To not drop this with the NHS

[Batgirl29]

Let me start by saying I'm not uk resident and am perfectly willing to pay for any NHS treatment I receive whilst in the uk on holiday. However, last time I visited I was pregnant and needed to extend my stay as my father in law became suddenly ill, he went on to pass away. I needed to have my 20 week scan and the hospital where my father in law was in ICU was kind enough to organize this (I was going to book privately which would have cost somewhere between £150-£250, depending on the clinic) but logistics meant it was far easier for us to just pop down a couple of floors to have the scan, rather than travel. I made it clear that I was not resident and asked for a price before the scan, the midwives and staff on the desk said they didn't know if I would be charged anything at all but would let me know later, I mentioned the figures I'd been quoted privately and they made comments along the lines of 'goodness it wouldn't be as much as that' but they couldn't say for sure how much it would be or if I would even be charged.

A few weeks later I get a bill for over £700, the scan took 12 minutes! Private clinics charge a fraction of that price but I can't get anyone to see sense. I paid the bill and then made a formal complaint, they have replied saying that is the price and that is that. My insurance won't cover it as the scan was not emergency treatment. I have no problem paying but am really annoyed that a profit making clinic charges around £200 and they've charge me over £700. Wwyd, leave it be or keep complaining? Obviously in the midst of my father in law's passing this wasn't a huge priority hence me just paying the bill and complaining later.

£700 is crazy for a scan. I live in a country where I see my medical bills and mine were nowhere near that much.
Sorry for your loss and it is totally understandable that you weren't vigilant about confirming the cost in advance, given the circumstances.
Absolutely do pursue it. Just because the NHS is in a mess doesn't mean you should pay 4 or 5 times the cost of your treatment to subsidise it.

I cost nhs imaging as part of my job in research and that figure is plucked out of thin air. a fetal MRi is about £300, and that is way more complicated than an ultrasound.
according to the NHS own national tariff the cost including a report for a normal ultrasound is:
Ultrasound Scan less than 20 minutes £44
Ultrasound Scan more than 20 minutes £56

www.gov.uk/government/publications/national-tariff-payment-system-2014-to-2015

No, no way. There was no one available to give you a price. You have a comparative price from a private clinic. Get another one, and write requesting the difference to be refunded. Find out the Chief Exec's name and write to him/her. What the bill come from Accounts or from Imaging?

My NHS scan: senior colleagues on hand for second opinions, support staff on hand to support bereavement, staffed operating theatre upstairs to deal with emergencies. Portering staff on hand to whisk me away immediately to the appropriate department if necessary.

My private scan: Once sonography in a stand alone clinic

yup, my private scan cost less than the OPs NHS one.

edit: Did the bill come from .....

I think people have been too harsh with you as well OP. You shouldn't have paid up as that gives you less bargaining power but then you were in a difficult situation and hindsight is a wonderful thing! I do agree that the charge is unreasonable and I would fight it myself. However as someone who works in the NHS I would also add that there is absolutely no way that any of us know how much someone would be charged - it sounds like their replies were polite murmurings rather than actual assurances. Not saying they were right - you might have a bargaining point there - I just wanted to defend the staff.

I agree with what someone said about private and NHS not being comparable. I've had private scans and I had to sign some paperwork that said they will of course tell me if they see anything abnormal or worrying but they will pass me on to the NHS when they do to advise me further. They literally do the scan and tell me the results - that's it. Whereas with an NHS scan they really will provide for anything afterwards.

one sonographer

OP YANBU. I am guessing you are a Brit living abroad?

Many people are not aware that it is possible to live outside the UK and yet support the NHS financially. My parents lived abroad due to my dad being in the diplomatic service and they paid NI. However obviously due to living abroad they never actually used the NHS.

OP you said you pay NI so I'm guessing you are in a similar position. If that is so you should not IMO be treated any differently from a regular UK citizen, and it's outrageous to charge you this 'tourist price'.

Even worse that you were misled by the clinical staff. If they didn't know they could just have said, sorry we really don't know, you'd need to ask the finance dept, here's their number.

I think conceivably the cost would be about half that in some more expensive private places, so worth pursuing. Also the length of the scan is not relevant for a lot of companies, I have paid £80 for blood tests that took about 1.5 minutes.

Taylia
Another NHS finance type person here.

A nurse/doctor/admin/ward clerk/receptionist would not know the cost for a scan. Thats why there are finance departments.

That might be common knowledge within the NHS, but a patient cannot be reasonably expected to know that they shouldn't rely on information given by members of staff.

Lalsy good practical suggestions.

TooMuch
I don't think you have a leg to stand on from a legal POV

OP's situation certainly sounds close to a misrepresentation (not that she should pursue it legally).

Batgirl And show them the National Tariff, as per carriemac's post above.

It is definitely a figure plucked out of thin air, or they are trying to get ahead because they have failed to collect from another private pt.

And it's not necessarily true that NHS is better.

My fetal anomaly scan revealed a kidney condition that might require surgery after birth. DH and I were very shaken. We were given no further information, not even a leaflet and no reassurance. Just told to book a repeat scan @ 33w so they could visualise better.

I left the waiting room shaking and holding back tears. No information for another 13w.

I started a thread about it on here as a matter of fact..........So no, the support isn't always there.

I would query whether someone has made an error with the bill, as that does sound steep.

The NHS doesn't have to charge comparably with private companies though- they are not seeking customers by pricing competitively, in fact they are overwhelmed with NHS work and, generally, don't have spare capacity for private/ overseas patients (the individual unit you visited may have had capacity, I am taking overall). The private clinic will be trying to attract new customers with attractive prices, the NHS not, so I don't think it is reasonable to expect the same price.

Also the NHS department employs and trains many staff which the private clinic doesn't.

The clinical staff and ward staff would have no idea how much the scan would cost to an individual, as they have no involvement in the billing process. In fact some of the cost may be due to the NHS needing to fund an Overseas Visitor Office to chase bills. The ward staff should have acknowledged that they didn't know the price, but tbh I wouldn't have interpreted their vague answer as them actually knowing the price.

I would have queried the amount in case an error had been made though.

That's terrible Revolting and also needs addressing, nobody should be left hanging like that

The standard should be support, and luckily for my friends who've had abnormal scans, it all clicked into place and they were looked after straight away, and that should happen for everyone but clearly more needs to be done to keep the standards up across the board

The £200 you quote at the private clinic is not for 12 minutes of the ultrasonographer's time. It includes their pay, pay for the radiologist who reads the scan, pay for the front of office staff, upkeep for the equipment, the cost of the building's lease and utilities, the price of the transcription of the radiologist's dictation, and profit.

The NHS has even more overhead expense, and as a non-citizen, you are not entitled to access the services of the NHS at "no cost". For patients like you, particularly when it is a routine scan and there is no urgency, the NHS must focus on cost recovery.

You chose the more convenient option without knowing what the associated costs were, and you paid for the convenience. This is not a case of taking advantage, this is a case of signing a contract before knowing all the details.

Is it really true (as some posters seem to be saying) that if you agree to buy something without agreeing a price, the seller can make up any number they like, and you have to pay it?

If so, I recommend the NHS hire private detectives to find out how much equity people have in their houses, before charging. For all they know they could have charged several hundred thousand for this same procedure. Whoever is wasting public money by only charging 10x a reasonable rate should be sacked.

The NHS has even more overhead expense

So basically you are saying the NHS charges more because it is far less efficient, and it would save a lot of money if all this work were subcontracted to the private sector?

When I had DD3 nearly seven years ago, I was only offered a dating scan on the NHS. I paid about £130 for a private scan at around 20 weeks. The place I went to is quoting £159 for a 40 minute anomaly scan now. I agree that £700 is robbery.

Sadly, Theoretician , there are many who say that having to answer to shareholders and 'the bottom line' would seriously affect the efficiency of the NHS. I do not agree, but I do feel that there is an administrative black hole where the NHS's money disappears and fewer levels of bureaucracy would free up millions to actually be used for patient care, where it belongs.

What I was actually saying, though, was that the radiology department of a hospital has significantly more overhead expense than a small private clinic located in an office building with a handful of staff.

Does that clarify it a bit?

To answer my own question, if a price has not been agreed, no you don't have to pay whatever they ask.

So if you haven't fixed a price, you don't have to pay a ridiculously high bill. All you have to pay is what you consider 'reasonable' and invite them to sue you for the rest.

www.bbc.co.uk/programmes/articles/1fdlwC9xzyxjCpWMlsCGG3j/supply-of-services

Naughty Theoretician !!

Screenshotting yeah, in one sense I don't begrudge. I live in a deprived area which receives lots of EU funding and the antenatal clinics are overwhelmed with many complex-needs patients such as women who will go to the HDU after birth, obese patients, patients who have chaotic lifestyles.

I don't blame the clinical staff AT ALL - well the sonographer was a bit of an arse but it's not his fault he didn't have back up!

My point just was, the NHS might be more expensive but that's not necessarily because you are getting 'extras'. It's because it's struggling to cope.

You could argue all that for the cost of a private scan, too, Shtoppen.

But paying the bill without a murmur will make it kind of hard to retrospectively claim you thought it was unfair.

You should complain. It was a non urgent treatment. Payment should have been made before services were rendered. I'm an expat and pay for treatment in the UK. The clinical staff should have sent you to the finance person for payment first before the scan. The amount is also wrong. I paid about £100 for a detailed NHS scan when I had to care for my dad.

Personally I think NHS treatment for non residents should be 10x the standard cost not 3x. Its very expensive to cater to additional unplanned needs.

700 seems excessive going by South Devon's pricing structure for private patients. For example they charged 302 for an amniocentesis.

www.torbayandsouthdevon.nhs.uk/uploads/23968.pdf