to think this is where the NHS lets people down

[peppatax]

After a series of A&E visits with concerning acute symptoms, MIL needs to see a specialist and has a 4 month wait for an NHS appointment. She can however see the same consultant in August privately for about £250.

AIBU to think this is fundamentally wrong? Is it just that some people are doctors for the money rather than helping people? No wonder NHS waiting lists are so long if said consultant is doing private appointments as a priority.

It makes me lose sympathy for the poor junior doctors who after sticking out their training can become consultants and prioritise patients that can afford to pay.

[peaceloveandtwirlywoos]

Dear god, this is like banging your head against a brick wall.
NHS consultants are employed, for example, 40 hours a week. They cannot be paid for any further NHS hours than those 40. After the 40 hours, they have personal time. They could spend it at home, or they could spend it working privately, for a different employer.
The NHS clinics are over-subscribed because lots of people can't afford to pay privately, so they choose to queue up (4 months in this case). The private clinics are quicker to see you because there are not thousands of people queuing for the clinic, because they can't afford to pay. Private clinics are also sometimes run outside office hours, which is more suitable for lots of working patients.
If we didn't have the NHS clinics, and all consultants' time was their own, to run private clinics, then you might have to queue for those as well, because the people currently queuing for NHS clinics would be queuing for the private clinics instead.

[DearTeddyRobinson]

Well we do sort of have a 2 tiered system don't we ? If you have health insurance or can afford to pay outright, you have the option of private care. If not, then you can have the same treatment for free, just with a wait.
I believe the us system is different in that they do not have universal free healthcare, there is Medicare and Medicaid for the poorest/elderly but everyone else needs to have insurance or be able to pay. You'd just better hope you don't get a nasty expensive cancer

[Ireallydontseewhy]

So, figures in 2015 suggested nearly 50% of households paid more tax than they received altogether in benefits and services like education and health. The average household paid in £500 less than it received. Although a common response to people complaining about their nhs treatment is that they have paid nothing like the true cost of of it in tax, that is by by no means always the case - depends on the individual, and some people will have paid more!
But of course you can't predict how much your healthcare will cost - you might end up needing very expensive healthcare. Afaik us insurance does not always cover the whole cost - not sure about other european, australian etc insurance based systems. But then i suppose nor does the nhs if you end up going private because of a 4 month wait to be seen for acute symptoms, or if you need dentistry, glasses etc.

[GiddyOnZackHunt]

No better than the US?
That may be true if you are able to afford to pay or have health insurance as part of your job. There aren't co-pays though here and I'd rather be poor and I'll in the UK than the US.

[oxcat1]

You also have to remember that consultants do not run clinics - and certainly not theatres - singlehanded. They need a clinic room to see you, a nurse to chaperone, radiologists, lab technicians, secretary etc - and that is just for an outpatient appointment; far higher demands for an inpatient op and stay. Even if the doctors were
Willing to work - for no greater pay - above their contracted pay, how do you expect to pay for all the additional ancillary staff, all the extra facilities, the extra theatre time, the double-booked beds?

We simply cannot work any aspect of the NHS harder than we are already doing.

[Lorelei76]

The reason you see the same person sooner if you pay is that the list of patients waiting is a lot lower, that's all.

[VimFuego101]

So correct me if I am wrong but it seems that we're no better than the system in the US where you get better care if you can afford the insurance?

That's not really how it works in the US. It's not a tiered system, it's expensive for everyone. If you are entitled to Medicare (for retired people) or Medicaid (low income), then you're all set. Most providers accept those, although there will still be out of pocket costs. However, if you're able to work/aren't eligible for either of those but can't afford insurance, then you get no care for most minor illnesses (if you're taken to hospital in critical condition then they only legally have to stabilize and discharge you). And, since Obamacare was implemented, you also get a tax penalty if you don't have insurance, so you get fined for not being able to afford care.

[MammouthTask]

Actually I agree with the OP in some ways.

When a consultant has his own clinic that he works at outside his working hours on the NHS (whihc probably use means he is working part time on the NHS btw), this is entirely up to him. You can chose to go and see him just as you can chose to go and use BUPA etc.. (Which you can do even wo having a BUPA insurrance. Of course, you pay quite a lot of money for that 'privilege').
I have a much bigger issue when the NHS 'offers' to go private to jump the queue, see their same consultant in the same facility and then reuse the money to fund whatever it is. Because THAT is in effect privatising the NHS wo saying it.
Just as, not having enough ressources altogether, which pushes people to go private. The problem being, of course, that not so many people can afford that. Or will push themselves to the limit to do so (eg screaming baby and seeing a paediatrician). If you just reduce the ressources a bit more, it's not just the ones 'that can pay anyway' who will end up doing that but it will also be pushing the ones who can't afford it to do so.

I fully disagree with the 'you should could yourself lucky' type of comments too. Yes it is still a little bit better than the US (even though we are very surely going that way see comments above). But it's also much much less than what you can get in other western countries such as Spain or France etc...
Eg In France you can get a SALT for a child wo any problem at all. Here it's impossible. I can't even find one privately where I live!

[RandomMess]

This is actually so unbelievable it's funny

"so you get better care if you can afford it"

Erm yes and the rich that run the country can afford that so they aren't that bothered about those that can't as the NHS does exist and is still far better than the US system.

I a very grateful we have the NHS and that the medics work for so little, it's far from perfect and underfunded but can imagine living elsewhere have to pay £50 for a GP appointment for your children?

[nocoolnamesleft]

I'm an NHS consultant. I am paid for 11 sessions per week. I work an average of 13.5 sessions per week - basically the NHS gets over a day for free from me every working week. When you add in that it's a good year if I get to take even half of my annual leave... I did some maths at the end of my first year as a doctor, and the NHS had already had 120 days work out of me for free. Haven't had the heart to add it up that way again.

I am honestly terrified at how far off the wait is for a follow up appointment, because all the focus is on time to first appt - but people need to be seen again with results, etc, and it's impossible. Even when I've offered to do some extra catch up clinics (follow up patients) for free, they can't/won't find the clinic space and clinic staff.

So, I don't do any private work. I'm too bloody knackered, and when you're in work as many weekends/nights as I am, having some time off is more important than the money. But if I did do private work at the weekend, having already given the NHS an extra day for free that week, would that be okay with you?

[PersianCatLady]

I don't think you understand how the NHS and private medicine work.

Doctors work their set paid hours for the NHS each week. In their "free time" they are then able to see private patients to supplement their income.

[parallax80]

(whihc probably use means he is working part time on the NHS btw)

As long as we define everyone in all other jobs who are contracted for 40-44 hours/wk and do 15+ unpaid hours a week as "part time"

[expatinscotland]

You have zero idea how the system works in the US, either. I left there about 14 years ago and am soooo grateful to the NHS.

'I did realise it wouldn't all be going in the doctor's pocket but even so, is this really not a big deal for people?'

Nope, not at all, especially after having lived in the US for 31 years.

[Ireallydontseewhy]

That's interesting catnip about other, insurance based, systems having waiting lists that are just as long as some nhs trusts - where are you thinking of? The impression i've got from a few mn threads about other european systems is that generally there aren't the same kind of waits for hospital referrals, ops etc, so it is interesting to hear that's not the case.

[Petal40]

Same argument with private schools...why should one child get a better education than another,just because one child's parents have more money than another child's

[gonetoseeamanaboutadog]

Why shouldn't doctors who've paid a fortune in student fees benefit from being able to charge those who can pay?

Worth bearing in mind that they have no really funded their degree in the sense that other, real uni fee paying countries would recognise. They are essentially trained by the state and owe them big time.

[gonetoseeamanaboutadog]

have not

[GiddyOnZackHunt]

Actually thinking about it my dad recently had need of a consultant appointment. The wait for the private appointment was only a week less than the NHS appointment so it isn't always the case that going private is loads quicker.

[Doyouthinktheysaurus]

I do think we have to be grateful for the NHS.

11 years ago when I had cervical cancer, it saved my life and my treatment was relatively very quick. From diagnosis to surgery was 5 weeks and in That time I had an MRI and an appointment with my surgeon.

For 'lifestyle' stuff, things that impact your way of living but aren't life threatening, the waits are long and that can be frustrating. It's likely if I need knee surgery, I'll end up going private depending in the cost because otherwise I'll be at the back of a stupidly long queue. It is frustrating but ultimately, I fucked my knee up running and I'm not incapacitated, I just can't be as active as I want.

I think as we have the savings to pay, we should endeavor to do so because the NHS is under such pressure, and there are plenty of people who could never afford private.

[BluePancakes]

I'm due to have an op for a hysterectomy this summer. The NHS target wait is 18wks from my appt until that op. At that appt, I was told it would be more like 26wks, and when I phoned up recently (to ask how much notice I'd get: whether it would be a couple of weeks or a couple of days) I was told that actually it would be more like 7 months from the appt. I know my consultant does private work (he sent me all the info about the op from his private practice as he thought it was better than the NHS leaflets) but I can't afford to go private. I don't believe my care is any "worse" for using the NHS - it's not like I'm being forced to use some back-street clinic! Yes, I'm in a queue, but if the NHS had more resources, the time would be quicker. What the consultant does outside of his NHS time is entirely up to him; and if he didn't work private, there would be even more people in my queue!

[Hoppinggreen]

Well by paying to go private you have freed up and appointment for someone who can't afford it so well done!

[KitKat1985]

The doctors see private patients as a second job essentially outside of their NHS contracts. Why shouldn't they make some money out of their years of training?

As a nurse, I promise you most doctors I know do so many extra unpaid hours each week for the NHS on top of what they are contracted for, so I sincerely doubt most are just in it for the money.

[Flannelmcpoppety]

I think the key here is that the waiting time for the NHS isn't longer because of the private option. Ie the consultant isn't spending half his time seeing private patients in order to make ££; it isn't his greed that's why NHS patients have to wait longer. If that consultant was hired by the NHS for more appointments, I expect he'd gladly do them and the waiting time would be shorter.

[IloveAiredales]

I have no problem whatsoever with this, I'm an ex nurse but still work within the nhs, it's on its knees and every patient going private is a help.
I'm fortunate that we have private healthcare provided by DH work but we have had to pay for dentists for us and 3 DC for the last 10 yrs as there is no nhs dentist in our area, I don't begrudge it, I prefer my nice relaxed unhurried dentist as I'm petrified at the dentist!