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…)

I used to have private medical through work, and whenever I mentioned it to my doctor he seemed to try and direct me down the NHS route. I would expect that if you had private cover it would make sense to take some of the strain of the NHS and use it. I admit that this was around 10 years ago though

@SucculentChalice

I know several people who have had to go private to get extremely painful conditions dealt with (hip replacement, cataract surgery, knee injuries) due to ridiculously long waiting lists on the NHS. When you factor into account that going private is not unusual and it offers you no discount on the tax you pay for the NHS, in reality many people in this country are paying twice for healthcare. Which makes it one of the most expensive systems in the world (and our private sector is less developed and therefore more expensive due to the NHS).

Its also a clear professional conflict of interest and banned in other professions. The fact that some consultants use NHS facilities to hold private clinics one day a week is utterly ridiculous.

No, you don't get a tax discount if you pay for private healthcare, but nor do you get one if you you don't need the NHS because you are never Ill.

Similarly, you don't get a discount if you don't need schools - either because you pay for private education for your children or you don't have any children.

That's the point of taxation and the welfare state. Thankfully, what we take out of the system isn't related to what we pay in. I suspect that over our lifetimes many of us (especially those of us with children) won't pay enough in tax to cover what we take out.

Her response "because you'll be seen quicker, this service isn't seen as a priority so the waiting lists are very long."

See, this is where I wish the NHS would be honest, and save people waiting about for stuff the NHS doesn't really want to do.
The NHS does some basic things well--eg universal vaccinations are OK. And at the other end of the spectrum, if you have a diagnosed life-threatening condition needing intricate surgery, the treatment can be world class.

It's the stuff in the middle where it falls down. Where you're not going to die (or at least that's what your diagnosis says) but your life is going to be more miserable without treatment. And where if you're offered treatment at all, it won't to restore full function but to restore a bit of it. (See the report of the relevant Parliamentary Group in 2018, where many women in their reproductive years were pushed hysterectomies for gynae conditions, even though this should only be an absolute last resort.)

Fifthtimelucky No, you don't get a tax discount if you pay for private healthcare, but nor do you get one if you you don't need the NHS because you are never Ill.

Similarly, you don't get a discount if you don't need schools - either because you pay for private education for your children or you don't have any children.

That's the point of taxation and the welfare state. Thankfully, what we take out of the system isn't related to what we pay in. I suspect that over our lifetimes many of us (especially those of us with children) won't pay enough in tax to cover what we take out.

Yes, I am aware of that. I don't need the basics of how a tax system works explains to me.

I did however previously live in another European country which provides a much higher standard of healthcare cover through a private insurance system, without the NHS. That to me, is a far better allocation of resources by the state and a far better return on the tax i pay. I do object to paying twice - once through general taxation and once privately - to get standard care in the rest of the developed world without a 3 year wait.

The NHS is in out of date, inefficient and often grossly negligent system. Its a poor performer and its so bad that entrusting my future health to it as I age is enough to make me want to retire abroad (and yes I do know how several of the foreign systems work and they would still suit me better).

@SucculentChalice
not only do you not get any kind of discount for holding private medical insurance, you actually pay insurance premium tax.

What is happening in some areas is very worrying and I feel so sorry for those experiencing a poor. service.

I went to my GP for help with mental health issues , as you are advised to do. He was lovely prescribed medication but said that waiting times were so long for specialist help (which he felt that I needed) that unless I paid privately I would be waiting years. I don't have insurance with work so have had to self fund for over a year - £400 an hour to see a psychiatrist (who also works for the same NHS Trust I would have seen through an NHS referral). It is crazy, has resulted in debt and causes all sorts of issues in terms of who is responsible for what (medication, med certs etc) but unfortunately where I live it appears there just aren't sufficient NHS services. Very frustrating when there are adverts telling you to go for help but it just doesn't exist. I know that there are better NHS services in other parts of the country but my own experience has been concerning and I feel so sorry for others going through something similar.

@Horcruxe

She wasn’t blaming the GP

No, you don't get a tax discount if you pay for private healthcare, but nor do you get one if you you don't need the NHS because you are never Ill.

But it is reasonable to question oneself about taxes if you pay them in but still don't get any benefit where needed.

I had to pay over £10k for surgery that I needed to restore my health and fertility. I've never had insurance and am on national median wage, but at least had savings.

Because such things are only likely to become more common as I get older, and I now have a DD who might also need private care before she's able to pay for it myself, I now make damn sure to stick every penny I can into an ISA.

Tbf, it’s nothing new.

My dh had various procedures 10-15 years ago and was advised my his GP to go private every time. I think it’s a good thing as it takes him off waiting lists and frees up his space for those without insurance.

Some posters have a point though. My aunt was kept waiting for years for a knee replacement and when she got it the other knee was crap as it had to take more weight and over compensate. She waited in awful pain for some years for the second knee replacement and when she got it the surgeon visited her after the op to apologise to her because her knee was in such a bad state that the bone was crumbling as he worked with it. He told her it should never have been allowed to get to that state. The strong pain killers those years ruined her stomach also. If that first knee replacement had been done on time though...She still thinks the nhs is marvelous because she didnt have to pay. I did have to mention there is a middle ground between what she got and the American system. What she got was substandard.

I cannot see how the GP "was pushing"
Really bizzare... Your post has a tone of the GP was in the wrong asking you... Honestly as a GP, my heart sinks when I know a pt is in for a long wait and I will always ask if they have insurance.
My heart sinks even more when I read another stealth bash the GP thread

What on earth is the NHS spending all its billions on. It's like an endless pit. Where does all the money go!??

I was asked whether I wanted to see a physio privately, but at the time it was a pregnancy related issue (sciatica) that only flared up when pregnant, so a waste of everyone's time on the NHS or otherwise.

Friends of mine did go private to get an MRI, and then was referred to the consultant who was NHS and private.

@lonelyapple

What on earth is the NHS spending all its billions on. It's like an endless pit. Where does all the money go!??

Not an exact answer to your question but Kings Fund has some answers:

www.kingsfund.org.uk/audio-video/key-facts-figures-nhs

@lonelyapple

What on earth is the NHS spending all its billions on. It's like an endless pit. Where does all the money go!??

Where do you think it goes? Do hospitals, community services and the like get run off of good will? Things are expensive, an mri machine for example is an incredible bit of kit, but bloody expensive to buy and to run. Even with chronic shortages its the biggest employer in the world- just for starters.

@ancientgran

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

It's not as simple as that though is it ? There isn't only one queue - there is one for investigations and then one for action. By paying for an investigation you get onto the second queue as it were faster. You are still in a queue if you go back but it's a different one.

I've given up on going to my GP now, its all just so utterly pointless. I've been suffering with eustachian tube dysfunction and retracted ear drum for about 3 years now, I was referred to ENT at the hospital where a consultant shoved a camera up my nose and then got in a shitty when I found it uncomfortable and gave up attempting to treat me, sent me on my way saying "it'll probably sort itself out eventually".

I have ingrowing toenails, which are very painful and prone to getting infected. I spoke to my GP who told me to go to the private podiatrist clinic as the waiting list for NHS was years long and that basically unless I have diabetes I will never get seen! I can't afford to go private so that's another thing I just have to live with.

I had my right kidney removed a few years back, I'm supposed to have regular kidney function tests but I've not been called for one yet! I'm also supposed to have a yearly blood test because I'm at high risk of developing diabetes, went for my appointment a few weeks back and sat in the waiting room for half an hour waiting to be seen, went and told the receptionist how long I'd been waiting and she apologised and said it wouldn't be long. I waited another half an hour and then walked out. I wont bother going back now, not for anything. What's the point?

@SucculentChalice

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!

My point was is that it's that person's own time.

I still don't understand the problem with them doing whatever they want with it. There are plenty of rules and regulations that prevent consultants or patients from gaming the system when there is crossover from the independent sector to NHS, or, vice versa.

The tax thing is another issue entirely, I've actually been having the same debate with somebody else today. whether or not you think there should be a welfare state is your choice, but the logical conclusion is that all the people who can pay privately will. All the people who can't wont, and many will probably die or be rendered unable to work from treatable conditions due to lack of healthcare. It's a perfectly valid choice I guess, but you have to remember that a lot of these people are the unskilled workers that do the jobs that nobody else want to, but that keep the rest of society comfortable.

@Picklypickles

I've given up on going to my GP now, its all just so utterly pointless. I've been suffering with eustachian tube dysfunction and retracted ear drum for about 3 years now, I was referred to ENT at the hospital where a consultant shoved a camera up my nose and then got in a shitty when I found it uncomfortable and gave up attempting to treat me, sent me on my way saying "it'll probably sort itself out eventually".

I have ingrowing toenails, which are very painful and prone to getting infected. I spoke to my GP who told me to go to the private podiatrist clinic as the waiting list for NHS was years long and that basically unless I have diabetes I will never get seen! I can't afford to go private so that's another thing I just have to live with.

I had my right kidney removed a few years back, I'm supposed to have regular kidney function tests but I've not been called for one yet! I'm also supposed to have a yearly blood test because I'm at high risk of developing diabetes, went for my appointment a few weeks back and sat in the waiting room for half an hour waiting to be seen, went and told the receptionist how long I'd been waiting and she apologised and said it wouldn't be long. I waited another half an hour and then walked out. I wont bother going back now, not for anything. What's the point?

Have you tried Fexofenadine anti histamine for your ear? I also had all these visits and they couldn't come up with anything and then I took this for hay fever and bingo!

I think a part of it (been around the NHS for a looooooong time) is that more can be done and people's expectations have gone up eg there is better tech for managing stuff like diabetes, more joint replacements are done and more joint replacement revisions are done, there is IVF, people live longer and continue to be treated, children who would not have been born or who would have died young, survive. More cancers are treatable. I am not suggesting that any of this is wrong, of course I am not but it IS expensive....but there is also waste, duplication, bad management as well.

hmmm that should have referenced @Patchbatch's post

It’s incredibly annoying. I have been asked this too. I would wait for the consultant and hopefully not too long

[quote PlainJaneEyre]@ancientgran

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

It's not as simple as that though is it ? There isn't only one queue - there is one for investigations and then one for action. By paying for an investigation you get onto the second queue as it were faster. You are still in a queue if you go back but it's a different one.[/quote]
yup, this

Sorry OP, but I think the GP was only informing you of the options - private will be this long or NHS that long. If people do choose you use private insurance, GP's have to refer to a different pathway than the NHS pathway. IMO the GP was only giving you choice?

PlainJaneEyre - I've not heard of that one, I usually just buy supermarket own brand hayfever tablets and they've not helped with my ears at all! Is it something I can buy over the counter? If it is I'll have to give it a try!