To think that consultants should do more nhs clinics and not private practice

[funnyperson]

My cardiology appointment is in June as that is the first available on the nhs. Yet I can see the same doctor privately next week at a cost of £205. AIBU to think this is outrageous. I have jaw pain , tiredness, and have recently come out of hospital under this doctor's care, and want to know my diagnosis, my treatment and my ability to return to work asap. Why is she getting an nhs salary to fund her time in private practice?

ohyoubadkitten I got the impression the secretaries are inundated with this sort of call- I guess heart conditions are so worrying that everyone wants to be seen urgently. However I did contact the charity helpline which deals with my sort of condition- they helped with advice but naturally can't start treatment.

YANBU

There was a news item earlier this week about increased death rates at the weekend when Consultants were not available.

What is needed is a recognition by the NHS that consultants are needed at weekends. At the moment, consultants work monday to friday and are on call over the weekend/nights. Most of the consultants I work with do a ward round over the weekend, and go in for emergencies and are in contact with the duty doctor by phone when necessary.

I do think it would be a really good idea to look at having a consultant actually working during the day on Saturdays and Sundays, but that would still leave the nights.

The European Working time directive has resulted in doctors below the grade of consultant, and the younger consultants, having far less experience than their colleagues who trained in the 70s and 80s. They are less tired, which is great, but it should be recognised that they need a lot more "hands on" support.

Weekend and evening clinics would be a great idea, as would longer theatre opening times, more post operative beds, more nursing and theatre staff etc. More clinics would not be particularly useful without the rest of the package. I can't see the NHS paying for it all though.

Yes OYBBK, it does. And to be fair it was only a holiday - but it was theme parks and not being able to bend my knee and it being the size of a ball was not looking good for a fortnight of constantly being on the go. I reckon the consultant must have been before too and knew that I wouldn't have a chance - DH was seriously considering the hiring of a wheelchair of some form, myy knee was that bad - and with no warning!

Mind, that needle behind the knee cap - ouch ouch ouch!!!

Mind, on other side of this was my very long wait for my Asherman's. And I was in regular intense pain with that - several days every month, including missing work for 2 or 3 days every month. That wasn't good.

that doesnt sound good at all!

I don't know what job you do, OP, but presumably your employer doesn't control what you do in your spare time? If a cardiologist choses to spend some of her spare time doing private work, that is up to her. Statistically, most consultants do 10-15 hours of unpaid overtime for the NHS per week. What they do outside their NHS work is their own business.

OP - YABVVVU

Why should you decide what your cardiologist does in her time off from her main job? If she's not to do PP work, what about other non-work things: grocery shopping? walk in the park with her DC's? Parents' evening for them? Having a bath? Are you going to decree what channels she can watch on telly or what novel to read in the evening, too? So Bl%£y entitled!

Good luck finding a non-burnt-out consultant who can work every hour God sends for you and you alone whatever hour suits You.

Have you even considered that there might be a good clinical reason for the wait anyway? (in my specialty often healing time, but settling on new meds, to let lifestyle adjustments show an effect etc) If you were seen as a PP it would be starting afresh, so no record of what had started to be tried iyswim, so would get you straight in, then review again in a few months (after trying the same things over) so actually adding time on, not queuejumping.

And 3LF

I'll work clinics at weekends and evenings when the support specialties do too. No point having a fracture clinic if no-one to do non-A&E XRays etc. Suddenly gets more expensive (for the taxpayer) when the extra lab, XR, portering, transport etc etc staff are factored in. We'd also need a new building as ours is used by the GP OOH guys OOH!

Now if you were after getting the practice nurse to be available to do a smear on a saturday (so I don't have to take a half day to get it done) I might have to agree.

Tis going to get worse. We have all been given 90 day notice (for redundancy). Work in NHS outpatients - clinical. Some doctors have also received their notices, less doctors, less nurses, less secretaries, less clerical workers. Go figure how it will take longer to get an appointment.

Well, I found similar; same doc at the NHS hospital, with a practice in the BUPA hospital down the road.

PH paid for the initial consultatation at BUPA - Consultant then jumped me to the top of the list at the NHS hospital.

In need, I now always pay for a private consultation and get bumped to the top of the NHS list. It saves at least 16 weeks.

OP, it's not an unreasonable question to ask, but it's not the individual consultant's fault, that's how all NHS consultant contracts are.
This was devised so that consultants would actually stay in the NHS and offer the benefit of their skills and experience, and not disappear into private practice the moment they finished their training, leaving the NHS with just a handful of professors and mostly juniors to treat all the patients. In countries where they don't have an NHS system, you see one of two things 1) all healthcare is state hospitals is private to some degree, and even their state patients have to pay, so in effect the consultants are doing private practice in the state health system. 2) those countries with systems that are free are in effect run by juniors - many state of the art treatments are not offered at all, and the inexperience shows in the sort of procedure they are willing to do - eg they will not agree to do a difficult operation at all, and drugs used are simple ones that are often not ideal for the patient's condition.

The fact is that if a consultant could only work in the NHS, the NHS salary bill would either be unsustainably high (we'd be paying National Insurance of 40% of our salary probably), or the consultants would leave the NHS. The fact is that Britain is unique in the world for having a system like NHS (if you don't count communist countries - and you don't want to see the state of the healthcare there. State of the art ITU or neonatal care, or expensive chemo drugs? Forget it) NHS care is unique in being free, esp for lifesaving treatments - from organ transplants to bypass surgery to Caesarean section plus neonatal ITU (SCBU): treatments which would cost in the realm of £20,000 to £100,000 in many other developed countries, depending on how long the hospital stay was. (Not counting IVF or cosmetic surgery, of course, which is in a different category.) You often hear stories abroad of people whose lives were saved by operations or transplants, only to find that the cost has bankrupted them or their families. Having to sell their homes. Or forfeit their child's university education.

You might also find that if your consultant is a veteran/older consultant, or is very popular (eg with a specialist skill or training that very few people have) she may simply have an extremely long waiting list because too many people have been referred to her. (If a doctor has been working for a long time, it stands to reason that a lot of her patients may be NHS patients from long ago who are still alive and need follow up, who need appointments just like you do). If your condition is supposed to be a straightforward one, there is no reason why you can't ask to switch to a younger consultant or one who doesn't have as long a waiting list - NHS consultants will be diligent in making sure all the records are passed to the new consultant, so you should get care that is just as good. But I would not switch clinicians if your case was complicated.

What I really mean is that private practice subsidises the NHS so that it can exist. (yes, i should have just said that!)

Dances - I totally agree with you. That is what I was trying, and failing, to explain. Of course it would be completely pointless to make the consultants work weekends as if it was a normal working day unless you have everything else working as normal. I just didn't list every other support service in my post.

Neither would I expect anybody to run a full weekend service without having 2 days off during the week.

I can't see that happening because of the cost.

When I worked, my company provided private medical cover at a v. low cost. It was (if not a life saver) a house saver. I couldn't return to work without treatment, yet in order to get the diagnostics done on the NHS would have taken months (without a wage).

Of course it shouldn't be this way, but by going private, I saved my house and I saved the NHS the cost of an MRI and a consultant appointment. When my marriage broke up, it also covered the cost of some counseling, again saving the NHS counseling and anti depressant costs.

Once I am back in work, I am getting me and DS private cover.

troisgarcon that is what I m hoping will happen.
dionethediabolist that is why I thought paying the money to see the consultant privately would be a good investment. It might make the difference between starting treatment 3 months earlier and keeping my job, being able to look after my family and, even perhaps prevent a readmission to hospital.

Its not really spare money though, its contingency money.

If paying to see a consultant privately gets you bumped up the NHS queue, then the NHS is fucked.

YABU - consultants work the hours for which the NHS pays them, what they do with the rest of their time is up to them. It is lucky that many offer private services so people have an option to go private thus reducing the queue for those on the NHS.