Cost of private CS in London

[time2deal]

Hi,

I had a very disappointing meeting with NHS consultants today which has made me very nervous about sticking with them for a (medically necessary) c-section later in the year. So I was wondering if I could ask for peoples experience of what it costs to go private in London.

The clinic seems ok for the monitoring and ante-natal care, so I'll stick with them for that, but the quite junior consultant I saw today was clueless about my issues (arising from cervical cancer treatment) and I realised I wanted a more experienced person holding the scalpel!

I do have private health insurance so the cost of private room and I think the hospital fee for surgery is covered, but they only provide £650 or so towards the consultant fees. Also the baby isn't covered at all, other than for a review by a pediatrician soon after birth. I guess that means it would be NHS for all baby care, including NICU if necessary.

Can anyone give some experience on the overall costs? And any experience of how things work if you mix NHS and private care.

Thanks!

[rockstars12]

It depends what funds you have available. For c section you are looking at £10,000 upwards in london for private. You need to check with you health insurance what they will actually cover. I checked out Watford knutsford maternity suite as an alternative to the really central london extreme prices. It's attached to an nhs hospital and you can choose your consultant. I have only done research on this rather than actually experienced it.

[time2deal]

Do you know how much of that is consultants fees? I believe (although will check) that everything other than consultant fees are covered by my insurance is it isn't a elective C-Section, but they have a fixed consultant fee level.

[rockstars12]

For the knutsford specifically the cheapest is £3000 and there's a husband wife birth team that are £4000. They were the only ones advertised online. That was a flat rate including cs or normal birth. The private section of hospital then charges a nightly rate of around £400, partner can stay overnight at a cost of £160 a night which includes food.Then you have anaesthetist fees and baby check up. You'd be looking all in £6000 ish.
In central consultant can start at £5000. The private section of st Thomas' is £900 a night. Uclh also has a private ward. It's a case of looking up the private hospitals and seeing what packages they offer. Consultant led is always much higher. You want it to be attached to an nhs hospital in case there are issues, in which case you could be transferred easily, you don't want escalating costs.

[minipie]

St Thomas's charges around 10k I think, of which about half is hospital fees and half is consultant fees. Anaesthetist might be extra.

[time2deal]

I'm at Queen Charlottes, and would like to stay there if possible. I guess I just need to find out exactly what health insurance covers. If consultant fees are £5k, then it seems crazy that the insurance maximum is £650! I wonder is there a single obstetrician in the country who would actually agree to those fees on a private basis.

[rockstars12]

You'll need to argue with the insurance companies over that. They'll do anything to get out of paying. Most people are relatively ok with nhs care during pregnancy but afterwards on the wards is where they are let down, which is why knutsford appealed, you can transfer to private for the better room which you'll want after a cs. I'm planning to have private scans at the fetal medicine centre Harley street.

[minipie]

Why not go back to your GP and see if they can refer you to a better consultant?

[minipie]

under the NHS I mean

[BigRedApple]

You can do delivery only option at Watford. So all antenatal care is NHS with your local hospital and you just deliver there. I was going to do that and I think it was going to be about $6000 I think (5 years ago).
In the end I had an emergency c section and my private insurance covered most of it.

Check www.thebirthteam.com
Sorry can't do link.

Alternatively, go back to the NHS and ask for a second option from a more sympathetic consultant.

Good luck

[time2deal]

Thanks all. I think I was just overreacting a little bit and feeling generally very worried. The clinic is overseen by an excellent consultant, and its early days so over time I may see other consultants. There is no way that kid would be doing sections unsupervised anyway!

£10k is out of the question but I am certain insurance will pay for at least the hospital costs, they have already agreed as they know my medical history well. I've had my cervix removed (cancer), so no question I need a section.

[StarsInTheNightSky]

I looked into having a private c-section after a horrendous first meeting with the NHS consultant I was assigned, DH and I had the money set aside (we have most things done privately due to horrendous experiences with the NHS previously), but I really liked our hospital's maternity unit in general, so I asked to be transferred to another consultant.
Our new consultant is much more senior and is absolutely amazing, very experienced and extremely thorough and caring. After seeing him, I couldn't imagine any one else overseeing our baby's birth, I trusted him from the start and I don't trust easily as we've had some very bad experiences with hospital neglect and negligence (we have since switched hospitals).

I would second what others have said and ask for a different NHS consultant, my experiences have been worlds apart. Also, I spoke to the supervisor of midwives at our hospital and explained my worries about the consultant to her, and she gave me some suggestions on which consultant to ask to be transferred to, it was really useful having the extra information about the consultants, their experience, their specialities, strength, bias etc, so it might be worth chatting to a SoM at your hospital.

[time2deal]

I didn't realise I could ask for a change in consultants. I'm not back at the ante-natal clinic for a while, so I will see what happens next time. Thanks for the help.

[Getmetothebeach]

Following this thread with interest. time2deal - who is your insurer out of interest? Highly likely i'm going to need a C section (preg with twins - bit of a shock to say the least). I'm with Pru Health who say ' we may cover a C section (inc consultant, hospital fees, anaesthatist) if medically necessary'.

I'm sure you can get a different consultant on the NHS. Aren't Prof Bennett and Mr McArthy at Queen Charlotte's and meant to be excellent?

Call the Queen Charlotte's private maternity on 0203 3313 3925/1466
I did yesterday and was given prices based on when i transferred (latest being 36 weeks). Hospital fees were c.5,200 (includes 2 nights in Sir Stanley Clayton) and consultant 4800.

[MrsM2013]

Did you actually see the consultant or one of his/her team?
It's not unusual for relatively junior docs (who may assist in your caesarean but would not be doing it unsupervised) to see patients in clinic and they may not get a full grasp of the issues, particularly if you are a complex case.
I would give them another try, but make sure you see the consultant or a senior registrar next time. Might save you a few thousand.

[SpringBreak]

I had private in an NHS hospital, covered by insurance. Same consultant did the op, but I got choice of anaesthetist and no students / trainees hovering around all over the place. You can absolutely request a change of consultant. if you stay NHS your issue may be that you're an "interesting" case and they want to show you to the students if it's a teaching hospital (my idea of HELL)

[time2deal]

Maybe I just saw one of the junior docs.

It is referred to as Prof Bennetts clinic so I may be transferred to him later. As I said I think I just freaked out! My insurer is Norwich Union Health (Aviva) and they have been great with my cancer treatment and understand why I need to C-section. They even tried to bend the rules to see if they could provide full private ante-natal cover, but my case doesn't fit into one of the pre-defined complications. Getmetothebeach, those prices are really helpful.

I am an 'interesting' case I think. The doctors are always telling me there are very few women post-cervical cancer who get pregnant, I think in the low 1000's worldwide over the last 15 years. I'm not too worried about students, over the last few years roughly, oh I'd say, one million people have had a poke or a prod or a look!

Cervical cancer + IVFx3 + Pregnancy = zero dignity!

[Inglori0us]

Portland and Lindo have a breakdown of costs on their websites (it they did when I looked last year).

[Ferreroroche123]

Yes McCarthy is at Queen Charlottes and I am looking at having him deliver my baby there privately due to previous band experience at my local hospital.

Fee for a c-section at private wing of Queen Charlottes is about £5250 (hospital fees) which includes c.2 nights stay.

McCarthy charges £7000 for any type of delivery if you transfer all your care to him before 32 weeks. It then drops on a sliding scale from that point on, to the £4800 I think Getmetothebeach mentioned.

I have had two consultations with him now as my ivf consultant recommended him to me, and he is a very experienced, polite man.

I assume he still does nhs obstetrics at Queens Charlottes, and it is meant to have some excellent consultants, so perhaps you could begin by asking to transfer to an alternative more senior consultant under nhs care.

Once you transfer to private, everything becomes private in your care, you can't mix and match. Nhs will transfer you as a fee paying patient.

But your baby will remain an nhs patient because he/she is a separate being in their own right and is immediately entitled to nhs care in NICU if required. The only exception would be if you went to the Portland which is fully private. I think then you would have to pY for your baby's treatment until they were transferred to nhs.

This was important in my decision making, because of the risk I have of prematurity.

[RedToothBrush]

Some London hospitals are being quite tight on the reasons for allowing an ELCS at present due to politics being more important than patient care. Many hospitals are putting midwives and consultants under extreme pressure to reduce the number and unfortunately that is translating into patients being second best regardless of your medical history.

HOWEVER, having said that, if you have a good case for wanting/needing an ELCS on medical ground which it sounds like you do, then it does make it very difficult for them to refuse ultimately. It can just be a messy, unclear and slightly laboured process in getting to that point. They just want to make it appear that ELCS are not being dished out to a certain extent.

As it stands the NICE guidelines on CS are in your favour in that they support women who feel they want (never mind need) an ELCS. They are a useful thing to know and be able to back you up even though you have a very strong medical case here.

It may mean that you need to stand your ground and be forceful about it - changing consultants if you don't like the attitude of your current one is a good start. A good experienced consultant is far more likely to understand your concerns and needs (and to be blunt about it be more willing and able to justify to their superiors why you are having an ELCS).

I've seen a lot of threads of a similar nature, and it seems that there is an almost institutionalised trend to try and initially put women off an ELCS, often without proper regard for the circumstances. The good news is that being persistent about it and making your concerns clear does eventually led to you being taken seriously within the NHS.

So sticking with the NHS may not be as bad as you fear if you are happy to be assertive if necessary. You may not need to be though. As others have said, it could well just be a difficult/inexperienced consultant.

In terms of going private, I think the prices people have put on this thread are around the right mark, however have a good look into it as the prices quoted can be a little misleading and not include certain things which you don't initially realise (basically read the small print). I'd also try and make a decision quickly if you are considering going private as my understanding is that they can get booked up if you leave the decision too long as there is such a demand in London at present.

As for students. I'm at a teaching hospital elsewhere in the country. I have it on my notes NO STUDENTS. They asked at my booking in whether I was happy or not with them (in part because I suffer from anxiety) and were completely fine with this. They can only allow you to be a subject for students if you consent to it - just make your wishes clear.

Being honest, my attitude here really is that, if you have a need for an ELCS why should you pay for that? Why should the NHS make you feel like you have to go private? And under those circumstances, unless you would feel happier with the extra facilities that private might offer, and you are comfortable otherwise with your NHS care to stick with it. You are within your Rights to expect the most appropriate care for your circumstances under the NHS and if you have a consultant that you feel isn't looking at your medical history properly, you are in no way being demanding or difficult in asking for a second opinion. Its a question of competence and responsibly as much as anything, and unless they are held accountable for poor care then it doesn't improve for you or anyone else.

[MrsM2013]

If you are in Prof Bennetts clinic sounds to me like you are under his care but saw one of his team. Generally you know if you see a professor (they seem to have an air about them and generally are older more experienced).
I would get in contact with his secretary if you have unanswered questions or feel a bit 'mah' about the whole thing, might be able to get into clinic to see the man himself.
Bit disheartening to see some attitudes to trainees on here- don't forget these are the people who will be repairing your pelvic floors and doing your hysterectomies a few years down the line.....

[RedToothBrush]

MrsM I was ADVISED that 'no students' might be wise given my circumstances.

Sorry but I don't particularly like the emotional blackmail attitude that you just used. Everyone is different. Some people will be fine with it; for others it will cause extra stress.

Better that people are able to decide for themselves without being lectured about how they are bad people for making a decision that is appropriate for them. No one should feel obliged that they should have to deal with students if that is going to worry them or upset them in anyway.

[time2deal]

Next time I go I will definitely ask for another consultant if I don't get more progress. But hopefully over time as the Prof's team become more aware of my case they I will move 'up the chain' a bit.

As I said, I'm fine with students, although I think it freaks hubbie out a little. I notice he keeps his distance from the business end when I have internal scans.

There is no question about getting a C-section. I can't physically give birth, I simply don't have the right anatomy anymore, so I don't think that will be an issue. It's just being confident that the doctor understands what operations I have had, and what needs to be done. I would like to have another child, and this one has to be done right to give me another chance. My doctors are always far too keen to suggest a hysterectomy!

[StarsInTheNightSky]

MrsM I also have "no students" in my notes, your comments came across as pretty judgemental, you have absolutely no idea the reasons behind why somebody doesn't want trainees attending them.
For me it's because I'm a survivor of sexual abuse, I struggle coping with routine gynae stuff anyway, I've never had a smear test as I can't cope with it, added to this I have severe birth trauma from the loss of our son less than a year ago, and the raft of issues that came with that which I won't go into here. Having more people than necessary involved with my care, or in the room would be extremely stressful for me, and I'm not prepared to put myself through that. We all have to do what is right by ourselves.

[MrsM2013]

Toothbrush I'm not trying to emotionally blackmail you- of course you are entitled to refuse students if you so wish for whatever reason. It's more the feeling that they get in the way and are generally annoying that I find disheartening. I feel sorry for them looking like a spare wheel sat in the corner!

[3littlefrogs]

If I were you I would speak to the supervisor of midwives (as previously suggested). There is no question that you need a CS, so there should be no problem.

Save your money for a maternity nurse to help you after you deliver, so that you can be discharged as early as possible.