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!

"I disagree. What a surgeon or doctor does outside of their contracted hours is their own business, surely?! If they want to work every evening and weekend, that’s their choice"

They are not working every evening and weekend. Whereas once a consultant might have done 4 days NHS and 1 day private, As the demand for private work increases (along with better money and conditions) the balance becomes more unequal, so perhaps 2 days NHS and 3 days private. Hence increasing the time that NHS patients are having to wait. Meanwhile if you have a few quid you can get treated much earlier. This is the issue.

Patient A (private), Patient B (NHS). They both have the same condition and need the same treatment.

Patient A calls the consultants private secretary and gets their initial appointment in 1 week. Patient B goes to the GP and is referred to the consultant on the NHS. 1st appointment is 18 weeks later (our service is currently seeing patients at 18 weeks for 1st appointment)

Patient A needs a CT scan. She has this in 1 week privately. Patient B needs a CT scan, she waits 10 weeks after her 1st appointment.

Patient A is then added to the NHS waiting list and waits 20 weeks for her surgery. Patient B is added to the NHS waiting list and also waits 20 weeks for her surgery.

Patient A total wait time 22 weeks
Patient B total wait time 48 weeks

Patient A hasn’t bumped an NHS patient off the list, they’ve just got on it sooner than they would have if they hadn’t gone private in the initial stages.

Also Patient A may choose to stay private for her surgery. The consultant could then pay the NHS for a theatre slot and patient A is operated on at an NHS hospital but has paid for this. Their total wait time would then be around 6-8 weeks.

This theatre slot WOULD NOT BE TAKEN FROM AN NHS PATIENT. Services guard their templated theatre slots with their lives. I have 5 all day lists a week. The idea that a consultant could pay to do a private patient on one of them just wouldn’t happen. They can pay to use an empty theatre at the weekend (although we are increasingly putting extra lists on for NHS patients to clear the backlog at the weekend). Or they could pay to use a theatre slot that a service has “dropped” because of staffing or governance. They cannot buy NHS lists when they choose

Usually the waiting time in the NHS is to see the consultant, have tests etc and then a decision made about operating.

So you can speed this up by going privately and then be ready at the top of the NHS queue for the operation or else you can have the operation privately as well. It all depends on the consultant/surgeon and the private/NHS policies.

Ultimately though you are going privately for the main stage that takes up the lengthy waiting list so that is always going to be much quicker. It’s also fairly standard for many people. By going privately for this stage though, it means the waiting list for the NHS is (theoretically) shorter.

The OP is talking about paying £2,000 private fee, not £200. This suggests to me that it is not the same as seeing the consultant but then being put on the NHS list.

That is one route, of course. But I don't think it's this situation. I think they would be having the operation performed as a private patient in NHS facilities, and paying the appropriate fee.

OP I had that procedure done privately and my work healthcare paid for it. Might be worth checking if you have anything similar?
The reason they have to repeat the scan is because the fibrous tissue could have changed, even over a short period of time.

I had the same thing but was seen within 2 weeks on the cancer pathway ( likely because I had some post menopaused bleeding). I had a hysteroscopy within a couple of weeks In Jan this year, where a polyp on my cervix was found and within a couple of weeks had an appointment to have the polyp removed. So all in all only about a month from being referred.

@Vooga

If People who can afford it go private then surely that shortens the waiting list.

No it doesn't because in this case they're using the same consultant and hospital.

Actually this is happening for my DM. She requires a back op with a 18 month waiting list. My DF is ill and is ok at the moment but will get worse. She saw a consultant privately for £150/200, he said they could do the op in the next few weeks for around £10,000. As they have plans for May bank holiday she said she'd wait until June, to which he said in June you can have it on the NHS if I get another referral from your GP. They are not paying for it privately, but will jump the queue.

Given the circumstances she is going down this route as in 18 months she may need to care more for my DF and he will be unable to help her post op. But she are jumping the queue.

@Hairyfairy01

Going private does not shorten the waiting list for others. It merely takes away that consultant / surgeon etc from his / her NHS caseload 'days' creating a two tier society of those that can afford healthcare and those who can't. Go private by all means, but don't think you are doing it for the greater good.

Consultants are paid in line with their contracted hours with their NHS contract, and they have to fulfill those. What they do outside of those contracted hours is their choice.

Hypie has explained it clearly.

OP, if you can afford to pay, and you need the procedure, you can do so without thinking there is anything untoward happening or disadvantaging anyone.

I have had one consultant try and bump a private patient up my lists. A friend of his wife. He went to my booking clerk and added which patients he wanted on his lists as usual and then tried to put this patient on an afternoon list. The booking clerk knew this patient had waited 4 weeks on our list and other patients who needed the same surgery had waited over 50.

She didn’t say anything as she didn’t want to argue with the consultant.

I was going over the theatre lists 2 days before this patient was due to be operated on and couldn’t understand why our booking clerk had put someone so far down the list on for surgery so soon. When I pulled her up on it (thinking she had made a mistake) she told me what had happened.

I phoned the patient and told them I was cancelling their surgery - 48hrs before they were due to come in. The consultant threw a fucking hissy fit and started shouting how dare I cancel one of his patients. I told him I was quite happy to discuss why but first I’d like to go and get the clinical director so he could explain to her why he was listing patients out of order. Weirdly enough he declined

@Hairyfairy01

"I disagree. What a surgeon or doctor does outside of their contracted hours is their own business, surely?! If they want to work every evening and weekend, that’s their choice"

They are not working every evening and weekend. Whereas once a consultant might have done 4 days NHS and 1 day private, As the demand for private work increases (along with better money and conditions) the balance becomes more unequal, so perhaps 2 days NHS and 3 days private. Hence increasing the time that NHS patients are having to wait. Meanwhile if you have a few quid you can get treated much earlier. This is the issue.

This will always be an issue in a capitalist system.

But it's still right that we have free-at-the-point-of-access healthcare for all.

"That's a nice sentiment, but are you really suggesting that everyone should have the same amount of money as everyone else. Because those who are better off generally get better everything. It's not fair, but life isn't. I'm a staunch supporter of NHS provision. I want to see it better funded and resourced. I want to see it have the best treatment in the world, as it once did. I put in effort to create that. I also have private health insurance, because I can afford it, and commitment to the NHS does not mean that I should go without treatment I need in solidarity with those who can't afford it."

If the NHS worked properly you would have no interest in private insurance, except perhaps for cosmetic issues or things like having your own room.

Many of us have experienced and followed similar medical practice options. The tax payer paid for nationally funded NHS and private pay as you use medical practice run in parallel with much overlap of service and facilities. The pay as you use private route is naturally an option with more immediate treatment and care compared to standard excessive NHS waiting lists. You are not jumping the NHS waiting list by paying for private healthcare but reducing this long list for others who are remaining in the free at point of use tax payer funded NHS. In many cases the quality of care is arguably broadly similar bar for some possibly expensive “experimental” less tried and tested options in rare situations which is not available in the publicly funded NHS system as the medical benefits may possibly be marginal and less proven. Both systems are world class and the more reason as an aside for all of us in these ongoing pandemic times to do what little it takes to make a big difference as regards to personal and collective Covid risk mitigation measures so that more of the NHS and private medical services can be better utilised to treat all medical needs and not focus on one disease to save as many lives as possible. Take care stay safe and all the best.

As an ex theatre nurse I've been paid extra to come in on my day off at the weekend to help with an operation in an otherwise empty NHS hospital theatre (weekend emergency theatre next door with it's own staff) staffed by everyone doing extra on top of their contracted hours. The theatre is hired, and they bill for any disposables used (drapes swabs etc).

The NHS makes money from this stuff. It does not impact the waiting list except by taking a person off and getting the next person seen quicker.

I've previously advised a patient NOT go to private for an emergency (appendicitis and they were in the anaesthetic room) as they were a) already prepped and it would waste their time. b) they would be operated on by the Consultant - rather than his registrar who does dozens a week rather then the odd private patient and c) it's the same theatre, staff and equipment (except for the consultant bit) so why wait in pain?

Go private AFTER emergency surgery. You get the better room and meals at the point it makes a difference.

Elfy "Go private AFTER emergency surgery. You get the better room and meals at the point it makes a difference."

So you'd have to be transferred after surgery? That's not safe I thought?
Sprty, i don't know this stuff.

YANBU, OP. I think a lot of people don't understand that you would be having the actual surgery as an NHS patient, on an NHS theatre list, with an NHS pre-assessment, recovering in an NHS bed on an NHS ward. You would get your NHS surgery much quicker by seeing the surgeon as a private patient for a couple of outpatient appointments, scans etc. He/she would then refer you onto the same NHS list that you might have spent a year getting onto as an NHS patient.

However in terms of NHS consultants also doing private work, they work sessions so clinics and lists should be matched, and lists should not be longer because a consultant works more days private. The NHS sessions will go to another NHS consultant.

My brother works for a private company who do private MRI scans but they are on the site of an NHS hospital. He doesn't work for the NHS.

The private company pays all their wages and they own the scanner that they use but they and the scanner are all in the NHS hospital.

The NHS can never be "fully" funded though. Somewhere limits have to be put in. We have never treated so many, or so varied a number of diseases as we do today, actually, when you look at it, it is amazing what IS achieved. We extend life in the elderly, we save tiny babies and give them life long treatment. We support cutting edge cancer treatments. We treat heart and brain injuries which a few years ago would have been left to end naturally.

We (the tax payer) pay, and the NHS (which isn't really the NHS) but NICE, CCG's, and others decide what to fund, and how to treat. I think what get's missed in all the "we need to spend more money on health", is that the NHS is actually very cost effective, and that we actually do treat many, many things, not necessarily available elsewhere in the world, that continue to be free at the point of delivery.

Here endeth my promotion of the NHS!!

”If People who can afford it go private then surely that shortens the waiting list.”

No it doesn't because in this case they're using the same consultant and hospital.

Yes it does because they are not using the consultant during NHS time but during his/her private time. The hospital will be used during their private time for private operations as well.

No you cannot jump the NHS waiting list, you can go private. It shortens the NHS waiting list for others.
It really doesn't help if you're broke. For example my nephew had tonsils out the list was 2 years to see a consultant and another year waiting in the operation by paying the consultant she skipped the 2 year waiting list and went directly to the operating list so he was done with 15 months publicly.
If she hadn't of went private he'd have waiting 3 years for the same public operation.

they normally have an arrangement that it benefits the NHS,
plus you are another case off the NHS list.

i had my tonsils out privately via my df bupa 40 years ago!
it is not new

The hospital will be used during their private time for private operations as well.
Normal people are not having the operation privately just the consultations for the service/operation.
Anyone going fully private is a good thing. It is splitting the service that is a problem.

and well said @BigWoollyJumpers