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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:
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?

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.

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

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.

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.

OP posts:
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 12:56

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.

OP posts:
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 12:52

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.

OP posts:
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.

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.

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.

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