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.

I think the point is that when people quote private medical premiums and compare them to the per person cost of running the NHS, they are not comparing like with like. Private medical insurance premiums would be sky high if they covered the range of services the NHS did and treated the type of elderly people with chronic health problems that the NHS does.

The two can work really well and along siede each other there is room for both.

My dd broke her arm at school sept 10 and was taken to A&E in an ambulance, she arrived at the hospital at 4pm, at 9pm she was on the children's ward recovering from surgery.

I wonder how long it would have taken in a private hospital at that time of day? surgeon etc available, room, nursing staff.

For routine ops or child birth fine excellent service, but for other care it doesn't always give a better service.

Some NHS hospitals have private providers within the grounds and this can work well - have the op in a NHS hospital and then the aftercare in a private hosptial - it free's up the beds and nurses for others

Part of the reason private healthcare is more efficient will be how planned things can be compared to the nhs

When I have medical care I want good quality experienced people,able to work under pressure.The NHS has delivered on this score for me every single time.

I snobbily used a private clinic for my IVF.It was the top one in the country at the time.I could have used the NHS hospital but paid privately,same staff(I had to pay either way).Big mistake.

Said private hospital had lovely carpets and wine menus but when I was on deaths door they were crap and who did they go running to oh yes the same hospital I turned down.

In a heap on the floor said private hospital gave my dp a wheelchair and told him to get me to the local NHS hospital immediately otherwise I'd die.They said they couldn't even get hold of an ambulance quick enough ie not one available.

Said dp got me there but couldn't get me out the car.The NHS clicked into action like a well oiled machine.Staff came running out I was wheeled in,bloods/tests done immediately,rushed off,the top consultant in OHSS came in immediately(on a bloody weekend).Within a couple of hours I'd been scanned and was having the drugs I needed to save my life pumped into me.

A friend of mine who is a nurse said she'd never have her kids operated on in a private hospital as when the shit hits the fan you really want the NHS and their intensive care units.

I can put up with waiting,NHS wards,shit food when I know I'm in a place that can save my life.

MrsHeffly, I take it your friend isn't an intensive care nurse, because if she was she would know that intensive care beds are nationalised so whether you are NHS or a private patient you get the geographically nearest available ITU bed based on need.

there are pros and cons but the good thing is if you have private insurance you can go between the two. I've used the NHS for some things and private for others. There have been times when I've KNOWN I needed a referal and the GP was fobbing me off saying I didn't need one, then when I say "insurance" he swivels round and types up a referral (that it turns out I did need). On the flip side I've found that private hospitals over medicate you because they can claim back ever single pill. And being in a private room is nice if you're well-ish, but scary if you're very ill as noone sets eyes on you until your set check time unlike a NHS hospital ward where there are other patients and passing staff to notice if you end up passed out on the floor!

They are nationalised to a point, reduce but in the event of someone needing unplanned ICU care, such as post cardiac arrest then the majority of patients go to the ITU within the hospital they are in. Sometimes this means discharging someone else out of ITU the patient in need may have to stay in the area they are for a bit, or go somewhere more appropriate such as Theatres whilst they wait.

The good thing about people using private medical care is it lessens the wait for NHS

It's all about funding, ivykaty.

If you're paying for your private care yourself - directly or through insurance- while gladly handing over your tax to pay for the NHS, that's hunky dory.

But a lot of people with private provision then start whining for lower taxes because they feel they don't need the NHS. And that's before we get onto the the NHS being forced by idealogical govts to hand over its cash to private hospitals for operations it could have performed itself.

I'm a GP. I'll refer anyone who wants a private referral, within reason. This does not mean that that I think that they necessarily need a referral but I take the view that it's their money and they can spend it as they wish. If they are self-funding and I think it's a complete waste of time, I will warn them, but I will still refer if they insist.

When I refer on the NHS, it is different because I am conscious not just of cost, but - more importantly - of waiting lists. The more people I refer unnecessarily, the longer people who really need to be seen will wait. I am not claiming to get it right every time, but I do always ask people to come back if they are not improving and I re-assess the need for referral each time. It would make my life 100% easier just to refer everyone who asked but, if all GPs did that, the NHS would be bankrupt in a fortnight and waiting lists would be a decade long.

Has anyone estimated how much it would cost (per capita, per annum) if all health provision came from the private sector?

There's a table here of health care per capita in various countries, along with other metrics like life expectancy and child mortality.

The UK could do better but is bloody cheap (so better funding might improve it). The US is crap - expensive, poor results.

Oh I've seen that Nilgiri (but thank you anyway - it makes interesting reading) :)

I was prompted I think by Cogito saying "A family of four could get a helluva lot of medical insurance for £900/month....."

Yes, Cogito has two problems.

She's asking how much medical insurance you could buy for X amount. When the correct question is, how much medical treatment could you buy for X amount (directly or through insurance).

And she's imagining that average spend applied to to a fit-and-healthy Cogito-aged family of four - instead of an elderly person or someone with complex health needs, ie exactly the people not included in the insurance companies' figures because they won't touch them with a bargepole.

lesley and others have done a good job explaining why Cogito's thinking is fallacious.

US private healthcare is neither efficient nor exclusive.

The costs eat significantly into the profit margins of businesses, especially small businesses. I don't think it's good for the overall economy, but when a system like the NHS is proposed, the cry of 'socialised medicine ' goes up -- the NHS is the closest you are going to get to single payer healthcare when you sit down and look at it, and an excellent system given that nothing is perfect.

In the US, private insurance spreads the cost of the healthcare of the majority onto the backs of the gainfully employed, including the chronically ill, the old, the obese, those who have smoked all their lives. The employed also contribute to the public health system through county taxes levied on private property and through county sales taxes (public healthcare is organised on a county basis) and also through payroll taxes that fund federal entitlements such as Medicare for the elderly. I think American taxpayers actually pay much more for healthcare than anyone does in Britain, and the self employed there are really screwed as they usually don't qualify for county/public health coverage and therefore have to pay through the nose for private health insurance, plus pay all the county, state and federal taxes.

Er, given that the average cost of procedures in the US is more than double what an equivalent procedure costs on the NHS YABVVVVVVVVVVVVVVVVVVVVVVVVVVVU!

How the heck is it efficient to create mind-bogglingly enormous profits for pharmaceutical and insurance companies out of life and death situations?

Amen -- the terms 'healthcare industry' and 'health insurance industry' should be an indication that healthcare for patients is not what it's all about.

www.leftfootforward.org/2011/11/tory-peers-private-healthcare-links-threat-to-nhs/
Now maybe I am wrong but any industry that buys up ex ministers like the health care industry needs to have seem pretty close scrutiny.

Americans pay through the nose for healthcare math you're quite right. It's the number one cause of personal bankruptcy.
ANd in terms of public money going to healthcare, in 2009 the US spent $7410 per capita, of which 49% was public expenditure and the UK spent $3285 of which 84% was public. In other words, the US spent $3630 per person of taxpayers' money compared with $2759 in the UK. So not only is the individual screwed when payng for healthcare but the taxpayers are screwed as well, shelling out when they get practically nothing in return, certainly not the safety net we have here
data.worldbank.org/indicator/SH.XPD.PCAP/countries

Another thing is that nilgiri hit the nail on the head - 80% of healthcare spending goes on 20% of the population (even worse ratio in the US), a helluva lot on end of life care. Someone has to pay for it.

And thats the great thing about the NHS, although not perfect that 20% in most need can get the care they need without having to panic about if they can afford it. The other 80% know that when they are in the situation of needing the NHS be if for critical illness or a broken finger it is there to help them without needing to worry about cost.

I'm currently working in a private, clinical environment and the difference between this and its NHS equivalent is astounding. Staff are well groomed and polite, well spoken and adept at the little social niceties like actually making eye contact, smiling and being able to hold a conversation.

Sounds exactly like my expereince of every hospital appointment I've had at an NHS hospital. Staff are well groomed .... what do you mean by that? Do you mean that NHS hospital consutlants are poorly groomed, can't smile, or be nice to you or have a conversation with you?

Said private hospital had lovely carpets and wine menus

Carpet.... CARPET is a hospital FFS! Newsflash, patients in are sick: blood, vomit, urine, how the hell do you clean a carpet properly in those circumstances. I would walk straight back out of any hospital with carpet in the rooms.

I agree about the carpet.

I went to the GP about my finger a month ago. 2 weeks later I had an appointment letter. Went to the appointment, within an hour of seeing the consultant I had been booked in for an operation (got to choose the date), had x rays, bloods taken and been assessed for surgery. My operation is in a couple of weeks.

That is NHS, and I have been very impressed. Of course if the NHS hadnt buggered my finger up in the first place I wouldnt need the sodding operation but that is irrelevant.

Ah, Le Queen..think you're on the wrong thread