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.

You don't have an NHS problem. You have a Jeremy Hunt and George Osborne problem.

Absolutely nothing wrong with this. It's great the option is there. It's like a second job for doctors. These people are highly trained and skilled and should be able to earn money commensurate with this which is not usually an option working 100% for nhs. Would you rather people went abroad? I had exactly the same experience seeing s Dr in 3months on nhs or in 2weeks at the Bupa hospital (same Dr). The nhs is woefully underfunded and with the increased pressures on it due to increased medical successes and treatments ageing population and to a lesser extent immigration I don't think it will be possible to fully find it. Having private options available takes a lot of pressure off the nhs. I actually think the interaction of the NHS and private medical is going to be the saviour of the NHS (that and people stopping visiting the Dr with a cold/a&he with a stubbed toe and demanding antibiotics for viral infections)

But actually you need some admin and management so that Drs and nurses can do their clinical work

Every time I am stuck doing paperwork that someone else can do that's a waste of NHS money and resources. I absolutely rely on my secretary to manage my appointments, type my letters, take phone messages, file and order records. I could do all that myself but I'd have less time for patients. My secretary is great value for money.

My ward manager and community service manager are also very much needed people. They sort rotas out, manage staff problems eg sickness, performance, investigate complaints and incidents, do audits and checks to make sure standards are good and take action where they are not, make plans to develop the service, manage the dept budget and troubleshoot problems on a day to day basis.
These things need doing don't you think?

They are both former nurses and it's usually the case that NHS Managers are not some other breed of person but clinicians who have experience and management training. Many private sector people have found that managing the health service isn't quite the same as managing a supermarket.
Perhaps NHS managers wouldn't be any good in the private sector but I'd respectfully suggest the reverse may also apply. They just aren't the same job.

Higher up managers like the medical director and chief executive have a really hard job. They are ultimately responsible for standards, safety and budgets for a huge organisation. They need to manage the contracts for services which are usually hard fought. They will be taking the ultimate rap for a bad CQC rating, big debts or a death or negligence case.

Mamadoc makes a good point re managers. Sure , there are probably some bad ones. There are poor employees in every organisation and the NHS is a huge organisation. So it will have sub standard managers, as well as suboptimally performing doctors, nurses etc. BUT you can't do away with all non clinical roles.

I used to be a trustee for a charity that had to bid for contracts and funding. We had so many battles with bodies that only wanted to fund client facing staff doing client facing work. We had to turn down funds for projects because of it. If no one will fund the accountant, hr person, admin and reception staff, ceo, or the time senior colleagues spend budgeting and managing staff (eg appraisals) then you simply can't have an organisation providing front line services at all.

The amount spent on non clinical roles OP is terrifyingly low. For the decisions and pressure and budgets handled, NHS managers get paid a tiny tiny tiny bit of what they'd earn for a similar role in the commercial/private sector. And sadly, you pay peanuts, you get monkeys.

Pay more for better and proven managers.

The simple answer is to put a lot more money in to the NHS so everyone can be seen by a specialist next week.

Not sure how to add a link but feel like this article supports my point to a degree

[NHS consultant paid £375,000 in overtime
www.bbc.co.uk/news/health-36898881]

I work 40 hours per week as an NHS consultant (well I work more than that but I'm paid for 40!). My trust can't afford to to fund any extra consultant sessions so even if I asked for more work I wouldn't get it. I could however do some private work in the evenings- I'm considering it because I have a mortgage to pay and kids university funds to save for. If I could do the extra work at my current rate of pay for the NHS I probably would as working in the private sector is more stressful and leaves me more exposed. Sadly the NHS can't afford to hire me for an extra session. Would the OP object to me getting a job in a bar or delivering pizza in my own time? Is it only me working as a doctor that you object to? I worked bloody to hard to get to where I am- I spent 10's of thousands of my own money on exams and training courses - there is nothing immoral in my trying to optimise my earning potential. Especially when my salary compared to those who work in the legal profession or the financial sector is laughably small.

peppatax have you wondered why a load of articles like that have appeared today? Good journalism? Surely nothing to do with the impending lawsuit over the junior Dr contract and the need to soften up the public before the consultant contract negotiations..... Be aware of the wider picture.

Re: the £375,000 overtime, there aren't enough details.

It could be some kind of scam, or it could be somebody who is being paid well for a skill that is highly valued and in short supply.

Many people have salaries well in excess of £375,000.

However, your salary compare to others in the manufacturing industry for example is actually quite high.... It depends really where you are looking (those who earn more or those who earn less).
But tbh it is beside the point.

There is clearly a shortage of consultants. And some trusts need to pay for overtime at very high prices.
Others have decided to not pay anyone with overtime (even though I suspect it depends on the speciality too)
No one says that as a doctors, you shouldn't be able to work privately. Even though, again, in some sectors this would not be allowed. But, atm, it is legal and then why not?
But it doesn't solve the very big issue that is waiting times on the NHS, quality of care (ie is it the just the minimum or is it optimum care?) etc...

Eg my MIL had open heart surgery. She stayed two days in ICU and then was out 2 days later. My FIL has clear mobility issues. He struggled to feed himself whilst my MIL was at the hospital. Was that optimum care to send her back home wo even checking if she could go up and down the stairs, shuffle up to the bathroom etc??
Other example: I have ME. Not a lot that can be done BUT the advice from the consultant is graded exercise and seeing a psychologist (plus diet, lifestyle adaptations etc..). Waiting time to see said psychologist? 12 months. Waiting time to see the physio for the graded exercise? About 9 months....
The psychologist who sees ME patients also sees peole who are suffering from cancer and other chronic diseases. Some of them have life limiting illnesses. I can wait 12 months. Can someone with cancer wait 12 months?

Selective quoting there.

Yes, one Dr earnt that crazy amount but it was clearly exceptional.

Later in the article it says the average amount of overtime paid was 13,000 and only about half of consultants ever get any overtime paid at all (I know I never have done)

It also explains that this will be mainly for surgeons and anaesthetists to run extra operating lists at weekends to get waiting lists down. Whoever it was who earnt so much must have worked every weekend doing extra lists.

I can't see how the article supports your point at all. These people are doing exactly what you want aren't they- giving their free time to the NHS rather than do private work?

Would you expect them to do it for free? You don't want Drs to earn extra for private work and nor do you want them to earn extra working for the NHS.

Changing the contract to encourage Saturday working as suggested in the article won't help as they'd get a day off in the week instead. Overall the same amount of work would get done.

The solution is simply to train and employ more Drs but the government has always been reluctant to do that.

If you want have a look at this article still on the BBC.
The choice is simple

• Pay consultant a hell of a lot of money to do extra work (but what are the risks associated with overwoprked consultants??)
• use locums (but then they want to avoid that too - plenty of reasons for that)
• send patients to the private sector (expensive too - and you'll find the same consultant than in your NHS hospital)
• make the patients wait.

Or ... put more money in the NHS, restructure the NHS, have a look at what other countries are doing to be able to have good quality health care, incl France, Spain or countries like Singapore.

Also the people working for the locum agency and in the private sector are mainly the same consultants as are working for the NHS. Very few people work exclusively privately. Nearly all were trained by the NHS unless they came from abroad.

It's a big demand and a small pool of people with those skills training. 5 yrs med school then probably 10yrs post grad experience to operate independently even more to sub-specialise.

It's just a supply vs demand issue. If you want pay to go down train more doctors to reduce competition.

However, your salary compare to others in the manufacturing industry for example is actually quite high

Given the shortage of people able to do some medical jobs, it is realistic to expect them to be well paid compared to anyone in any industry, but the article gives no further explanation of why this person was paid this amount of money, so on its own it's a pretty meaningless figure.

If you can find people who want to do it. Applications for med school have dropped by nearly 15% in two years. It's still competitive, but a few more years like that and it wouldn't be. I'm a doctor and I hope my kids do something else, or do their medicine in another country.

The NHS isn't a God given right. In Plenty of countries people have to pay or get insurance.
We are lucky in the UK, and much of Western Europe to have this service.
Doctors need to be paid like anyone else.
I don't see the problem. The NHS is great if you are in an immediately life threatening state.....otherwise it just works slowly and inefficiently like any other service.

The bigger picture is that I don't think the conservatives are at all bothered if most doctors do all their work privately.

Be thankful that consultants work privately, they provide services and operations which are not available on the NHS. How do you think new procedures and services are developed?

I think if you can pay, then do so and then people wouldn't be waiting so long for an NHS appointment would they?

kennington
We are not lucky to have the NHS. We are laying for it! (But are lucky to be able to)
Besides, a health care system is good fur the country. If people aren't treated or treated correctly, it means a lot bad news fur the economy too (think work days lost, people with lower income unable to buy etc etc)

Hmm, I'd be prepared to argue quite strongly that free medical care is a human right! And that plenty of countries refuse to acknowledge human rights, but we don't normally point to them as something to aspire to.

I also agree that doctors should be well paid and not overworked and I think it's ridiculous that they have to pay university fees for training for such a vital and socially necessary role (ditto teachers and nurses).

That said, comparing a consultant's wage to the even higher sums earned by the lucky few is a bit specious. The PM doesn't earn as much as the Queen (comparing roles of similarly high profile here), but presumably we shouldn't be raising her wages on that account. Of course, if doctors weren't leaving university with a huge debt, the wages might seem a bit more commensurate.

We ARE lucky to have the NHS. It is a unique and wonderful thing about Britain and in surveys is consistently cited as the thing British people are most proud of (justifiably in my view)

There is no other major economy health service that I know of that is free at the point of use and paid for from general taxation. Those are the unique features of the NHS.

For the money we pay as a proportion of GDP the results are 1st class. It is a really efficient system because there are huge economies of scale eg on drugs budgets. Not my opinion but the opinion of the WHO. Whether you pay through taxation or through insurance you still pay. A good healthcare system costs money it's just a case of who pays.

It is also most importantly a fair system. Access is based entirely on need not on ability to pay. As soon as you introduce some element of an insurance based system you start to discriminate against the poor and the disabled and chronically sick.

We have a system that is fair and value for money. Why anyone wants to mess with that I have no idea. It might look to you like some European insurance based systems are better eg shorter wait times but they are not better for the most disadvantaged who are excluded or get a lower standard of care.

The Tory government want to push the responsibility and the bill off themselves and onto individuals to fund their own care because they believe in a smaller state. This will lead to a more expensive, more inequitable system. I sincerely hope they do not destroy one of the things that makes Britain great.

I'm totally disillusioned with the NHS. After my DD needed treatment to help with a serious, life changing, condition it was not available on the NHS. She would have to either wait until she was an adult or we'd have to pay. We paid otherwise she would have had 7 years of pain and disability. Thankfully when she was young and had cancer the treatment was available for her.

are you kidding me?

NHS doctors can't do anything in their own free non contracted working time?

If he wasn't seeing his private patients during that time, that doesn't mean he'ld be in NHS clinics ON HIS DAY OFF - he'ld just be on a day off! Should he not be allowed any? is that what you're saying? Christ you must be the only person on the planet outside the gov who supports the new NHS killing Doctors contracts so!

Good luck when they all leave the country!