To go private because GP won't refer me?

[JustGettingStarted]

I had a basal cell carcinoma removed from my face 8 years ago. It required a skin graft and left a scar the size of a 50p piece. This was in Scotland. I hadn't recognised it for what it was and left it several months due to being pregnant and then having 3 children under 5.

I was told at the time that I would likely get more and that I should be checked by a dermatologist periodically.

Then I moved to England. I have had very little cause to see doctors and I haven't been checked by anyone. But I keep an eye on things and I recently noticed a new, tiny bumpy patch very close to the site of the first lesion.

So I went to the GP this morning to ask her to look at the thing on my forehead and refer me to a dermatologist. She barely leaned forward in her chair and she was very dismissive.

She just said it's nothing, don't worry. I asked her to refer me to a dermatologist and she said no. No referral unless "it grows really big or starts to ulcerate."

She didn't even get up to lean over and really look at it. She just said that nothing would be done unless it looks like a carcinoma to her, a GP.

I told her that I have had one removed and was told I was likely to get more. I told her that I had let it grow last time and was told that I should have gone earlier. In fact, I was told that I should have periodic checks by a dermatologist. She said that wasn't going to happen in England.

I just can't believe that unless she thinks it looks like a carcinoma... After it's grown and gone scabby... there's nothing to be done.

So I am paying for a private dermatologist to look at it Friday afternoon. If a dermatologist who specialises in treating BCC's tells me it's nothing, I'll let it go. I also figured that I would rather get a carcinoma treated privately as then I would have control over the timing of everything instead of just waiting for letters. I was impressed with being able to get an appointment with only two days notice! I have to travel for my work and I like the idea of being able to schedule things around work.

I am paying 225. But if a dermatologist tells me not to worry, I won't worry, so money well spent. And if he thinks it is a carcinoma, money well spent! Alternatively, I can also request a referral to the NHS for treatment, thereby getting around the obstructive GP (should it be a carcinoma) while saving money.

But an acquaintance of mine believes very strongly that paying for private medical care is wrong because it perpetuates a two-tier system that favours those who can afford it. She encouraged me to seek a second opinion from another NHS GP.

I'm not made of money. I wouldn't be able to pay for anything major. But I can afford to pay a few hundred if necessary. I figure I'm saving the NHS money.

AIBU?

[Moreisnnogedag]

The private dermatologist may be able to refer directly as it's on the cancer pathway(I think). I have had GPS who will just do a letter based on info from the private consultant. It'd take an incredibly brave stupid person to refuse to refer at that stage.

[TatianaLarina]

The UK has one of the lowest cancer survival rates in Europe. The key is early diagnosis.

Nice warns GP delay in referring patients are costing 10,000 lives a year

BMJ study found cancer patients dying because GPs fail to refer for tests

[Floellabumbags]

You're doing absolutely the right thing. I really hope it's ok

[JustGettingStarted]

The doctor I'm booked in with is also an NHS doctor, although he's with hospitals in Merseyside and I live in Oldham. He can refer to a different trust?

[TatianaLarina]

I might also have tried a private GP first, as they are cheaper and can refer back in to the NHS

I don't think they can actually - that's certainly not my experience.

There's not a lot of point faffing about with another GP, she may as well put that money towards a specialist appointment. It's just another delay.

[Floralnomad]

YANBU to go private to alleviate your worry , however the GP is not being negligent . BCC are extremely common , my dh had one removed from his face a few years back and when he saw his GP recently with another lesion in the same area was told they have to be over a certain size before they can refer to dermatology.

[Bezm]

User147 you're assuming the GP has no idea. They could be absolutely correct! You assume they have had no dermatology training, again, you have no idea.

[Bubbington]

I had a BCC removed this morning at 10.00am, beside my eye. I have another (larger one) one being removed from my face in early October. I had one removed in 2000 from my eye lid. You MUST get a second opinion; my GP told me that lumps like that get a hospital referral in 2 weeks.

The one that was finally removed in 2000 had been on my eye lid for like 5 years and my then GP did nothing. On changing GP's due to a house move he referred me immediatley to the hospital and it was removed within a month, with no scarring.

Good luck, I hope it is nothing but your GP is wrong not to investigate further. Also the hospital told me that there are not usually long waiting times for BCC's as they are done as day cases.

[JustGettingStarted]

floralnomad that's crazy!

It's true that some tumours grow slowly over years, but if mine had been caught early, perhaps I wouldn't have a big round scar on my face! Perhaps I wouldn't have needed a skin graft!

I know a woman with no nose. Just a plaster over the centre of her face. I was told that she had a carcinoma (not sure which kind) that wasn't dealt with properly and now has no nose left.

If your husband went to a private dermatologist, he could get a referral for removal?

[TatianaLarina]

I think for an NHS appointment with him you'd have to see him at his NHS practice wherever that is.

I don't know if he can you directly to an NHS consultant in another trust, you'd have to ask a doctor. It may be necessary to go through your GP.

[TatianaLarina]

^ refer you

[wheredoesallthetimego]

my GP told me that lumps like that get a hospital referral in 2 weeks.

that's not correct. suspected melanomas or squamous cell carcinomas go in on a two week wait, suspected BCCs go to an urgent OPD clinic but doesn't have to be 2ww as they are slow growing

[InvisibleCities]

My GP sent me to the skin clinic for a new sunspot. He said the NHS policy is to cast a very wide net for these things because though most are harmless the very few that aren't can be very harmful. Your GP is negligent.

[JustGettingStarted]

I wouldn't expect him to treat me himself on the NHS. I just don't know if he can refer me to the Oldham treatment centre.

I am not sure what the options will be at the appointment. Perhaps I can pay for a biopsy without full removal. Perhaps it's small enough to treat in the clinic.

I'm definitely going to make it clear that I am only going to relax if they feel certain it's not a carcinoma. If it's a "maybe" I won't take a wait and see approach.

[Floralnomad]

We are not concerned , I'm talking tiny pin prick sized mark at the moment . He was actually at the GP because he has recurrent lipomas and wanted a couple removing , which he is having done and just asked about it as he doesn't go to the GP very often and was clearing everything up in one visit . His previous BCC was pretty small when he had it removed and you can barely see where it was .

[LifeofClimb]

Just do it! Go private. Who cares what anyone else thinks - it's your health, you can afford it, and the service is there.

Out of interest, where did you find a dermatologist that only charges £225 for removal? Or is that just the consult? I'm looking at mole removal and I'm seeing much higher prices!

[JustGettingStarted]

It's just for the consultation. It's £650 for removal, but I doubt that price includes a possible skin graft.

[JustGettingStarted]

There was a cheaper clinic in the same neighbourhood, but they didn't call me back.

I am impatient... I will pay more for expediency!

[massistar]

I had to see my GP practise 4 times about a blemish on my nose which turned out to be a BCC. Was seen by 4 different GPs and the first 3 told me it was nothing. Eventually got referral to dermatologist who confirmed it and had it removed by laser in January.. no scarring at all, just the skin looks a bit paler if you look really closely.

If I get another one I'll be demanding a consult..

[user1471531877]

Please update us OP
Then Bezm can tell us all we have no idea

[Changednamesorry]

tell your friend to fuck off. its very easy for people with nowt wrong to bang on about what they would do if it was them.

I have rheumatoid arthritis. was fobbed off for YEARS by the NHS......I mean 15 years. Told everyone gets aches and pains (limbs freezing up at 16 years old? normal!)
here is Spain - one visit to my GP mid flare up resulted in instant (think 48 jours) blood tests, radiology within a week, rheumatologist within a fortnight - treated, diagnosed and managed within 6 weeks.
NHS is on its knees - its not the doctors´fault - it that the cuts mean they can´t do their job properly. forget ethics. go private and take care of your health.
then tell your friend to fuck off one more time.

[TatianaLarina]

I wouldn't expect him to treat me himself on the NHS

It's possible he would though. I've been given a choice by private consultants in the past whether to continue privately or to shift to their NHS practice. It might involve a re-referral from the GP.

There are many people in your situation who don't have health insurance, who can stump up money for a private appointment but can't afford private tests and treatment.

[NotMyPenguin]

Just do it -- it would be silly to risk your health in order to make a point.

Yes, if there are any specific concerns/recommendations from your private check up then you can go back to the NHS to have them dealt with. Make sure any letter is cc'd to your GP and then chase for follow up referrals to make sure they are made.

While the NHS may not offer periodic checks as a matter of course, it seems wrong that your GP isn't taking your specific concern (changing mole, after history of BCC) seriously. If you see the specialist and it turns out you were right to be concerned, make a complaint.

[spidey66]

I'm an NHS nurse and a strong defender of it. However, even I can see the private sector has it's benefits. The main one being it takes people off NHS waiting lists!

I've just had a verruca removed and had to have it done privately. If I'd waited for an NHS chiropody referral I'd have to wait until I was either elderly or diabetic. Which is fine for me as I can afford it, but not so fine for others who are on a low income and are in a similar position to me.

[JustGettingStarted]

Well, BCC's aren't generally fatal and can take years to actually eat holes in your face, so I guess it makes sense for the NHS to wait until the situation is critical before acting. After all, not wanting a big, flat, silvery, circular scar between my eyes is just vanity.