients over the 6 years that I worked there.
Good luck with your choice. And Sparklies, most of my girls still work there on the Hearing Screening Team, the Senior screener, Sarah is lovely as is our longest serving member of staff Maureen, so I hope one of them get to do your babys hearing screen!
Sh77 - I hope one of the girls came to see you before you left!

[NatzCNL]

Sorry, should have said my old manager had all 3 of her children there, not 2!

[sh77]

sparklies I agree - no harm in asking about a side room! I did ask but some were being refurbished and others were given to cardiac patients. I was in first thing on Wednesday and out by Friday evening.

Natz Kaye is still there. Quite a character. Baby was screened for hearing very quickly.

[Sparklies]

Natz - Thanks for sharing - that's very reassuring and about what I hoped for! I shall keep an eye open for your ex colleagues :)

sh77 - Ah good, no three night stay then - that's not so bad! Obviously that's assuming all goes to plan of course.

[Confused2011]

Thanks to everyone for your advice. Lilly, Sh77, Sparklies and Kitstwins I?ve read your comments on previous threads too.

I?m still not sure what to do. I might stay with the NHS until 16 weeks and make a decision then.

Like Lilly, I have another medical issue which impacts on pregnancy, causing brain damage if not adequately under control by Week 12, and I?ve been horrified how difficult it has been to arrange for it to be managed on the NHS so far. The C&W midwife I discussed it with when I was 5 weeks said she felt my GP was competent to manage it throughout pregnancy. Even though I?ve had a similar problem previously, the GP?s suggestion was to repeat the blood test in case it was an error. This didn?t exactly inspire confidence. At the suggestion of a gynaecologist I know I called the consultants? secretaries three times to ask if I could be seen in C&W?s joint obstetric/endocrine clinic, but my call still hasn?t been returned four weeks later. Luckily it?s one thing that IS covered by DH?s health insurance policy, so in the end I?ve taken matters into my own hands and I?m seeing a specialist privately for this one issue. I?m definitely intending to make a formal complaint to the chief executive at C&W though, as it?s a serious problem with their system, which will continue to affect others in the future.

I also completely see Lilly?s point about our expectations in the UK for the standard of healthcare. Although pregnancy is ?not an illness?, complications frequently arise and we do need to be screened adequately for these. A close friend is a midwife, and I have every confidence that midwives are perfectly competent at screening us according to their hospitals? protocols. On the other hand, I also think that where a medical issue arises or we have genuine medical concerns they should not stand in the way of us being seen by doctors if we wish to.

Kitstwins, re the tax bracket, if we paid tax at 20% then £10,000 would represent £12,500 of our gross salary. If we pay tax at 50% £10,000 represents £20,000 of our gross salary. Of course, as you say, someone in the 50% tax bracket would be expected to have more disposable income, but things are not always that straightforward, particularly if their partner is not working or there are other pre-existing commitments.

Misty, I see your point of view and have often heard people suggest that those who can afford private healthcare/school fees should volunteer to take themselves out of the state system to free up resources for others. On the other hand, my husband and I have paid astronomical taxes over the last 20 years and, like everyone else in the country, we have a right to free NHS care. In order to improve NHS resources, rather than singlehandedly opting out of NHS maternity care, which actually wouldn't save the NHS any money, as they would still employ the same number of midwives, doctors, cleaners, etc, throughout my pregnancy, I might be tempted to take the opportunity to lobby the government for more funding for the NHS. Perhaps I?ll start by voting "YES" in the Alternative Vote Referendum on 5th May ? I live in a safe parliamentary seat so my general election vote currently has no influence whatsoever and perhaps the AV would give me at least a small say in our political system!

PS if anyone objects to me going on a luxury holiday, don?t worry, if we go down the NHS route we?ll be spending a week in Cornwall and put the rest towards our mortgage - or perhaps a doula and maternity nurse - good suggestion Mr Claypole and Kitstwins?!

[lilly13]

Hi Confused, may I suggest that you book a private consultant until you have made up your mind (you can still stick with NHS until 20 weeks, or the time when the private wing/consultant deposit is due). The reason why I sugggest this is that poupular/most experienced consultants get booked up very quickly. My rationale has been that if I were to spend GBP10k+ on a private birth, I must get one of the best consultants... For example, Sh77 had Mark Johnson at NHS and spoke very highly of him. I wanted him privately as there was a different less experienced consultant assigned to my postal code under NHS, but when I called Mark's secretary at 2-3 weeks since conception (beginning of September 2010 and he was fully booked through the end of May 2011!!) which means some people booked him at the time of ovulation or 1 week after conception... A similar situation was with a couple of other doctors. Please feel free to PM me if you need any advice re private consultants. Good luck!

[naughtymummy]

I realy would nt waste the money, having worked in both the nhs and private wards in C&W . Why on earth would you want consultant led care unless there was a complication ? Surely you are more likely to end up with a medicalised birth ? You could end up paying 10K for a 6 hour hospital stay I would have