To want to work for cash to pay for treatment

[gopherit]

AIBU to think that if the nhs can't give you the treatment you need and you're expected to self fund (in my case, 2 different types of physio and long-term counselling) then you should be able to work additional hours tax free to be able to fund it? As it is, if I work extra, my universal credit will reduce and it still won't cover it. To do it properly, long term private physio and counselling is already setting me back around £300-400 month which I can't sustain.

I am so fed up. When I chose a vocational career to qualify in, it's because you could survive without luxuries if that's what you chose. I'm not someone who needs or wants 5 long holidays abroad every year! I'm happy to shop cheaply and forego expensive treats, to do something I love and that's good for society (3rd sector). That was the choice I was happy to make when choosing my area of study/speciality. BUT, there was a half decent healthcare and benefits system at the time, which now there isn't. I'd like to work extra to pay for my treatment, but I can't.

Would it enable a society that could more easily fund treatment, rather than struggle to stay in work without?

Apols if I post and run, will be back this evening!

No. You are feeling negative due to the replies you are receiving which suggest you should grab this opportunity to have a side huddle while you can.

You’ve now drip feed extra circumstances as to why you cannot and now talking yourself out of being able to handle the side hustle you first presented in here….

have you considered you are battling yourself first and foremost ?

With respect, you know nothing of the full extent of my circumstances. So yes, a non-intentional drip feed, as I foolishly thought I could go around needing to detail my circumstances.

Thank you. I should have known better than to post really!

My dentist is private. Costs me £25 ish a month I think. I'm self employed shall I keep back £25 a month from my accounts to pay for it?
What a strange concept

I actually think you can do that if it was physio for an injury that affects your work!

Or rather put it through as a tax deductible expense.

Op - no I don’t think you should be able to. But I absolutely do think you should get physio and counselling on the NHS!

Some of the comments scream naivety. I hope these folk never have to deal with health issues not covered by the NHS (women especially are impacted in this way) or try to navigate a benefit trap despite working because minimum wage isn’t a living wage in 2026.

How would it be decided what was a genuine need? How would it be decided what was a genuine practitioner? It would be a system open to abuse.

quite right, I don’t and neither does the rest of Mumsnet.

we can only go by what you have posted up when posing the question and your responses.

You initiated that and sought forum help based on the info provided.

personally I think you’ve got it in you to make good changes and better decisions.

I’m not coming from wanting to be mean to you it’s just that long term therapy is hugely expensive and the NHS can’t afford it. It offers short term therapies because those can be given to more people. The choice is a few people get a rolls Royce service and the vast majority get nothing or everyone can have a little bit. For you to have years of 1:1 therapy with a highly qualified and experienced therapist just isn’t affordable to the NHS and it never could be. I am sorry that you have been harmed and need trauma therapy but it’s not an unusual situation there are so many people who want to have the kind of therapy you are paying for and the NHS cannot fund them all. I am suspicious of long term private therapy that goes on over many years as I often see people who have developed a dependency on a therapist
under those circumstances. Some things the NHs does not find because they are a luxury over and above the basic level of service and some because they are not shown to be effective or to cost effective. I don’t know which your therapies fit into but no I don’t think it’s reasonable to believe that stuff you want should be tax deductible. I think the same about private education and am glad the government levelled the playing field on that.

To be fair NHS mental health care is a disgrace.

There's lots of services & 'talking therapies' for people with not alot wrong with them for mild anxiety, depression be etc & for coping with a one off event eg a serious assault, sexual assault etc.

These services (usually known as IAPT) do have exclusion lists - so anyone with a more serious diagnosis eg bipolar, schizoaffective, anyone with a complex trauma history eg severe & complex childhood abuse, and anyone where there is a recent suicide attempt or high risk are all excluded from these NHS services.

You then have severely underfunded & fragmented secondary care (CMHRS, CMHT, EIP, AOT) that have a very high threshold - usually as an alternative to admission under section, managing people on CTO etc. None of these provide any type of 'therapy'. Where therapy exists for severe & enduring mental illness & complex trauma it's often out of area with very long waiting lists (over 5 years).

Many people do end up paying privately & it's the people with the most severe & complex needs that end up doing so. That's not the same as wanting NLP coaching or homeopathy.

You can get both those things on the NHS and/ or in the charitable sector. What you can’t get is to choose the specific practitioner that you want. That’s a private sector luxury.

Thank you for this 🙏

I know what IAPT and it usually isn’t called that any longer it’s called NHS Talking Therapies these days. You are being ridiculous to suggest that community therapies in 2nd care would only be offered as ‘an alternative to admission under section’ or for people on CTO. Community mental health teams do offer longer term therapies but not ones that go on for years in an open ended fashion and not to everyone who could conceivably benefit. It is bizarre and insulting for you to suggest that a service I actually provide doesnt exist

CMHTs and EIP teams ‘none of these provide any type of therapy’ WTAF are my psychology colleagues doing in that case I wonder. Misinformation.

I expect you will get your wish @gopherit when they actually formally dismantle the nhs and admit that they do actually believe that access to treatment should be based on wealth rather than needs. When that happens I expect that all spending on health insurance premiums and direct payments for appropriate health treatments will be tax-deductible. Yet even then there will be limits - a blanket zero-rate for spending on health is an open loophole for medical service providers to create entirely unnecessary expensive treatments solely to boost profits, so it will come down to why you aren't currently getting these treatments.

Under the current NHS system there are a lot of treatments that exist in countries that have privatised healthcare but which the NHS doesn't fund because they are scientifically unproven or the research shows that the incremental benefit that some patients report is too small to justify the cost. So if the reason you aren't getting the treatments is because NICE doesn't think they are good value for money, you may find they are also excluded from any tax-relief scheme introduced after the collapse of the NHS - but of course if they are recommended and NICE approved treatments but you aren't getting them because of staffing and capacity issues that would be different.

@Shrinkhole I get you have to come at it from a policy perspective, but the fact of that matter (for me) is that it quite frankly sucks to be me when you're considered not cost-effective. Especially when the rest of society is so quick to believe you're just a shirker. I have always worked hard when I can.

Where I am (Ireland) we can claim tax back on all health expenses, and there’s tax relief on private health insurance premiums as well.

I do have sympathy genuinely. I just have to take it from a societal perspective that if I can help a lot of people a little bit or a few people a lot I will help a lot of people a little bit and/ or at least I will try to make sure that I direct my resource to those who have greatest need and can least afford to pay. Thats why I work in the NHS exclusively shit as some people may believe it to be.

A lot of the time private health care won't continue to fund treatment indefinitely either. I have tendonitis my achilles tendon, it flares up sometimes as it is weak due to a rupture injury 15 years ago. I got 30 weeks of physio paid for by my private healthcare provider.

They have now cut me off as it is considered, by them, to be chronic. My only option would be to self fund single sessios, like you. I treat it myself with daily loading exercises and pilates.

And if anyone is a therapist or a Dr who the NHS trained and now works in private practice you are part of the problem.

And is there anything so wrong with that? They taught you tools to self manage. Having more sessions would not necessarily cure it.

This is the same with many therapies eg CBT and DBT give you tools to manage and you need to practice them and use them. You can still continue to make progress after therapy ends by doing that. The length of the course is not the time taken to be cured. More sessions will not necessarily cure a person it’s about learning and applying skills.

My (private) dentist told me that people don’t need to pay for so many hygienist appointments which are mainly a racket they need to lean the techniques and thoroughly clean their teeth themselves. It’s actually dangerous to think someone else will deep clean so I don’t have to try.

You make a valid point but wouldn't you agree that access is limited by both subjective referral patterns of GPs and Consultants and limited capacity? I think a lot of people struggle to access what they need due to this.

Limited capacity yes. Subjective referral patterns I don’t know what that means. There are service criteria that are applied and some people do miss out or have to wait a very long time but it’s not at a CTO only level otherwise what are the CMHT psychologists doing? They do offer treatment for PTSD, OCD and depression as well as bipolar and schizophrenia which are more medication dependent in any case.

You could ask your MP to suggest it in parliament. It's true that many people simply cannot afford to pay for treatment that is now only available privately. Your solution may not work but some solution needs finding.