to be gobsmacked by the efficiency of private healthcare?

[grovel]

I have never used private healthcare before and we have no insurance. Over New Year my left knee "went". I could not straighten it. Very painful. DH called a GP friend (not in our area) who told him that real diagnosis could be weeks after initial visit to our GP (referral to consultant, probable referral to MRI unit, back to consultant etc). If surgery was required I might have to wait weeks after diagnosis. In the meantime I would be on crutches and painkillers. I was prepared to suck this up.
DH wanted immediate diagnosis. He called the local private Orthopaedic practice. Appointment next day. Scan immediately after consultation. Diagnosis immediately after scan. Offer of surgery within 6 days. Price for all of this - £4,100 (initial consultation, scan, surgery, anaesthetist, 5 physio sessions, follow-up consultation etc). We have decided to go ahead. We are lucky that we can afford to (just about - Butlins, not Greece this year, I suppose, and no car upgrade).
Now I love the principles of the NHS and will defend them until Kingdom comes but this experience has got me thinking about how it is organised. Why do I have to see my GP to get anything started? Why do consultants have to correspond with GPs? Does it really cost the NHS less than £4,000 (fully-loaded) to treat my condition (cartilege-related)? Could Landsley even be right about a physician-led service?
I may be spouting nonsense because I am so relieved to be getting resolution to my discomfort.

YANBU... the tragedy is that what you experienced should be the norm and could be the norm if we weren't so manacled to the outdated idea that a 'free at the point of need' public health care system can only be provided by employees of the state. My doctor has on several occasions referred me to private practicioners via the NHS and the service has been excellent.

Lots of interesting an valid points raised here.

Doesn't take away from the fact that emergency care in the NHS is second to none. People involved in multiple trauma or GSW's for example receive an amazing standard of care that the private sector could not ever provide.

Yes, the smart environments, menus and private nurses are all very well but when you have a piece of M25 central reservation sticking out of your chest it doesn't really cut the mustard.

A friend of mine is an obstetrician in New York. New York state has a scheme to help people who have been made redundant pay for health insurance. It is state-subsidised and far cheaper than the usual cost of insurance. They pay $1600 a month (about £1025). Subsidised. And many things such as drugs are not included.

£1600 is what each person pays for the NHS per year in the UK.

I have no problem with anyone in the UK using private healthcare, indeed I think it's a good thing as it takes some of the pressure off the NHS. But I think it's incredibly naive to be "gob-smacked" that a knee op was done efficiently when the charge was nearly what you would pay for three years of NHS care.

I've just done a quote online for Bupa and it comes out at £152 per month for us as a couple (dh and I). That's full cover (consultation, diagnosis, treatment)

That's a loooooooot of money.

OP, I have had the same treatment as you four times. THe first two times were done on the NHS and the second two privately. The third time I started treatment on the NHS and was told I would have to wait 16 weeks, before remembering we had health cover. I then saw the same (NHS)surgeon and had the operation the following week. The day I had the oepration I got a letter from the NHS booking my operation for 2 weeks later so the 16 weeks prediction was seriously overestimated.

FWIW, I did once roll up at A and E with a knee that wouldn't bend or straighten, was swollen and sore and I couldn't walk on. They sent me home with painkillers and booked me in for an MRI scan three weeks later then an operation six weeks after that. Not much of a wait really, just pointing out that going to A and E doesn't necessarily speed things up.

It might be worth ringing the hospital and asking them what the wait is likely to be before spending £4000- although my private care was much more pleasant and 'nice' it wasn't £4000 worth better. If it helps, my knee normally eases off after a week or so and I can function on an almost normal level until getting it sorted- hard to believe at the start when it is agony but it might be worth thinking about...

(I'm studiously ignoring the fact that my knee is knackered again as there is no way I am going through surgery again...)

I have seen friends have good and bad experiences with private medicine.

1. Had a hip operation on NHS at a private hospital. Was very very pleased with care and nursing, along with private room and good food.

1. Other had a hysterectomy. Surgereon was great, but nursing care was actually pretty negligent. Made worse by the fact she was in a private room and so more easily ignored by the nurses.

1. I had some diagnositic tests done privately. They were done very well, but it took loads of phgoning for them to send the results over to the NHS consultant. They were not efficient at this at all.

So mixed experience. Yes the surroundings, rooms, food are much better than the NHS. But as someone with ongoing health problems I see this as added luxuries -nice but not essential. What matters is the quality of medical and nursing care.

nilgiri and those who have posted in agreement have it.

Efficiency for the individual (short or nil waiting times, plush surroundings) is not the same as efficiency for the whole community (maximising use, prioritising resources, minimising costs.)

The private sector in the UK can cherry pick.

Restructuring the UK system on the assumption that the cherry picking experience can be extrapolated across the whole NHS is just bollox.

Now would someone please tell Andrew Lansley cos I am beginning to believe that he is a tad hard-of-thinking.

And I have had same experience as neatfreak - told I would wait a long time for an operation and then actually seen really quickly. The times they give you are average waiting times. If you are flexible it can be quicker.

at nightlark and Lansley's hard-of-thinking-ness.

YANBU Private healthcare is vastly superior to the NHS.

"£1600 is what each person pays for the NHS per year in the UK"

The budget equates to almost £2700 per man woman and child. £106bn total. A family of four could get a helluva lot of medical insurance for £900/month.....

£160bn... typo.

cogito - The "problem" is that most of the NHS medical resources aren't spent on families. They are spent on old people with many multiple health problems. My parents who both have multiple health problems are frequent users of the NHS and I am certain their medical care costs a lot lot more than £2700 per year. And given that travel insurance quotes for a 2 week holiday for both of them are usually about 1.5 to 2k, I am sure any medical insurance premiums would be sky high.

Private medical insurers in the UK on the otherhand tend to treat younger people who are having short term straightforward surgery e.g. knee operation, hip operation, etc. These kind of people are much cheaper and easier to treat.

Exactly lesley. You are unlikely to see a poorly controlled diabetic with advanced chronic lung disease having a hip replacement in a private hospital.

The pre/peri/post operative care of such patients is expensive, complex and often cannot be planned, i.e may need longer on a ventilator/ICU etc. They may have complex discharge needs that require input from external agencies.

But despite what many people think, we have the good old NHS for that sort of thing.

Those saying they got quick treatment on NHS ops at private hospitals, this is why.

The private hospitals/clinics get paid for a fixed number of operations, regardless of whether the operations happen. So they have exactly the right resources sitting around waiting for that number of operations.

However at some hospitals, as few as 56% of contracted operations actually occurred. Shackled by the government contracts, the NHS has had to shell out £217 million for these non-existent operations.

Efficient not the word for this!

Of course it's not surprising the private hospitals demanded fixed-number contracts. If the numbers are under the contract, that's free money.

And if the numbers go over the contract, they simply turn people away. No interest in who picks up the pieces.

The contracts are now being changed, but
a) it's cost further money to terminate the contracts

b) this was an entirely predictable failure

c) the cause of the failure will not go away: private companies will always seek to dump risk back on the government, if necessary by running away if they find the contract too hard (ATOS from Tower Hamlets this year, National Express east coast rail franchise in 2009.). As the saying goes: privatise profit, socialise risk.

The elasticity - the ability to scale up to cope with a bad winter or terrorist attack - all that's being left in the NHS's hands.

Private companies want to cherry-pick the bread and butter work.

Yep, Nilgiri - didn't see many private hospital coping with the scale of destruction that the NHS did on 7/7.

Post 7/7 there has been lots of training/planning in terms of what we would do next time, lessons learnt etc. As you say, no private hospital is going to touch 1000 + exposed to a chemical bomb on the underground.

The NHS has many excellent qualities. However I believe that MRI scanners and other expensive bits of equipment should be used 24/7 - including weekends and holidays - on the NHS. You should not have to be fearful of going into hospital on a weekend/ bank holiday because the consultants are away and overworked junior staff in control.
Yes- I know I am in cloud cuckoo land....

Don't know about 24/7 (apart from emergency stuff), but evening and weekend scanning could possibly be a clever idea for some NHS sites.

I guess it depends on cost of staffing (inc access to site) vs capital cost of equipment vs rate of deterioration of equipment per use vs demand for equipment (if there's a bottleneck's elsewhere, then no gain).

amyboo thanks for your post. On many threads on here I have pointed out that the US system is not the only alternative to the NHS (it seems to be the only alternate system that anyone every seems to discuss). I've lived in Belgium and France (which has a similar system) and thought they were great for medical care. The payment of ?5-10 ensures that you only see a dr when you really need to and deters the timewasters that my GP friends complain about who are at the surgery every day, clogging up the appointments. There is a safety net for the really sick. You get a choice of who you see and when. I wish we could have the same system here and disband the NHS.

yes by all means use private health care if you prefer but sorry I think that there should be an opt out of the NHS for those that do, it does not seem fair to me that only those who can afford can get preferential treatment then choose to use NHS for picking up the bits after an accident or for illnesses private are not keen to treat. let private care fund these for themselves and leave the NHS for those who cannot afford an alternative. FWIW I had knee ops and a hip op on NHS and was seen quickly and operated on within a few weeks of initial GP referral.

I don't get why people are saying private healthcare is rubbish when it comes to frontline work/7/7 etc.

Private hospitals are not MADE to take frontline and emergencies, they are not built with the facilities. Besides, who has a car crash and then gets straight on the phone to their medical insurance provider to get transferred to a private hospital for treatment? Yes we will take major traumas from an NHS hospital IF the patient is stable to does not need any life saving emergency surgery, we can do the surgery for them if the particular private hospital does that sort of surgery.

They are all built for purpose, not every private hospital will do gynae, same with NHS hospitals, some are more specialised then others. Much like private hospitals where some are better at orthopaedics then others. It depends entirely on the facilities and consultants.

Sorry not making much sense, been on a night shift!

I understand what you mean about private hospitals not being built for the purpose of major traumas etc.

I used the example of 7/7 and complex patients to highlight how difficult it is to be seen to be as efficient as the private sector when the user groups are totally different. Private hospitals do not suddenly need to find the funds to review and rewrite it's procedures for a major incident using a dirty bomb whilst still doing the 'day job' if that makes sense.