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AIBU to feel private psychiatric fees in the UK are exploitative

38 replies

Shabbyaristocrat · Yesterday 12:37

Mental health care is in crisis in the UK. I have recently had a very bad experience. I have complex mental health needs relating to childhood trauma. I may also have neurodivergence.
The lack of care on the NHS is breathtaking. It is in fact dangerous. This is my experience.

I have recently inherited money. A substantial sum. I can now afford private psychiatric care. What I have discovered is that it is a two tier system and it disgusts me.

It disgusts me because of the extortionate fees these people are charging. Many of whom have exited the NHS to set up private practice. I understand that in many cases several years have been spent training. Yes, I get that.

However, to be in such a position to do so much good and seemingly charge individuals many thousands of pounds seems inhuman. For example, I recently approached a psychiatrist who says that she cannot tell me how much her charges will be based on my written information to her as she believes I will require multiple assessments at over £700 for 45 minutes. This makes me feel extremely vulnerable - where is the ceiling on this? A lot of the neurodivergence stuff can be done on-line via questionnaires. I need a psychiatrist to lead because I have for instance confirmed CPTSD in the mix.

People are dying especially around the age of menopause because they cannot access timely treatment. To say it is a bloody disgrace that us humans have got ourselves into this position is an understatement. To say that some are deserved of these types of assessments and possible support based on what someone can afford is disgusting. I despair at the state of the human race most of the time.

OP posts:
Meadowfinch · Yesterday 12:46

In 2009, I was "made redundant" first day back after maternity leave. They had given my job to the sales director's wife. I met with a partner at a well regarded (but not top 5) employment lawyer.

Similar academic requirements & training periods for law and medicine.

An hour with him cost me £1,000, so £700 for 45 mins seventeen years later does not surprise me.

Having said that, he was very good, did his job well, and forced my ex-employer to pay me a year's salary in compensation.

I guess if you have the money, and treatment will be of material and lasting benefit, it's hard to argue.

Icanthinkformyselfthanks · Yesterday 12:47

@Shabbyaristocrat , yours is the second post I’ve read within the space of a couple of minutes which details wildly unreasonable expectations of healthcare.
You’ve inherited some money so you have a choice to go privately, luck you. Either wait to see someone on the NHS that will be a long wait or pay the going rate to jump the queue. Highly qualified professionals don’t owe you anything.

FoxtrotPapa · Yesterday 12:50

Completely agree with you, the cost is extortionate. Charging £700 for an initial consultation is daylight robbery and just plain wrong morally. It’s to do with a person’s mental health and so it is wrong to make excessive money from that. They know people will pay it out of desperation.

Shabbyaristocrat · Yesterday 12:52

FoxtrotPapa · Yesterday 12:50

Completely agree with you, the cost is extortionate. Charging £700 for an initial consultation is daylight robbery and just plain wrong morally. It’s to do with a person’s mental health and so it is wrong to make excessive money from that. They know people will pay it out of desperation.

This exactly.

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Octavia64 · Yesterday 12:55

Standard for initial assessment including a report.

i have physical disabilities and assessments and reports on my physical disabilities (for the insurance company as they resulted from an accident) cost similar.

this isn’t an initial consultation fee.

Shabbyaristocrat · Yesterday 12:56

Octavia64 · Yesterday 12:55

Standard for initial assessment including a report.

i have physical disabilities and assessments and reports on my physical disabilities (for the insurance company as they resulted from an accident) cost similar.

this isn’t an initial consultation fee.

It was advised that one assessment would not be enough.

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Changeisstillpossible · Yesterday 12:57

Mental health is underfunded in England

"Currently mental ill-health costs England around £300bn a year and mental illness accounts for over 20% of the disease burden yet receives less than 9% of NHS expenditure."

Mental health at risk of missing out on funding after government changes - Centre for Mental Health https://share.google/TGtoJNDjlxf3hTPWj

Independent investigation of the NHS in England

Lord Darzi's report on the state of the National Health Service in England.

https://www.gov.uk/government/publications/independent-investigation-of-the-nhs-in-england

Shabbyaristocrat · Yesterday 12:57

Shabbyaristocrat · Yesterday 12:56

It was advised that one assessment would not be enough.

Then add on the cost of a potential ADHD assessment the cost of an Autism assessment. Many thousands of pounds.

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Meadowfinch · Yesterday 12:58

I don't know how old your psychiatrist is, but few graduate from medicine with student debt of less than £70k. Plus the interest on that, say another £40k.

Then the cost of setting up in practice - premises, computer sysrtems, admin & nursing employees, legal work, insurance. I suspect the cost of getting to that point will be £300k. Then a decent salary on top. Maybe £100k pa.

Our student doctors can no longer train for free, and and they have to cover their student loans by doing private work. Doctor's aren't charities.

Lolarose20 · Yesterday 12:59

I think people are massively out of touch of what healthcare costs, but also the costs for any business that charge by the hour.

I spent time in a different country and in general health care is loads of money.

Its similar to saying a baking company is exploitative because the cost of ingredients is x amounts.

The cost you would pay for a session is not just covering the psychiatrist wage but also the admin wage, the cleaners wages, the people above them in the food chain eg ceos and clinical supervisors that may never see a patient, the cost of hr support, all the mandatory training, registration fees, building rent etc.

This is often higher in private practice because there are less practitioners to spread the cost around.

I work 7.5 hrs a day and I see on most days about 3 patients (because of admin time, meeting times, dna's) however if you then averaged out my time off sick, my time off annual leave, days i have to take off for essential training it would be less. I dont work privately but if I did then I would also need to account for empty slots etc and each slot would need to pay for far over 33% of a days running cost.

I looked at working privately and was amazed at how much i would have to charge to draw a similar wage to the nhs wage. There are much more perks eg flexibility, smaller case load and less hours etc but all that is gained by having to increase costs of sessions

Isittimeformynapyet · Yesterday 13:06

"I understand that in many cases several years have been spent training."

This should be in all cases. I wouldn't be paying that for someone with less than 25 years on the job experience and ongoing training, which they have to do to stay registered I believe.

Dandeloosha · Yesterday 13:07

It’s odd that we attach a moral value to the cost of a psychiatrist or other medical professional, but not lawyers, vets, dentists, accountants, financial advisors, interior designers, architects, etc. many of whom can command similar fees, especially if the have years of qualifications and experience, or deal with high net worth individuals. We moan about their fees, but not that we shouldn’t have to pay it. They are providing a service and you are not obliged to use it. Are you sure you need a psychiatrist rather than a psychologist or counsellor?

Ghost84 · Yesterday 13:07

YANBU and frankly many are beyond lazy and are just walking encyclopaedias of drugs providing info you can get yourself off the internet. My vulnerable son was fleeced out of a huge sum of money from private mental health treatment. The whole industry needs to be regulated better as it’s just a license to make money. One private psych I went to for another child having paid an extortionate amount of money told me he was a psych not a therapist when I asked what type of therapy my child should have alongside the medication. I’d made it clear at triage that I wanted to know what was wrong and what course of action to take. I should have been told prior that I wouldn’t get that info from the appointment I was paying £££££ for.

Sesquioxides · Yesterday 13:08

YANBU OP but people in the UK think this is normal. I am in East Asia and for my child I just got a full developmental assessment from a well recommended doctor including multiple appointments, MRI to rule out brain issues, and culminating in an AuDHD diagnosis. £360 for the lot, and full access to all notes and diagnostic details. Doctors are not poor here, they are just not taking the piss either.

Octavia64 · Yesterday 13:08

You aren’t wrong but in many areas autism and adhd assessment lists for adults are closed so it’s pay or cope.

we paid for my dd. There’s ongoing costs aswell as nhs GPs largely won’t do shared care anymore so she sees a private psychiatrist every six months at 140 a time and the drugs are 70 a month.

no pay no get.

it’s the way it is now.

Doctordoolittle · Yesterday 13:15

Meadowfinch · Yesterday 12:58

I don't know how old your psychiatrist is, but few graduate from medicine with student debt of less than £70k. Plus the interest on that, say another £40k.

Then the cost of setting up in practice - premises, computer sysrtems, admin & nursing employees, legal work, insurance. I suspect the cost of getting to that point will be £300k. Then a decent salary on top. Maybe £100k pa.

Our student doctors can no longer train for free, and and they have to cover their student loans by doing private work. Doctor's aren't charities.

Edited

I agree with this.

Sadly with the NHS struggling the way it is this isn’t uncommon in multiple areas of healthcare including mental health.

Whilst it would be lovely as a doctor to be able to provide all services for free, it is not. In my opinion it’s no more morally wrong for a psychiatrist to charge the fees they are worth (and they will be paying a lot of hidden costs to even be allowed to come for work including very expensive indemnity insurance for private work, plus lots of tax) than a lawyer or banker or footballer or pop star.

Shabbyaristocrat · Yesterday 13:16

Ghost84 · Yesterday 13:07

YANBU and frankly many are beyond lazy and are just walking encyclopaedias of drugs providing info you can get yourself off the internet. My vulnerable son was fleeced out of a huge sum of money from private mental health treatment. The whole industry needs to be regulated better as it’s just a license to make money. One private psych I went to for another child having paid an extortionate amount of money told me he was a psych not a therapist when I asked what type of therapy my child should have alongside the medication. I’d made it clear at triage that I wanted to know what was wrong and what course of action to take. I should have been told prior that I wouldn’t get that info from the appointment I was paying £££££ for.

Edited

So sorry to hear of your experience. And this is what I fear.

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Shabbyaristocrat · Yesterday 13:20

Doctordoolittle · Yesterday 13:15

I agree with this.

Sadly with the NHS struggling the way it is this isn’t uncommon in multiple areas of healthcare including mental health.

Whilst it would be lovely as a doctor to be able to provide all services for free, it is not. In my opinion it’s no more morally wrong for a psychiatrist to charge the fees they are worth (and they will be paying a lot of hidden costs to even be allowed to come for work including very expensive indemnity insurance for private work, plus lots of tax) than a lawyer or banker or footballer or pop star.

I understand what you have said.

It is the whole system though isn't it. People have very sadly lost their lives because of it. And those within the NHS appear to not what to speak out about the state of things for obvious reasons.

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Shabbyaristocrat · Yesterday 13:22

Shabbyaristocrat · Yesterday 13:20

I understand what you have said.

It is the whole system though isn't it. People have very sadly lost their lives because of it. And those within the NHS appear to not what to speak out about the state of things for obvious reasons.

Access to the right treatment (in some but not in all cases) could literally be
life saving.

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Ghost84 · Yesterday 13:23

Doctordoolittle · Yesterday 13:15

I agree with this.

Sadly with the NHS struggling the way it is this isn’t uncommon in multiple areas of healthcare including mental health.

Whilst it would be lovely as a doctor to be able to provide all services for free, it is not. In my opinion it’s no more morally wrong for a psychiatrist to charge the fees they are worth (and they will be paying a lot of hidden costs to even be allowed to come for work including very expensive indemnity insurance for private work, plus lots of tax) than a lawyer or banker or footballer or pop star.

But psychiatrists are not worth the fees.

Shabbyaristocrat · Yesterday 13:24

Ghost84 · Yesterday 13:23

But psychiatrists are not worth the fees.

Ghost You are going to get blasted...but could you elaborate or at least pm me. I am feeling very nervous about approaching another one privately.

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Shabbyaristocrat · Yesterday 13:25

Shabbyaristocrat · Yesterday 13:24

Ghost You are going to get blasted...but could you elaborate or at least pm me. I am feeling very nervous about approaching another one privately.

Sorry Ghost, you posted above about your experiences. Thank you.

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Shabbyaristocrat · Yesterday 13:27

Shabbyaristocrat · Yesterday 13:25

Sorry Ghost, you posted above about your experiences. Thank you.

It feels like you have been robbed doesn't it. Sadly, I have had a similar experience.

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Doctordoolittle · Yesterday 13:45

Ghost84 · Yesterday 13:23

But psychiatrists are not worth the fees.

I agree some are definitely not! However if the OP feels it will be useful and needed, hopefully they can find one that is worth the money.

I speak as a doctor (not a psychiatrist!) who works for the NHS and also a patient haemorrhaging money on private mental health treatment as the NHS can’t provide it.

I agree it’s rubbish, but given the lack of alternatives I have to find the money.

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