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.

In ROI the GP consultation rate is approx one third of that in NI. Health outcomes are v similar. A lot of people consult over very little in the UK.

I'm a doctor but don't/ wouldn't work privately. However, if every doctor who did private work stopped tomorrow the waiting lists wouldn't improve. You could run routine clinics/ theatre lists at weekends but you would need to employ many more people (not just doctors) to make this happen. Otherwise you are just spreading existing resources more thinly. This is why Jeremy Hunt's vision of a 7 day NHS, without actually increasing staffing levels, won't work.

I have more of an issue with the state of dentistry. Most doctors who work privately will put in many years as a junior doctor first and will continue NHS work. Dentists can work exclusively privately with no expectation of NHS contribution after qualification. Despite high seeming fees they don't come close to paying for a medical/ dentistry degree.

Good point re dentists Moonrise.

Moonrise you do realise that since 2006 that the DoH has put a cap on NHS dentistry? That even if there is demand for NHS dentistry the practices are only allocated a certain amount of units of care (udas) Practices can only expand their NHS services if they bid for funding and this is rarely available.

The vast majority of dentists do a year's foundation course in the NHS the equivalent of a junior doctor. However there aren't enough of these places for all of the qualifying dentists to take up.

I realise the government is largely responsible for problems in NHS dentistry. However, 1 year foundation is in no way comparable to the amount of NHS work most doctors would do before starting private work. Depending on specialty this may be 8-10 years as a junior before becoming a consultant.

Plus the insufficient out of hours dentistry provision - that really is a situation where private patients increase NHS waits as they clog up the ring back queue for the GP OOH service demanding pain relief and analgesia...

I am not blaming the dentists. I think the government could and should change the system to make NHS dentistry easily accessible. I have to drive 20 minutes across town to get to a dentist that will take on NHS patients. It would be more like an hour by public transport.

Considering the vast majority of NHS dental care is now corporate based I am not sure this would be an 8-10 years of work that would result in a dentist being consultant grade level.

Pain relief and antibiotics...

I have seen figures of around £250k quoted as the true costs of medical/ dental training. Surely it is crazy to then have a system where there isn't a number of years put back into the NHS?

Effiels again this goes back to 2006 when the DoH took out of hours care over from dentists. They decided they were not prepared to pay us to do it and would run OOH clinics locally.
10 years later emergency dental care is heavily triaged; the only real emergencies can limited to swelling, bleeding or trauma. The clinics can be varied with often limited clinics or those available a fair distance away. This was not a decision made by dentists, it eas enforced by the contract change.

So NHS still the final common pathway for those in pain. Not to mention the GPs who have been sued for treating 'out with their expertise'.

peppa I recently needed to see a neurologist. My wait was much much shorter. I hope this means your MIL is suffering a less serious condition than the one I've been diagnosed with and her longer wait is so that people like me could get seen quickly with potentially life threatening conditions that need to be dealt with urgently.

You're totally incorrect.

I have a lengthy medical history involving private health care. The majority of my surgeries have been done in evenings or on weekends, not during surgeons NHS working hours. Also, when the surgeon has seen me every day, it is always either before they start or after they finish their NHS working day.

You could also look at this as anyone that can afford to go private is one less person in front of your mum in the NHS queue.

Wishing your Mum and full and speedy recovery.

The DoH does not see NHS dentistry as a priority. We are not on the agenda most of the time.
There are repeated pilots for new systems of working and when they prove to be more expensive than the existing system they are sidelined.
The bottom line is, dentistry like medicine is expensive to provide. It needs expensive equipment and trained staff both clinical and clerical. Unlike hospital medics dental practices are privately owned when the NHS is unviable economically or ethically dentists can choose to leave,

Apologies for the thread hijack had a hot, stressful week,

OP: Well this thing you hold dear, really isn't right for me. Why is it like this?
MN: Well we're quite fond of it.
OP: But it should be more like the thing I want it to be.
MN: Nobody's making you use it
OP: But I want to use it and I want it to suit Meeeeeeeeeee
MN: Off you trot, love.
At least this is how the threads from new MN users who start threads telling regular MNers what's wrong with the site, end up.
Just sayin'

My apologies this will be long but I have used paragraphs and punctuation!!!!

My husband is a consultant in Scotland and I am a nurse. We currently work in the NHS, but have worked in both the private and American systems. So I would like to address a few thing here.

Being educated in Scotland, we did get our university fees paid but we got nothing else from the state. Despite working 2 part time jobs while studying my husband left university with a great deal of debt which we have only just paid off 18 years later. So I am afraid to say that we do not particularly feel beholden to the government for anything they paid for.

As a junior doctor, my husband worked so many hours per week that he was effectively working for approximately £1.50 less than the minimum wage at that time and the only way I could see him at times was to meet him in the staff canteen for lunch!!! He was granted 4 hours off the ward to attend his own fathers funeral, and was disciplined when a colleague offered to cover his weekend to help our his mother after the funeral!! Caring profession???

When we were first married it was just as bad, he would be on call in the hospital for 12 days and then off for 2 and then back again. Great way to start your married life!!!

Now that he is a consultant he works 10 clinical sessions (approximately 42 hours per week) 1 educational session and 1 research per week, about another 6 hours. This does not include his 1 weekend a month oncall, any compulsory education/training that he needs to do or the general crap that lands on his desk. In total I think he does about 70 hours a week at least for the NHS. And while folk think that doctors are well paid if we did the calculations I am sure that his hourly rate is no better than many other professionals.

We have had family holidays interrupted by people wanting to ask about patients. We have had to go in and see patients on our way home from concerts/date nights because it is expected of him. While I was in labour, a junior colleague barged into my room to ask about some trivial matters. And he was continually being paged!! He has missed important things in our children's lives due to his caring for his patients and the demands of his job.

He does not do private clinical work, instead he has chosen to do medical legal work in attempt to improve the care that his clients get in life. No, this money does not get filtered back into his NHS department, it is his and we have chosen to use it to build a nest egg for our children. I would like to see many of you giving back half your bonus or overtime to your workplace.

The problem with the NHS is funding, but to be better funded we have to pay more taxes. And that is the same for many government services. The NHS do not tend to pay overtime, like many companies do. They also work on a system of financial funds, they have funds which pay for nurses -broken down into normal nurse staffing, bank nurses and agency staff. When one fund is empty they move onto another one until it has run dry too. The same goes for physios, dieticians and doctors. But again it is the same system for education, social care etc.

My husband works very hard as do his colleagues, I take exception to the belief that they somehow are neglecting their NHS jobs to line their pockets, when in fact they are neglecting their families a nd their own well being for the sake of the NHS and its service users.

Yes you may be able to be seen sooner in the private sector and good for you if you have only ever used it. I have accessed care there myself but it is not because the consultants are lazy it is because the NHS is so over stretched by people misusing resources that it is struggling to cope!!

OP be very grateful that you are in the position to have the added choice and please research your facts before jumping to conclusions.

Bravo redastra!

Another doctors wife here, my DH is a consultant in a huge, understaffed, under-resourced, under-funded teaching hospital in North London. Our lives pivot around the needs of his patients and colleagues, completely understand redestra's comments:

I have been post surgery and have needed him at home with our kids but he's had to go in to the hospital. If he ever takes annual leave he has to go into the hospital, email, speak to etc (for the past five years he actually hasn't been able to use up all of his annua leave allowance as there simply wasn't the staff to cover his clinics).

He works roughly 80 hours per week (above and beyond his salaried hours) and quite frankly he is too completely and utterly exhausted to undertake any private work!

Having said that, many doctors used to be able to negotiate a 70/30% contact, freeing the 30% left for private work. Although I think the contracts are different now.

My point is that the quality or the expertise of the doctors is not any better in private medicine; as the OP states, privately they would still see the same physician. However as others have said, if there was anything urgent that needed to be done, the NHS would get it done.

Medicine is by definition a lot of the time a process of elimination, I presume the OP's MIL is on medication for her condition; I would absolutely not pay for the appointment sooner. If her consultant felt that things needed to move quicker based on her other test results, he/she would do it. It's his/her GMC licence, his duty of care, she's his patient.

Unfortunately the debilitating system within which the NHS has to operate, forces everything to be based on priority of care, who needs what and who needs it first...it is what it is.

We could always open our doors to thousands of insurance companies competing for us to have policies with them while the have nots just rot.

My aunt is in America, she's 85, as her age has determined the viability of her medical insurance, her cost for her diabetes medication has gone from $68 per month to $250, because she turned 85!!!

I work 9 sessions (4.5 days) for the NHS plus on call.
I do a few hours extra over what's contracted and paid for nearly every day for free.
Tonight I've spent my whole Friday night writing a coroners report and a police report. There is no extra pay for that and no time in my day job to do it.

In the half day off I have I often spend it with my kids, do the housework, get my haircut, catch up on some sleep, go to the gym or do my voluntary work but sometimes I make some extra holiday spending money doing private work. Sometimes I also do some work for my husbands business completely outside of being a Dr.
Do you mind awfully if I do that any of that? Did I miss the clause where I have to give my every waking hour to the NHS or be labelled a money grabbing, greedy fat cat?
It's really no-one else's business what I do in my spare time.

My NHS trust doesn't have the money to pay me for the extra half day so they've never offered.

OP: Well this thing you hold dear, really isn't right for me. Why is it like this?
MN: Well we're quite fond of it.
OP: But it should be more like the thing I want it to be.
MN: Nobody's making you use it
OP: But I want to use it and I want it to suit Meeeeeeeeeee
MN: Off you trot, love.
At least this is how the threads from new MN users who start threads telling regular MNers what's wrong with the site, end up.
Just sayin'

I'm not sure at what point I said that I wanted to use it and wanted it to suit me, if you read further back I said that I had no issue personally as have private healthcare. I'd use it in an emergency yes but as others have confirmed for this care then the NHS is the best in the world and I agree.

redastra this is my research! Learnt more on this thread than I would do any other way...

I agree with the NHS being underfunded but don't agree that it would be better with more funding, there's a pervasive issue that not enough is spent on clinical and too much is spent on administration - hence the point about the NHS manager who couldn't manage outside the public sector. The amount spent on non-clinical roles is frightening and is the real crime.

Oh my

You've stated yourself that this very same consultant works for the NHS. He/she could choose to work entirely in the private sector and earn way, way more than they do in the NHS.

It's entirely up to the doctor concerned what they do outside their contracted NHS hours; it's buggar all to do with the NHS itself!!!

If there were more funding, and more Consultants could be employed, then the waiting lists would go down.

You clearly have no idea how the NHS works.

The other way to look at it is that allowing consultants to do private work outside of their NHS hours (and in addition to their NHS hours) actually keeps good doctors in the NHS. If they couldn't do it, a lot would go totally private, not just because of the money, but because the resources available in the private sector allow them to develop cutting edge practices. I've worked in the department of health and worked on doctors contracts and the NHS benefits from this

My husband is at this very moment sitting in the waiting room of a private hospital waiting to see a consultant about a minor operation. On a SATURDAY MORNING. The consultant quite obviously does his private work above and beyond her committments in the NHS, hence the weekend and evening consults in the private sector. Hubby has also been told that his op will probably be scheduled for a Saturday.

I also personally know a couple of consultants who do no private work whatsoever. Some choose not to. I know one other who regularly works evenings and weekends doing extra sessions IN THE NHS operating on patients to try to minimise waits for routine procedures. I also know an NHS physio who is contracted to 25 hours in the NHS and supplements her income doing private work at the weekend and evenings.

There is also often not the option to go private - a couple of years ago my son needed a particular operation carried out by a paediatric orthopaedic surgeon - he told us he did no private work, and didn't know of anyone else in Scotland who could do that operation privately for us either.

I don't get this animosity against how doctors spend their free time. It's up to them whether they sit on the sofa watching telly or take on extra private work.

Agree also that private doesn't get you "better" treatment. It just gets you faster treatment, in more comfortable surroundings and you often have more flexibility over where and when you are treated.