Appointment with GP - heart sunk

[MarriedThreeChildren]

Had an appointment last week with my GP. I’ve had a bad flare up from a chronic illness.

Went through everything, agreed to be referred back to hospital consultant. And then came the killer question

Do you have an insurance and want to go private or are we going NHS?

With the clear feeling that really the ‘right’ answer was going private :(:(

Since when is the NHS pushing patients to go private? Not so long ago it was such a big No-No. No GP would ever ask that question as a routine question. Rather people would ask if they knew they could get quicker/see who they wanted to see.

But here we go. The system is so fucked up that GPS are now trying to push people to go private rather than NHS.

I find it extremely worrying (I mean which insurance will ever cover me with a chronic condition that has been there for 15 years anyway??). Is it now the only way to get some decent medical support?
I have no idea when I will be able to see the consultant. GP ‘wasn’t aware about the lead times’ (last time I went to see them the wait was about 1 years. It was pre covid etc…. So I suspect…. much more than that…)

On the issue of Consultants doing private work. They have to fulfill all of their NHS sessions, and yes in our area they have to be full time. Full time is counted as 10 PAs, they are not allowed to register for private work unless they are on a 10 PA or above contract.

The day of the week makes no difference whatsoever. My dh is contracted to do 11 PAs but in reality he works 12.5 (doesnt get paid for the extra!). So he's doing beyond what the NHS actually pay him for. He also does one small private clinic a week in his own time.
What anyone does in their own free time is their own business. Lots of people work 2 jobs.

This is so incredibly depressing. I'm sorry got you op. I worry there will be no NHS for my children in the future and that's scary af

@MissyB1

On the issue of Consultants doing private work. They have to fulfill all of their NHS sessions, and yes in our area they have to be full time. Full time is counted as 10 PAs, they are not allowed to register for private work unless they are on a 10 PA or above contract.

The day of the week makes no difference whatsoever. My dh is contracted to do 11 PAs but in reality he works 12.5 (doesnt get paid for the extra!). So he's doing beyond what the NHS actually pay him for. He also does one small private clinic a week in his own time.
What anyone does in their own free time is their own business. Lots of people work 2 jobs.

In the sense that it is in the interest of the consultant to push them into private treatment/surgery and say that it is not possible to do it on the NHS, it is a clear professional conflict of interest. This happens in orthopeadics a lot.

Another example of the growing, gaping chasm between the haves and have nots in this country.

It doesn't sound like you were being pushed at all. Some people have private insurance and would prefer to use that so she was just checking which route you'd like to go down before doing the referral.

In the sense that it is in the interest of the consultant to push them into private treatment/surgery and say that it is not possible to do it on the NHS, it is a clear professional conflict of interest. This happens in orthopeadics a lot.

DP and I got a referral to an NHS assisted conception unit (because of our circs, we would still have had to self-fund). My fibroids were clear on my notes. Yet when I had my initial scan, the nurse (no sonographer) went, "Oh, fibroids, I can't do this scan, you need to get one done by the dr." Wait for this was over 2 months. Nurse gave me his details in case I wanted to go private. Dr emailed me from his NHS address saying I could have a scan that week privately if I wanted, oh and as a gynae he could sort the fibroids out too...
I'm not in principle opposed to hybrid working, but in that case the NHS ACU seemed to be a handy siphon for the dr's private business.

@janj2301

My daughter was born 40 years ago with a heart defected corrected by surgery at 4 months. I had privte health care then and mentioned it to the consultant thinking he'd tell me off, no he was really happy, he had a set budget and treating her privately left money in the pot for other heart babies. I now work for a GP, most waing times for referrals are 12 months lots of our patients will pay out of their own pocket for an initial private consultation

At about the same time I asked about private surgery for one of my children, he was 3 and had already had one surgery and I wasn't allowed to be with him. I was willing to find the money for the operation on the basis I could stay with him. The Consultant said he wouldn't do it and he wouldn't do it for his own children as if anything goes wrong they just have to get transferred to NHS for treatment.

We waited a year for the surgery, Consultant wrote on his notes to the ward that I must be allowed to stay on the ward. The sister was furious but stay I did.

@MissyB1

On the issue of Consultants doing private work. They have to fulfill all of their NHS sessions, and yes in our area they have to be full time. Full time is counted as 10 PAs, they are not allowed to register for private work unless they are on a 10 PA or above contract.

The day of the week makes no difference whatsoever. My dh is contracted to do 11 PAs but in reality he works 12.5 (doesnt get paid for the extra!). So he's doing beyond what the NHS actually pay him for. He also does one small private clinic a week in his own time.
What anyone does in their own free time is their own business. Lots of people work 2 jobs.

I have no issue with that. The thing I disagree with is people paying for an initial private consultation so avoiding waiting for months and then getting put on the list for NHS treatment ahead of the people who have been waiting for months to see that Consultant.

If you go private fine go private. If you need to swap to NHS get back int he queue.

I do think its a trend possibly due to long waiting lists with NHS.

I'm in Wales - waiting list in many areas were dire before covid.

(In fact have ove rteh years seen many posts suggesting welsh education and NHS state pre covid was a reason not to move to Wales both bits Welsh Government are in charge of).

As PP says though I do wish it was more upfront.

When we moved here 6 years ago we found there were no NHS denstist taking anyone on - but they'd never admit this. There were different ovesight/quango groups with lits of NHS dentists always with one practise on - when I did get in touch hadn't taken NHS on in over 5 years. When I reported back to aythorites holidng producing these list they said they'd update - never did.

We finailly found one that took kids on as NHS and us as private - I've seen a poster get very het up about this saying it's not on and should be reported but I was bloody grateful to get that and not have to pay for all of us or have no-one or have to travel to next cities along - which many of their peers have.

The NHS consultants doing private work nay-sayers - I'm an NHS consultant who doesn't do private work - clearly don't have any insight into how NHS job plans work.

NHS consultants will have a standard contract of 10 PA (paid activities) which a PA is 4 hours in office hours or 3 hours outwith office hours (7am -7pm mon-fri).

In order to do private work and still be able to have pay progression, be eligible for excellence awards, they must offer the trust an additional PA taking them up to a nominal 44 hours per week. No trust will pay for more than 48 hours per week i.e. 12PA.

If you consider that on my 12.09 PA job plan (I do the 0.09 and then some for free) and because I work every 5th weekend 81 hours straight, some overnight work every 4th week etc, those 12PAs leave me with every Wednesday completely free. The trust can't pay me to do any more work in that time, and even if they could, there wouldn't be the clinic, theatre or ward space to accommodate me or my patients.

I think its perfectly reasonable for people to do whatever they want in that time, be it going to the gym, earning some money from creating novel pottery or using their skills to reduce NHS waiting lists by treating people willing + able to pay.

@AnnaMagnani

Even Great Ormond Street do this - of course they do, the Trust makes a fortune out of it.

Every NHS Trust that can, has a private wing or consulting rooms to make as much money as possible for the Trust. It certainly isn't the evil consultants making the biggest mint here.

Big name trusts can make mega bucks - people fly in from all over the world to go to the private suite at the Marsden. At UCLH they have a whole floor called 'Harley Street at UCLH'. Moorfields has a whole building over the road from the main hospital for private patients. The list goes on and on.

Even the total nonentity trust I used to work for had a set of rooms for private outpatients and small ward of single rooms for private surgical patients.

Those trusts would be gutted if their NHS consultants weren't doing private work as well to bring in the extra money.

Actually to add to this before covid my grandson was having a lot of problems getting a diagnosis for a long term condition at out local hospital. We paid for a private consultation and tests at great ormond street . They got a diagnosis and referred him back to nhs for the correct treatment and an op .

Some of the treatment was carried out at GOSH under nhs by the consultant that saw him privately.

FixTheBone The NHS consultants doing private work nay-sayers - I'm an NHS consultant who doesn't do private work - clearly don't have any insight into how NHS job plans work.

I'm not a naysayer, I'm just fed up of paying twice, once through tax, and once again privately to get treatment that in other countries you have to pay once for. I'm aghast at the lack of organisation and the relatively limited reach of the private sector despite its growing use and will probably get my orthopeadic surgery which is necessary for me to maintain my quality of life done in Germany. Because its cheaper including the air fares and accommodation.

I wouldn't be allowed to work for the same client twice outwith my employment because its a clear conflict of interest and a breach of the standard fiduciary duties that all employees owe. It is actually written quite clearly within our professional rules set by our professional governing body and we are all educated on it at university in some detail. Fiduciary duties and conflict of interest rules in particular are supposed to apply to all professionals.

With regards to orthopeadics, the standard amongst some healthcare trusts is so dire that its very difficult to sue the NHS for professional negligence because its hard to prove that another doctor would not have been equally neglectful! And I assume you are an orthopod, judging by your username.

Carrying out private work for profit is hardly equivalent to going to the gym in your spare time!

@Doggirl

Not all self-employed people but a number have it as it makes sense for them.

DF went this route, in 2000 and 2006, for hip replacements. His job involved walking, so (leaving aside pain etc.) if he couldn't walk, he couldn't earn. If he couldn't earn, then given (AFAIK) there was no unemployment relief for SE, he couldn't have paid the mortgage and would have been on the breadline. I don't suppose any of the people fulminating against private insurance would have been offering to pay his bills.

Self employed people get the same out of work benefits as anyone else.

If you can afford to pay for a private consultation, or have insurance, it's often worth making an appointment if the specialists are in a high demand field. I saw a dermatologist privately because the NHS waiting list is 4-5 months, even with an "urgent" referral, and he then transferred me to the NHS clinic for further investigation and phototherapy but it has taken three months of considerable discomfort to get to this stage.

It's shit op. The NHS is now shit.

Put it this way, I know I'm likely going to need hip and/or knee replacements in future. I'm getting health insurance to go private as there's no way I'll get treatment quickly on NHS, if it still exists by then.

You were not being pushed but gently reminded that you will be seen to quicker if you go privately than if you go via NHS. It is just a statement of fact. It sucks.

@Overthebow

I have health insurance through work. I’m never too sure what to use if for, so would be glad for my GP to ask this so I would know when it would be beneficial to use the private insurance instead of NHS.

It depends on the level of your cover. Some private insurances have dedicated GPs in places with x rays etc eg so no need to use an NHS GP at all. Read your cover.

The NHS is one of the worst performing health services in the developed world. It's nothing to do with funding - the issues are bureaucratic and structural. It needs a total overhaul and reform on every level. But that will never happen because of the suicidal way in which people mythologise "our NHS" and insist that it needs "protecting", as if the only alternative is the US system. A health service that needs "protecting" is fundamentally broken. It is meant to protect us, not the other way around. As soon as people stop being so sentimental about our appalling health service, the government might actually feel pressured enough to reform it. There are many, many models for a health service - take Germany's. Everyone has to have health insurance. If you can't afford it, it's underwritten by the government. If you're unemployed, it's covered by your unemployment insurance. No one slips through the gap. A purely socialist model isn't the only way, neither is the American model.
The NHS is not and has never been a national treasure - it's a national disgrace. But because people will insist on "saving" rather than reforming it, the beat we have to hope for is for it to collapse entirely so we can start again from scratch.

My GP suggested I go private to have a breast lump investigated.
The waiting list to be seen on NHS was 6 weeks, and I was a bundle of nerves and anxiety.
I contacted BUPA ( I have no health insurance), and was seen the next day at a One Stop Breast clinic- one fee £399.
Thankfully benign, I think my GP was acting in my best interests.

Years ago our doctor explained to my husband that if he waited for the NHS to agree to his operation he'd have to live with the pain / discomfort until it got much worse, so if he had health insurance he might like to use it. Another dr in the same practice has asked me on a couple of occasions if I have health insurance and if I have, it may be a good idea to use it. We no longer have health insurance but if either of us faced a long wait for a necessary procedure we'd use our savings. I realise that others aren't fortunate enough to have savings but if we went private it would mean we'd free up our appointments for others who have to rely on the NHS. I know that we might have to forego holidays and other treats to safeguard our health and also that our savings might not be enough for all treatments. I REALLY wish our gov would raise taxes and provide enough medical training places so we can all have the kind of NHS the country needs.

@XingMing

If you can afford to pay for a private consultation, or have insurance, it's often worth making an appointment if the specialists are in a high demand field. I saw a dermatologist privately because the NHS waiting list is 4-5 months, even with an "urgent" referral, and he then transferred me to the NHS clinic for further investigation and phototherapy but it has taken three months of considerable discomfort to get to this stage.

So you paid to leapfrog the NHS patients waiting to see the consultant and then get the treatment.

Whereas I have exactly the reverse situation where a private consultant is insisting that I transfer back to his NHS clinic for treatment rather than pay privately (which means I have to wait months for treatment to start)

@speakout

My GP suggested I go private to have a breast lump investigated. The waiting list to be seen on NHS was 6 weeks, and I was a bundle of nerves and anxiety. I contacted BUPA ( I have no health insurance), and was seen the next day at a One Stop Breast clinic- one fee £399. Thankfully benign, I think my GP was acting in my best interests.

That would normally be seen under the two week rule but since Covid I think it has gone up to 6 weeks because of waiting lists.

I think you're overreacting. It was just a question and lots of people have private health insurance through their employment. My husband does.

Chill out. It's just a question not the demise of everything you hold dear!

'Killer question'