Do you think surgeons put more effort in with their private patients than NHS?

[EachandEveryone]

Im not going into too much detail or it will be too outing. Last year I underwent a massive gynae surgery. Took longer than expected and there were complications. The gynae team where ob top of it. And ten days in hospital I saw them every day. Even had his email if I had any further questions. The pain was dealt with before it even happened.

This time around it shouldve been straightforward. They acted like it was. The discharge summary was printed before I had the op. The consultant never said two words to me before or after. My pain was horrific so much so that i was on fentantyl most of the night and they still wanted to send me home there and the but I stood my ground. They never once looked under the dressing until I asked them to just saw I could eyeball it myself. I know its early days but it looked terrible Incant find my belly button 😧 if id have paid to see the surgeon would I have at least met him?

Obviously you meet the surgeon if you're a private patient and you get a longer initial consultation and will be visited by him afterwards. You also get a private room. Your actual treatment however will be the same.

We’re both these ops on the NHS?

That sounds awful

DH has recently been very ill and had two surgeries and two admissions. Both surgeons also work privately in a different part of the hospital and he was an NHS patient. The care the first week was shocking, the nurses were great but he didn’t see the consultant till the penultimate day and only after I made some calls and went ballistic. The guy was eventually apologetic and said he’d been busy. I’m sure he was but he was prescribing my already very sick husband with third line antibiotics which made him much worse and never bothered to even fucking look at him. I was bouncing off the walls livid.

It might have been because of that that when he went back a week later he was under a different team and everything was transformed, despite being on the same ward. New consultant was on rounds every day, answered questions, took the time to explain, delightful. The difference was genuinely shocking.

He was also moved to the private hospital bit during his second stay as it was empty and the ward was full and while the consultant stayed the same every single other thing was different and amazing. I was relieved as he finally slept, had some privacy, ate half decent food, was given water regularly, didn’t have to struggle miles for a bathroom or have to try to clean the loo before using it. But I was also raging about the injustice of it all.

I think consultants and surgeons vary hugely and that’s not specific to private vs nhs but private care is a whole different ballgame in terms of actual care and it’s been sobering.

Both NHS both work privately as well. The second experience as whole was worse. Nurses giving me pain relief never ever on time and not putting the water near me. I dont know why we cant control our own pain relief really. Having to stay in a packed booking in room for 6 hours nbm. If i hadnt have caught the eye of the anaesthetist who’d seen me before and insisted I went to M and S for a coffee I dont know what I wouldve done. You see I feel sorry for those not in the business because we should all be treated the same.

Lots of surgeons do NHS work in private hospitals now, the NHS contract work out to get waiting lists down. When I had gynae problems, I could have been referred to see my gynaecologist at an NHS hospital but it was a minimum of 3 months waiting list just to get an initial appointment, without the wait if Ineeded surgery, my marriage had ended a few months before & I was a single parent & couldn't afford to be in pain & unable to work for too long. By going choose & book I had my initial consultation within 2 weeks, my first laparoscopy within a month & an operative one to remove a cyst & endometriosis within three weeks after the first one. It also meant that I knew exactly when everything was happening, no cancelled operations because there wasn't a bed & was able to arrange childcare. The hospital I used does over 50% of its theatre & consultation time for the NHS, as well as gynae work they do general surgery, orthopaedic ops for joint replacements & other bone related complaints. Now if ever I need to see a consultant for anything, I always check first to see if they have a contract at the private hospital, after spending several hours in an NHS hospital last weekend, from what I saw the NHS standards are falling, care is nowhere near as good as it should be & I can see that the whole service is on it's knees. Contracting out bread & butter work to private hospitals is the only way to keep the service going. If i had had my ops in an NHS hospital, i would have been in at least overnight each time which would have cost money, but by going to the private hospital, having my op in an evening, I was home & done within 4 hours each time, they seem to be more efficient & organised, things like drugs & dressings for after discharge are all sorted before you go to theatre, pain relief is written up & waiting when you come out of theatre, obs are done on time, if you need pain relief, it is given straight away, when you are discharged, there is no waiting all day to be discharged, as soon as they can see you are fit enough to go home, you get your drugs etc & you can go, I don't mean that they push you out, I had the option to stay overnight but I was fit enough to go home.

So are you asking about surgeons, or about all the care that surrounds it ?
Obviously, by paying privately you are paying for private room, more nursing care, less mass produced food, and more 'time' for each patient, so you don't all have to rock up at 7.30am and sit about waiting all day etc etc. It is about your 'comforts'.

However, if you are asking about the care and skill the surgeon puts in to the operations (which it would appear from your title), then there is no difference.

Private hospitals will provide a better ‘experience’ but it easier to provide a more polished experience when you’re funded properly and you can cherry pick the easy work. Anything non standard or expensive gets dumped back to the NHS hospitals to cope with.

Yes but what about bedside manner? Its not too much to ask for him to explain what hes going to be doing , is it?

No, it’s not. But DH experience was that the care from consultants varied massively even when all other variables were the same - hospital, ward, nurses etc. Some are great, some aren’t.

It was also all very well the first chump finally bothering to show up after my outburst but what about the other patients who didn’t have angry vocal wives willing to jump up and down? A lot about the system sucks.

I’ve only had one op on bupa. Was meant to be day case but struggled to come round from GA so they kept me in as i couldnt speak or sit up.

Was kicked out at 9am the following day even though I felt awful with very little advice. Was in agony by the evening so rang the private hospital for advice and they said nothing to do with them, such a level of aftercare wasn’t included in the price and I was to ring OOH or go to a&e.

I’m now a midwife and knowing what I know now I also believe the op was totally unnecessary and probably done to get some cash out of bupa. I had heavy bleeding and pain since having a coil fitted. They never took the coil out (until during the op) but did a laparoscopy to have a look round. Why they didn’t just remove the coil to see if that helped first I have no idea!

Whenever I, my dh, m dparents, or any of my dc have had any form of surgery, then the surgeon has explained everything beforehand, to us. So I'd say yes, from that pov it has been the same.
I'm sorry if somehow this didn't happen for you, but typically it does.

Surgeons working in an NHS environment also have to deal with emergencies which in a private environment they don't so have more allocated time.

Private surgery is only done on healthy patients because there is no A&E / trauma centre on site to deal with emergencies.

No one is going to look under a dressing that looks fine just for the sake of it post op as it will make the surgical site more prone to infection.

The surgeons won't always see you post op in the NHS because they are quite literally busy saving peoples lives, that's what they do.

They will monitor your situation behind closed doors as it were, they won't have forgotten about you. If they do come out and see you it's not a good thing it means there's something they're concerned about.

Post op the nurses are more than capable of looking after you and contacting the consultant or surgeon if necessary.

Obvs if they have the time then they will if they can come and see you.

My exposed tibia and plastic surgery was NHS, and it was great. My tib pos repair was Choose and Book, and it was also great. The only difference was under C&B the NHS patients got tea and toast while the private patients got a full English. I got my own back by bringing in the Guardian.

I have found the opposite. My first surgery last year, I met with the surgeon in two previous appointments and given lots of really good interim care until surgery. Before surgery, I met the team who would be operating on me.
It was very complicated and ran over by around 3 hours.
Afterwards, either the main surgeon or someone else looked in on me, sometimes more than once a day. Pain relief was always available at the switch of the button to call the nurses.

At some point, I was referred to private. And never, ever again. From the moment I was wheeled through the doors the service dropped big time. It was a horrific experience that ended up with me back under pysch care. Friends thought I was exaggerating and convinced me to go back with one of them. The second complaint was submitted. They since contacted me for a third needed operation, I'm taking my chances with the nhs waiting list knowing there's a very high probability I will end up in intensive care beforehand. I'd asked them several times for clarification about the surgery and to double check as each time they got it wrong. The last time I asked was about 6 weeks ago and I am still waiting for them to tell me the correct surgery. They want to remove something that needs replacing, and removal will have me admitted seriously ill within 24 hours.

And the food 🤣 I complain about the nhs food, but my god compared to that shite it was a 5-star restaurant. And at least when I was under nhs, I had choices other than cheese-loaded or spicy. Even getting some water was crazy which was needed as I dehydrate extremely quick. They should have run 2 units of fluids over-night despite me drinking more than enough liquids. Not that they gave me any for a few hours despite asking them.

And never mind the urine test, not for infection, but for pregnancy even though I was still in recovery from a total hysterectomy.

I know for a fact that in many cases they do. Private work is where they work like they want to work and not under the pressures of the NHS. I have been in many meetings through my work where surgeons discuss this freely. Take for example a major gynae cancer operation. All surgeons agreed that privately they like working as they can have the bowel and bladder surgeons on call ready and waiting if the gynae op shows that the cancer has spread and that the bowel and bladder people can be the experts and do that part of the surgery. They are under no time restraints so can spend their time doing the work how they want. NHS they are under time pressure for the theatres and they often can’t have other teams on standby just in case so they end up working on other body areas themselves. One said the he often doesn’t operate as well or as thoroughly NHS because he’s always under pressure to get in and out of the operation. There are also a number of procedures which are considered better methods which some surgeons simply aren’t allow to do on the NHS as they’re not approved as standard.

My personal experience is that private care is in a different league to NHS and hearing eminent surgeons discussing it confirmed it

@ffswhatnext were the health professionals surprised at your urine dip/pregnancy test result?

If you weren't so unwell/in pain you could have wound them up and demanded a second testing... or even suggested an ultrasound just to make sure.

@savingshoes
It was never done. Basically I ended up getting told off because I couldn't pee and it was impossible for me to be pregnant, and I said for the millionth time I needed something to drink. Not my finest hour, the specimen bottle was chucked at the idiot, told to fuck off and test the water from the tap. I got told off by the person who requested it for abusing the staff member and refusing to give a sample. Tried to explain, wouldn't listen.

I can laugh, just about, it now, but then not a chance. It wasn't exactly an elective op to begin with, just had to be done to stop me slowly bleeding to death.

I'm still convinced that the private team-fucked with me deliberately to see how far they could push me as I'm honest about my personality disorders. Whereas everything the nhs surgeon took everything into consideration and put me into medical menopause before surgery. The private surgeon wanted me to walk down several flights of stairs when I could barely walk across the room. 🤣

Utter, utter shower of shits. And in contrast, I made no complaint about what went wrong during the original surgery, but within weeks they wrote apologizing and explaining what had gone wrong. Not a peep from the private sham twats.

In my experience whilst private stays may be more pleasant, actual care is better in NHS.
This is the same in RoI. My mum and brother have received fabulous public health care. My dad has been in a Blackrock Clinic and few times and the care is not brilliant by a long shot.

No. I don’t. I have had experience with very badly broken foot:ankle due to fall a year after having knee surgery (I did too much, fatigued knee so it gave out on stairs, hence fall badly breaking foot:ankle).

I saw a surgeon in the nhs fracture clinic who also happened to be part of the private practice I saw for my knee. I asked to go private for foot/ankle surgery but he said I needed it done faster than he could see me private so I had surgery on NHS.

So my surgeon put my medical needs in front of my going private. In my experience, No, surgeons don’t put more effort for private patients vs NHS patients. (Also have absolutely no scarring years down the line, surgeon did excellent work).

The bottom line is some Consultants are more thorough than others, and some have much better bedside manners than others. My dh does daily ward rounds when he’s the ward consultant and sees every patient, but we know for a fact one of his colleagues sends the registrar instead, and will only see a small handful himself.
Doctors are notoriously bad at calling out poor behaviour by their colleagues. They find it very hard to confront each other. And whistleblowing can lose you your job.

I have been through a similar large gynae procedure but didn't have the complications which you suffered.

My surgeon worked in both the NHS and private practice. I wouldn't say more effort. I would say that she had more time, was less rushed and easier to contact afterwards. I didn't see her immediately after surgery but she was in twice daily contact with the hospital until I was discharged. She gave me her personal email address to contact her if I had any worries. That wouldn't happen in the NHS but in a NHS hospital there would be gynae specialist staff around in the hospital at all times, not just one day a week.

Oh and the nursing in the private hospital was first rate. Will never forget the lovely Irish nurse who helped me the night after my hysterectomy when I was in so much pain I couldn't even turn over in bed. I pressed the button and someone was there within a minute.

Bedside manner shouldn't differ. I work in this environment and I know first hand in my area the 'older' consultants treat their private patients differently. But I will say this is in the minority and 95% treat everyone exactly the same.

Some consultants have a better bedside manner; I was in hospital for my pregnancy and none of the women liked one of the consultants but the midwife told me that despite his manner he was the best one and the one they preferred to have as was spot on.
I learnt to ask a lot of questions.
When you pay to go private you do get a better “customer service” type approach and they have more time to talk to you but the actual treatment and surgery will be the same although not with a waiting list