Shocked to find this out about private healthcare

[brasty]

If an operation goes wrong, private patients find it far harder to get compensation that NHS patients. NHS patients operated on by Ian Paterson through the NHS, have already received compensation. Private patients may never receive any.

"Linda Millband, national lead lawyer for clinical negligence at legal firm Thompsons, is acting for more than 500 of Paterson's former private patients.
She said private policies have very stringent restrictions, which can be revoked in cases of criminal activity, meaning the patient is not necessarily covered.
"So people are not as safe in the private sector as they are in the NHS because policies are subject to review, so even if you sue somebody, if the insurers say it is criminal conduct it falls outside the policy," she said."

www.bbc.co.uk/news/uk-england-40124691

I work in the court of protection and I can tell you categorically that we do not have a compensation culture when it comes to clinical negligence

Hmm. I think the barrier to getting any compensation is high but, once you clear it, pay outs are high too. Average pay out now higher than in US, where medical litigation is falling (from a high baseline). The recent sudden change to how payments are calculated (discount rate) has destabilised many insurers including medical indemnity organisations, which is not at all in patients' interests.

Apparently, fewer than 6% of private hospitals even had a crash trolley in 2015

I honestly cannot believe that - where did you get that figure? Are you sure it wasn't only 6% had one in their outpatients department or somewhere else fairly low risk (not that I am condoning)?

I was shocked as well shiny I heard it at a medicolegal conference I went to but I can't remember any details it may have been outpatients! But when you think that dentists get reprimanded by the CQC for only having one oxygen cylinder...

I'm having a look for details now!

Shiny new username. I'm sorry but you are talking bollocks. I've been working in the field for over 10 years and the level of damages is nothing like the US. The largest settlements we see are in the region of £5m and those are for children who are brain injured at birth and require 24 hour nursing care for the rest of their lives. Virtually all of the condensation goes towards the costs of the care.

If you lose you bowel and end up with a colostomy. You'll be lucky to get £50k

• compensation

Maybe anyone getting private healthcare should by law have either insurance or money to pay for any complications, rather than the NHS paying?

I get private health care through work. There's no way I could afford to have it otherwise and if I had to pay for an insurance then there'd be no point in me having it as I couldn't afford the extra expense.

"NHS trusts in England paid out more than £1.4bn in medical negligence claims last year compared to £583m in 2008, analysis shows.
The NHS Litigation Authority (NHSLA), which handles claims on behalf of trusts, said it was trying to reduce the costs.
It blamed big rises in claims and legal costs from claimants."

It's out of hand and needs to be curbed with changes in the law (people are suing for all kinds or things). Can we not just accept that sometimes things go wrong and just live with it rather than having this entitled claims culture tax payers are currently having to pay for?

Private medical care in the UK is usually used by relatively wealthy people to queue jump for a procedure which will almost certainly be carried out by a NHS trained practitioner.
By relatively wealthy, I mean people who can either afford to pay out right or have some sort of medical insurance from their employer that is typically reserved for the better paid.

Lucysky2017 people aren't suing for all kinds of things. The law simply doesn't allow it. Yes the NHS did pay out huge amounts in legal costs last year. Would you like to know why? Because they defend the indefensible and drag claims out until the last minute.

It's all very well saying accidents happen but how is someone meant to live if they can't work and they need to pay for expensive care?

I'm a solicitor by the way and my husband is a doctor. We've both worked for the NHS.

Stop reading the daily mail.

Well I'm not relatively wealthy! I have no qualms about 'queue jumping' either - I used private healthcare to have my gallbladder out. I'd had pancreatitis and had the choice of 'queue jumping' and going private or waiting for the NHS and feeling shit for even longer!

I think the 6% refers to crash trolleys manned at night...

owl am I correct that some Drs in the USA don't have indemnity because they can't afford it (particularly Obstetrics)? I'm sure I read something about the state taking over the role rather than the individual. Same in Australia or am I conflating things?

You either had insurance through work, or yes you are relatively wealthy to pay for a gallbladder operation

I wish everyone understood that the business model for any insurance company is to avoid paying out!

They'll use any and every loophole they can. They are not benevolent charities, they are there to make money.

Lucysky2017 people aren't suing for all kinds of things. The law simply doesn't allow it. Yes the NHS did pay out huge amounts in legal costs last year. Would you like to know why? Because they defend the indefensible and drag claims out until the last minute.

Absolutely spot on.

You cannot sue for anything, you should hear me on new client rota, turning many MANY things away because they have no claim.

Then when you have gross negligence, the NHS defends it until their dying breath and rack up the legal costs accordingly. But of course, lawyers are to blame.

I've been working in the field for over 10 years and the level of damages is nothing like the US. The largest settlements we see are in the region of £5m

None of that stops the average payout being larger in the UK. I agree that the highest payments in the US are much higher than here, though you are underestimating the highest UK ones - there have been several lifetime payments greater than £20 million.

The total US annual payout has fallen substantially over the last decade - see link, whereas here they continue to rise.

NHS trusts alone paid out £1.5 billion in 15/16 and that excludes almost all GPs - the majority of the medical workforce - and all private work. The NHSLA which only covers NHS trusts (not GPs/private work) has known claims of £12.5 billion already on its books.

I remember doing an agency nursing shift in a private hospital in central London. One of the patents had a cardiac arrest, and basically they called 999, and took him round the corner to University College Hospital A&E, as there were no emergency services or crash team on site.
I was, just seemed really negligent to me.
It might be different now, but I've just done a but of googling, and reading between the lines, it looks like the only private hospital in London with emergency services for their own in patients is the Portland. Yet most of them have operating theatres. Scary.

You either had insurance through work, or yes you are relatively wealthy to pay for a gallbladder operation

My point was that ifailed lumped the two in together and they are very different. Working for a company that provides private healthcare doesn't mean I am 'better paid'.

Anyway, I didn't mean to go off on a tangent!

The solicitor's quotes say the insurance is revoked if the doc is found to have done something criminal.
Which is extremely rare.
You can still sue private doctors

I used to work in an NHS hospital that was near to a private hospital
The private did elective surgery. They had no crash team so if anything went wrong they dialled 999 and they came to us
Complex patients often ended up with us when their insurance ran out
We had more than 1 patient who had been refused surgery with us unless they lost weight or had to comply in a different way only to go private then end up with us for months due to complications
I've changed some details in the last example for confidentiality

All private hospitals are regulated by CQC. (So I'd be surprised if only 6 % had crash trolleys.)
Some of the smaller ones have to transfer patients out if things go wrong, and there will be processes in place to support that, but most of the London ones have intensive care units.
I think its not fair to generalise and say private hospitals give shit care.
Some probably do, but the same could be said for NHS.
I worked in the NHS for 25yrs , and did bank in a private hospital. The private hospital has an ICU, and each ward its own crash trolley. They also used an early warning score to flag up deteriorating patients and had a resus meeting every morning and evening to highlight any unwell patients.
A lot of the staff had come from the NHS because it was getting so grim. Nurse patient ratios were 1:5 during the day and 1:6 at night.
The surgeons were all NHS surgeons. The ICU consultants were from a nearby large teaching hospital, and the RMOs were senior registrars taking time out to do a PHD.
I'd say the care was pretty good, although obviously I only have the perspective of that one hospital.
I know one doctor lost practicing privileges because there were concerns about his treatment. Any doctors involved in a patient incident were referred to GMC.
If I had private insurance, I would probably use it, but only in a hospital with an ICU.

As for NHS claims, I know of one case in the hospital I worked at where a patient, who was fairly well known, developed a not so nice complication. This was recognised before the patient left the hospital but they refused to wait to see the consultant. Subsequently things didn't go well. The patient sued, and the hospital were advised to settle. As the damage to reputation would be far worse than the costs of defending.
It's not all black and white.
Those poor patients who were mistreated by that animal Patterson deserve to have compensation. If his own insurance will not pay out, surely they have other options?

My point was that ifailed lumped the two in together and they are very different. Working for a company that provides private healthcare doesn't mean I am 'better paid'.

My point was that private health insurance is rarely offered to the lower paid, usually to 'Management'.

You got your gallbladder sorted out, good for you. Probably by the same surgeon who would have done the same Op at a NHS hospital sometime later.

Compensation is complicated. Even for serious, life changing injuries the actual amount paid for pain,msuffering amd loss of amenity is really very small...as stated above £50k for colostomy, spinal injury without paralysis but with bladder injury etc.

The rest of a claim is made from evidenced financial losses. Salary, pensions, cost of care and so on. This will be both backdated and projected forward. If a claimant is quite young and has a good salary and unable to work then they have very significant losses. And the recent change in payouts is long overdue because it is calculated on claimants being able to invest at rates of 2.75% which has been unachievable for years.

So we are not talking about greedy compo culture grabbers but victims of avoidable injury. Victims who would far prefer their lives back than any amount of cash. And yes, the medical protection insurers will stop at nothing to deal and fight these claims causing even more pain and suffering.

It's a nightmare to be involved with.

Doctors are obliged to have personal insurance and will not receive practising priviliges at a private hospital without providing proof of personal
Indemnity cover. This is expensive and can cost thousands per year depending on how much you earn.
It is not mandatory for working in the NHS as NHS work is covered by crown indemnity, however you are strongly advised to have it for your NHS work in case you need to clear your name in a case that your NHS trust would otherwise just settle on out of court.
Hope this is helpful.

It is my experience that private health care is inferior in many ways. They only take on low risk cases, all complications are shipped back to the Nash, night time cover is at best variable and at worst dangerous. There are surgeons doing procedures in the private sector that they wouldn't dream of doing in the NHS (due to lack of subspecialist interest) and new cancer diagnoses are never seen with a clinical nurse specialist although thankfully they are now discussed at the NHS cancer MDT to standardise care.

Yes some London hospitals have ICU's. Outside of London, they do not have.
A friend with a complex health problem but private insurance,actually chose to go NHS because she thought it was safer.

ifailed I'm definitely not management. Maybe I just work for a good company, I don't know.

Yes, it probably was the same surgeon who would have done it on the NHS months later despite the fact I was classed as an urgent case. In his words, I could die if I didn't have it out so why would I wait?

You sound quite bitter about people having private healthcare.