To think it’s so wrong that if you have money you can jump NHS waiting lists?

[ImaHogg]

I have some gynae issues. I had a scan in September 2020 and a telephone consultation with a gynaecologist. I was told that I need a hysteroscopy with a biopsy and to remove some polyps.
Obviously due to Covid I, alongside so many others am now on a waiting list. I (and my gp) have chased many times but just get told they have absolutely no idea when my procedure will be.
I am getting problems from the issues I have and have had enough so rang my local private hospital to ask if they do this procedure (can not really afford to go private but I am getting desperate and wanted to know how much it may be). I was told they don’t do this procedure at this hospital but there may be an ‘alternative’! They would talk to the gynaecologist and get back to me.
They rung back to say they had spoken with the gynaecologist and he would be happy for me to have a consultation at the private hospital (£150) then I would need an ultra sound scan (I would have to have this done at the private hospital even though I have a copy of the NHS one from September, same gynaecologist), then he would be able to do the hysteroscopy but at my local NHS hospital - wtf!!
So basically for a fee of £2000 I can skip the NHS waiting list, skip the luxury surroundings of the private hospital and have the same procedure at the same NHS hospital that I have currently been on a 8 month waiting list.
So if you have money you can push back NHS waiting lists even further by flashing the cash!

@TheirTheyre - but they're not bumping anyone up or down! The Consultant/Surgeon is employed by the NHS for x-amount of hours/day/schedule. The NHS have also decided that certain operating theatres are available for private hire at certain times. The private patient isn't jumping the NHS list as there was never any plan/availability to schedule it then anyway

No, NHS hospitals see private patients all the time. As do GP surgeries. It’s still private.

Lots of NHS bashing on this thread but the realty is that it has been hit hard by the pandemic, as have many industries. Standard operating procedures were implemented for all areas of health care and have impacted massively on healthcare. The government has taken a lot of criticism over how they have handled the pandemic but without SOPs it would have been so much worse.
Both DH and myself have had life threatening conditions recently. I was diagnosed with breast cancer after routine screening, delayed by pandemic, but fortunately this hasn’t impacted on my prognosis. I received exactly the same treatment/timeline as I would have pre pandemic, probably better because non urgent patients are not being seen. DH had a stroke a fortnight ago and as a result of the rapid response by paramedics, A&E staff and Acute Stroke Unit he is likely to make a full recovery.
I have had a lot of interaction with others in the same boat and no one has had to wait for surgery/chemo or radiotherapy. The NHS may be broken for non acute medicine but for those who need it it is doing fine.
However I do have issues with GPs. In fact most of the health care professions are critical of their reluctance to return to “normal”.
As a dentist, and one of the HCP most at risk of contracting Covid ( studies have shown that many of us contracted it in the early part of 2020 before the first lockdown ) I was back treating patients face to face by June 2020, albeit with ridiculous levels of PPE which were in short supply, along with crippling SOP we could do very little treatment. Now 2 yrs on we are expecting to go back to normal levels of practice (well the NHS is expecting us to meet normal targets from April ) , GPs are still operating predominantly via phone., using practice nurses and other healthcare workers to do hands on consultations. DH has been contacted to go for a blood test and BP this week. Really he should be seen face to face by GP, but it is likely that GP will ring him later in the week. As a stroke victim, how can they effectively assess him without seeing him?
I see upwards of 20 patients a day many of whom have symptoms of chronic disease that needs a GP consult. A phone call is not sufficient, you cannot see the subtle symptoms that point to more serious problems.
We are rapidly becoming a screening service, along with paramedics and 111 service.

@Hypie

You will not jump the NHS waiting list. You will just join it sooner.

I deal with a waiting list of over 3000 patients. I literally decide when people have their surgery. We have plenty of patients on that list who thought they would be operated on sooner if they went private in the initial scanning / diagnostic stages. They are very disappointed to find out that isn’t the case. You’ll get to see a consultant sooner. You’ll get to have your scans sooner. As soon as you hit the NHS you’ll wait like everyone else.

I’m paying for a private op (surgeon is not employed by NHS) in a private hospital that also does NHS work.

The NHS will not refer me for the op because the decision maker (physio) does not look at the X-rays. I would need to join a queue of ‘at least several months’ to see a different consultant about a different procedure which the private surgeon says is physically impossible in my case. Then I could go through the whole process again and get on the queue to see the NHS surgeon and in maybe late 2023 join the NHS statistics and list for the op, several years long.

If I could only afford to jump the first two stages to get on the list, it would still be money well spent.

@RandomLondoner

Actually I think the OP could be right about this. I think it is possible to get NHS treatment sooner by having a private consultation (instead of an NHS one) prior to the treatment.

The consultation is a necessary step in the treatment pathway, so you have taken some pressure of the NHS by having that privately.

This was my understanding too. If you have the private consultation (£150-£300), you're already one step ahead as the private consultant can refer you for NHS treatment and you're just on the waiting list for that treatment. So while it might take 12 weeks to get a consultation and another 8 weeks to have the treatment done on the NHS, you can skip the 12 week NHS wait by getting a private consultation but you still have the 8 week wait for NHS treatment. I know a few people who have done this.

The private sector profit twice - once because you were forced there, second because you aren't using their facilities?

No because they have to rent the NHS facilities.

NHS docs see private patients, but once you’ve been referred / seen a doc on the NHS, ethically they won’t transfer across to private. So it’s very naughty if the referral to a specific doc has been made, or a first consultation.

I paid to go private for something, and it freed up my spot on the NHS list for someone else. I count myself very lucky that I can afford to do this

@NoSquirrels

We could all pay more taxes and stop bloody voting Tory as a country and then the NHS might have a fighting chance. Most people don’t want to pay higher taxes.

I think that is a little naive, with respect. It does not explain the situation in (for instance) Scotland. SNHS is in every bit as much of a mess, if not worse. Up here tax rates are higher except for the very low paid, thresholds are lower and ScotGov gets more money from the UK pot per capita for health. It is still an absolute bloody farce with some waiting lists stretching to 4 years in some areas. Even before covid I couldn't get my gallbladder out, though it was deemed urgent after giving me sepsis! You bet I scraped together the money to get it done privately, and hoped that somebody else might benefit by getting theirs done slightly faster.

I think some people don’t understand what ‘full time’ means for an nhs consultant.

It’s not operating 5 days a week.

My husband is in theatre on Mondays, Wednesdays, Thursdays. On Tuesday, he is lead tutor in charge of 50 odd trainees, so he has to sort out their training/rota/queries. They charge every six months, so it’s rolling work.

On Fridays he completes CPD and other activities that support him to remain up to date.

His private work is at weekends.

So, he’s a full time nhs consultant doing private work.

Where’s the problem?

Fgs the NHS management piss money against the wall in Wales during covid they appropriated all private healthcare for the really sick. Cancer patients were treated ditto renal etc no-one could Access private treatment in the UK. They saved lives so socialist virtue signalling doesn't wash.

The revered NHS wasn't treating the private sector stepped in

NHS seems to love management. We went from having 1 manager to having 3 🤦‍♀️

@TheirTheyre

If the same consultant is doing the procedure ‘private’ but using the nhs hospitals and facilities to do their ‘private’ work, then they are effectively using the facilities and blocking them from being used by and for nhs patients. So therefore, it’s a false narrative. They are not making the waiting list shorter. They are effectively bumping someone further up the list for an extortionate fee, and bumping someone in nhs further down. Hence the reason they can’t tell you when you will get your procedure on nhs. And if they can bump enough people into private care, then they will scrap the nhs altogether, which is what they’ve been trying and failing to do for years.

Not necessarily. My private consultant did my laparoscopy after his 9-5 scheduled surgeries for the NHS. He only does his private work in evenings and weekends when he wouldn't be doing his NH work.

There is also the inside that consultants working overtime (which they are often prepared to do) are penalised through the tax and pensions system.

In a nutshell, if they do more work, the increased earnings pushes them into a higher tax bracket and adds to their pension pot. If they pot too much into their pensions, they are penalised.

So the government really needs to sort this out. They’ve known about it for years, and they know doctors are willing and able.

It just doesn’t suit the government to sort it out. They’d rather you paid privately.

Private healthcare waiting lists have grown . Consultant 4 weeks, then another month to have cat scan or MRI. Interestingly the cat scan and MRI is mobile a pantechnicon. Talking to the staff in the vans they cover a huge patch Wales and North West. They're in Yorkshire one day Wrexham the next much better use of equipment in my opinion. Our health board let ours gather dust for financial reasons

If you have the money, you would be helping others by shortening the NHS list

It is the same over here and it is awful that if you have money you get seen before other and yes usually the same consultants but at a different private hospital. I think it is so unfair and there should be a system that is not broken and that serves everyone equally. I hope you get your operation shortly and please talk to someone about hrt for afterwards or else your hormones will be all over the place as the surgically induced menopause the symptoms will hit you at once so try to be prepared as you will be going though recovery from operation.

A consultant contract is 10PAs
Alot of consultants can choose to drop sessions or PAs. Several of my colleagues work between 6-10PAs meaning they can do private work in day time hours. NHS facilities (actual building and equipment) are utilised and the fee is paid. To do private it takes time, money and effort to build your reputation so not all consultants launch into it immediately.

New consultant contracts categorically state you cannot use your PA time for private. So if you can drop to say 8 PAs which include 6 Direct clinical care sessions and 2 admin/SPA sessions thats 3 days per week physically in hospital meaning you can leave 1 day per week for private. You could have a list of 3 cases (cataracts) self funders each paying 3K per eye.

Thats how it has been for years and why many people drop PAs. Its not going to change.

I don't know why people are saying it's not possible to jump the waiting list, I've done it twice.

The wait for an appt with an ortho consultant was monstrously long here. We have insurance through work which is very basic, but will refund you 50% of the fee for a consultation with a specialist. In 2012 I got a very quick private appt with the surgeon I'd been referred to by my GP, who had a 12-month waiting list at the time. He added me to his NHS list straight away, knocking a year off the waiting time. I had had the surgery I needed long before I would have even seen the surgeon if I hadn't seen him privately.

In 2020, I did the same with a different ortho consultant, after having been royally pissed about for 18 months by a combination of Covid, the complex pathway for for ortho referrals and the woeful incompetence of the phsyio service that couldn't organise a piss-up in a brewery. He added me to his list for NHS surgery in December 2020 and I had the op last October, around the time I would have had my first appt with him.

I felt dreadful for doing it, it goes against all my principles, and consider myself to be a total hypocrite for doing so, but I was in bloody agony and, the first time, I was on absence management at work because I was having so much time off.

And just to make me feel even more guilty, the second surgery was carried out in a private hospital but paid for by the NHS, because they were desperate to reduce the waiting list.

@SoManyTshirts, your experience with physio sounds very like mine.

The physio service would send me for one scan/x-ray/test at a time, then no-one would even look at the results until I'd chased them up about it, then I'd eventually get referred for some other investigative procedure. It was 2 years post-referral by the time they finally agreed to refer me on to a consultant, by which time I'd seen him privately.

What really got right up my nose was that the first physio was bang on with her diagnosis and what was required, and the "advanced practitioner" was adamant that the first one was wrong. If I could only remember her name, I'd send her a copy of the discharge letter with a note saying "You know that meniscal tear you said I didn't have ...".

I wonder if we might live in the same NHS trust area, there surely can't be 2 that bad.

@Malteser71

There is also the inside that consultants working overtime (which they are often prepared to do) are penalised through the tax and pensions system.

In a nutshell, if they do more work, the increased earnings pushes them into a higher tax bracket and adds to their pension pot. If they pot too much into their pensions, they are penalised.

So the government really needs to sort this out. They’ve known about it for years, and they know doctors are willing and able.

It just doesn’t suit the government to sort it out. They’d rather you paid privately.

The govt would rather run the NHS into the ground so they can privatise it without everyone being up in arms.

Lots of nhs hospitals have ‘private’ beds. Private surgeons us3 the facilities out of hours

@Aprilx

No you cannot jump the NHS waiting list, you can go private. It shortens the NHS waiting list for others.

When I was a student nurse in the early 80s, Consultants did have private patients in NHS hospitals. Has this changed? I hope so because most nurses were unhappy about it because it meant that other just as needy, if not more, patients who couldn't afford to pay the consultant , were pushed back down the waiting list. Also, some private patients seemed to be under the illusion that we nurses had to put them before all the other patients who were on the NHS, and a small few even treated us like maidservants! This didn't sit well with nursing staff as you can imagine. On a few occasions, I heard Ward Sisters and senior nurses remind private patients that the nursing staff had many other patients to care for as well as them and that we did not get paid any extra for looking after private patients! I think private health care is grand so long as it takes place in private hospitals as then NHS patients are not pushed down the list. They should not be taking up NHS beds needed by just as sick or even sicker people, who just lack the money to go private!

@LakieLady, I’m in the SW. The NHS trust has added a referral service as an extra layer between GP and consultant, and a physio between the GP and the referral service (MSK problems). It’s also a requirement to do a period of physio before getting an X-ray.
I never subscribed to the “too many managers” view, but I understand it now!

@SinkGirl

And you definitely can jump the list.

When we were waiting months to see an opthalmologist on the NHS for our son and he developed worrying symptoms, I contacted a private consultant as I was worried.

He called me and said that it would be best for him to be seen in the NHS but he moved my son to his NHS list and fitted him in the following week. That wasn’t my intention but that’s what happened - good job I did and he did as he needed an urgent MRI.

That is just an NHS doctor seeing that someone needs urgent care and providing it - the only thing the fact that he was also private did was give you a direct line to him.

The NHS is supposed to prioritise based on need, so that is perfectly reasonable.