london private consultants

[emsken]

Hii all,

I am pregnant with No 2 - not due til april so am being WAY ahead of myself BUT.... I had no 1 at the portland but my consultant has now retired. Can anyone recommend any consultants at private wings in london and also how much do they charge for whole package?

Thanks

anyone??!

Everyone will have their own opinion, and as for package you'll need to call their secretaries and get a price. If you're able to go through your insurer you get charged a different, lower rate.

Mark Johnson - delivers privately at the C&W and Portland. You won't find a negative word about him on the net. He delivered my son in March. Very reassuring, beautiful manners, very kind (as well as being very experienced). He gets booked up very quickly.

Nick Wales at the C&W gets v good reviews also.

Yes was going to post Nick Wales and Keith Duncan at C&W.

Just out of interest - would you expect/want an obstetrician to give you figures for outcomes for women in their care? Rates of emergency c/s, assisted delivery, episiotomy? And would you want these to be better than typical rates in the NHS for women having midwifery care?

I think that if was paying someone ££££££££'s to ensure a good birth, I'd want some evidence of this.

You're not comparing like with like though, Spudulika, as private consultants get such a high proportion of their patients via insurance, which only pays out if you have complications or need a cs.

Its not just the birth, its the pre-care, the birth and the post care... all of which i think are better than on the NHS - or at least from my experience!

thank you all for suggestions.. x

I must be misreading what you've said Bag - are you saying they may have higher rates of intervention because they only get paid if something goes wrong?

Or are you saying they deal with more complicated cases than NHS consultants and therefore have higher rates of c/s etc?

I would assume a private obs are the only doctors in the UK who routinely care for low risk women in pregnancy and labour. NHS obstetricians wouldn't have any involvement in the care of this group.

The private midwives I know keep very detailed records of their deliveries - the risk status and outcomes. Surely private doctors do the same?

"Its not just the birth, its the pre-care, the birth and the post care... all of which i think are better than on the NHS - or at least from my experience! "

Well yes - that's true. But if I was paying thousands of pounds I'd expect an optimal outcome: namely, to come out with a healthy baby and an intact perineum and abdomen, if this is at all possible.

No amount of posh magazines in the waiting room and pampering after the birth is going to make up for a shredded perineum.

Firstly, your snippy comments about posh magazines in the waiting room and pampering post birth do you no justice at all. Your previous posts are usually really intelligent and thought provoking. Private obstetrics isn't about magazines and pampering and commenting in such a way highlights your ignorance of what care one can expect.

Secondly, the way that the private sector works in the UK is very insurance driven. Yes, there's a cohort of patients who have the financial weight to simply pay the bills. But the vast majority of private health patients are there because they have insurance, and obstetrics is no different.

Most of UK health insurance policies cover the costs associated with private delivery IF a cs is clinically indicated. Uncomplicated or vaginal births aren't covered as a rule. So therefore private obstricians, because of the nature of the patients they are dealing with, have a higher rate of cs, because they are the births that are covered by insurers. So their cs rate is only a consequence of the financial environment in which they work. The Portland has a HUGE cs rate for example, because many of the patients there are having then on their insurance, and if they weren't, they'd be up the road in an NHS hospital having a VB.

"So therefore private obstricians, because of the nature of the patients they are dealing with, have a higher rate of cs, because they are the births that are covered by insurers."

Higher than who? NHS consultants? How can that be if a fair proportion of private obstetric care is provided to low risk women? NHS consultants simply don't provide care in pregnancy or labour for low risk mothers.

Again - to press the point, why would this impair their ability to discuss their results in a meaningful way? If private midwives do this then why can't doctors?

"The Portland has a HUGE cs rate for example, because many of the patients there are having then on their insurance, and if they weren't, they'd be up the road in an NHS hospital having a VB."

Are you saying that there are more high risk mothers giving birth at the Portland than at Kings, UCH, Chelsea and Westminster and the other large teaching hospitals in the area?

I wasn't aware it had the facilities for dealing with complicated multiple births etc. or for dealing with mothers with pre-existing complex health problems such as HIV, severe hypertension, severe obesity - something which most NHS hospitals are dealing with on a day to day basis.

Anyway, sorry for being snippy. I'm aware of the wide range of reasons women opt for private care. I had private care myself with my last two children. I didn't mean to sound dismissive.

It just surprises me that people aren't more interested in results when they're paying for a service.

I highly recommend Ms. Gubby Ayida at Kensington Wing, C&W.

I'm sure all the individuals mentioned on this thread are wonderful. But however great a private consultant was, I'd still rather be in trolley-wheeling distance from an NHS A&E department in case of serious complications for my baby or me.

"So I would expect a Consultant's "unassisted/uncomplicated" statistics to be MORE favourable for private sector work...."

Yes - this is what I was thinking.

I'd be asking about their assisted delivery and emergency c/s rates. Also how many of their mothers deliver over an intact perineum.

They ought to have figures for this.

QTPie: "Actually I am not sure that most private births are complicated cases because that is only what insurance companies cover..... Most of the ones that I am aware of are either foreign nationals (whose foreign insurance covers routine births) or people who just choose to pay for it themselves."

They aren't necessarily high risk or complicated cases, just cases which fall inside that which an insurer will cover so malpresentation for example.

As for the people on your course, they quite possibly don't represent many insured patients as the insurers are unsurprisingly reticent about signing off the cs until v late in the proceedings - waiting for placentas to move, babies to turn etc so all these patients have all their antenatal care on the NHS.

Spudulika : ""So therefore private obstricians, because of the nature of the patients they are dealing with, have a higher rate of cs, because they are the births that are covered by insurers."

Higher than who? NHS consultants? How can that be if a fair proportion of private obstetric care is provided to low risk women? NHS consultants simply don't provide care in pregnancy or labour for low risk mothers. "

Because (and admittedly im extrapolating) private obs are not under pressure to keep their cs rate down whereas on the NHS there's a pressure to consider an instrumental VB where privately ELCS would be chosen.

"Are you saying that there are more high risk mothers giving birth at the Portland than at Kings, UCH, Chelsea and Westminster and the other large teaching hospitals in the area?

I wasn't aware it had the facilities for dealing with complicated multiple births etc. or for dealing with mothers with pre-existing complex health problems such as HIV, severe hypertension, severe obesity - something which most NHS hospitals are dealing with on a day to day basis. "

No I'm not saying there are necessarily more high risk patients, just more c sections. Although c section isn't without risk, the patient might well be, in all other ways, LOW risk. For example, malpresentation is an indication for cs. So it's perfectly possible for a woman who is low risk in every way, but requests a section, to get it on her insurance because her consultant says the baby isn't lying correctly, in his/her opinion.

As for facilities, my understanding is that they are the same at The Portland as anywhere else. As each consultant manages their own cases they can choose to reject very complicated cases, or advise that they deliver elsewhere - many of the consultants practice in several different places including the NHS. But in every way The Portland is just the same as anywhere else. I had my twins, complicated by macrosomia, polyhydramnios and unstable lie, and on anti coagulants. No one seemed particularly phased, and there was another set of twins in when we were there.

Thanks for your comments about snippiness, it didn't sound like (my perception of) you at all. x

I think the consultants I've come across in the private sector take rather a philosophical point of view...the consultant's clinical opinion is the last word - so even if the baby had moved on the morning of the surgery, it's still the cons' call whether he highlights that fact about his customer, as it were.

Obviously none of this is discussed overtly.

'No amount of posh magazines in the waiting room and pampering after the birth is going to make up for a shredded perineum.'

Based on my unscientific poll of two NHS births and two private consultant births, I would say attention to the perineum was about 1,000 % more in the private births. The midwives (two different hospitals) didn't seem to care and assumed stitches were inevitable. I am still quite shocked at the difference in attitude!

Have to say - my private midwife was very preoccupied with my perineum too. Managed to deliver an 11lb baby over it and I didn't need stitches afterwards..... That feat alone made me feel her fee was well spent!