Help! Choosing a private hospital in London for 1st birth?

[LoveLondon2012]

Hello, I am an American expat, new to London, and my husband and I are looking to have a baby while we are here for the next couple of years. We are very confused about the process here an NHS/Private. We are considering getting Bupa International coverage and having the baby privately rather than through NHS. Are there any downsides to this? How does one choose a hospital? I have looked into Portland but do not know the alternatives. What is the difference in a private hospital like Portland or having private insurance and going to an NHS hospital? I live near Bupa Cromwell but don't even know if they deliver. How close do you need to be to your hospital? Thank you for any help!

Private maternity can be a real minefield to navigate, especially if you are new to the system.

Basically, in London you have two options if you want a hospital birth - you can either go to the Portland, which is the only private maternity hospital in the UK, or you can go to the private maternity wing of an NHS hospital. These are:

the Lindo Wing at St Mary's (Paddington)
the Guthrie Wing at King's (Camberwell)
the Sir Stanley Clayton Wing at Queen Charlotte's (Acton)
the Kensington Wing at Chelsea and Westminster (Fulham)
the Lansdell Suite at St Thomas's (Westminster)

Further out, there are also private wings at Kingston hospital and Watford hospital.

I have looked into getting the BUPA international coverage myself, and it looked very generous to me - it covers a VB, which most domestic policies don't, and pays full fees for c-sections (again, domestic policies usually cap the amount you can claim for certain services, like an epidural). So I'm not aware of any downsides to their coverage. One thing to look out for would be coverage for the baby; I would check what the situation is on that.

Now, if you want a private hospital birth, you can either go private all the way or have your antenatal care on the NHS and switch to private for the delivery. In either case, you need to find an obstetrician who has practising rights at the hospital you're interested in. This can be quite tedious - you need to call their secretaries all individually and see if they have space, take your insurance etc. Some very popular consultants get booked out very quickly. You'll find their details on the hospital websites, or you can ring the maternity wing and get emailed all the info. You can go on tours of the wings and meet the midwives before making a decision. In terms of how close you have to live, there are no restrictions, and you may find that if you have private ante-natal care that that's all done in Harley St anyway so where you live doesn't matter.

So sometimes your choice of hospital is determined by your consultant as they may only practice at one place. Other times there might be a choice. At this point, lots of people will opt for the private wing of the NHS hospital rather than the Portland with the rationale that there is greater emergency expertise/facilities in the NHS. There is also a persistent view that the Portland doesn't have a NICU or SCBU (it has both). I had my baby at the Portland and didn't have any concerns but then I also had a fairly straightforward pregnancy and an ELCS.

Another option is to have your baby at a private birth centre with a midwife - hopefully someone will come along who can tell you how that works.

You'll find lots of threads on mumsnet about the different wings and consultants - every place has its fans and detractors, and the same with consultants.

I can't answer the other queries, but I just had my first at the Portland and had a fantastic experience. You don't need to live particularly close to the hospital if you are having the baby privately, as they will arrange things with you to make things easiest for you. I had mine by c-section, but if I'd been having her some other way we would have come up with a plan that worked. Not everyone likes the idea of the Portland, and some people will probably tell you that it's more risky to have your baby there because there is no NICU or SCBU. That is not true though - I think they are now geared up to be able to care for babies from 30 weeks gestation, so unless something goes badly wrong they will be able to look after the baby. I lost twins at 20 weeks last year, and the people at the Portland were absolutely lovely and really looked after me, so it was really nice going back there to deliver my daughter, who is now 2 weeks 4 days old :)

The other main alternatives if you want to give birth privately in London are the Lindo wing at St Mary's, although it was close for a while and I know it didn't reopen on schedule so I don't know the latest on that, and the private wing at C&W.

Even if you have the baby privately, you will be discharged into local NHS care for the local midwives and health visitors to monitor the baby. The hospital will arrange this for you, so you don't need to worry about giving birth outside your local area.

Look at the hospital and consultant you are buying quite carefully. Does the hospital have a history of rather nasty deaths of women and babies by any chance? Does it have a SCBU? What would happen in an emergency - would you have to wait for ambulance transfer to the nearest NHS hospital? Put the name of the hospital into 'thisislondon' (Evening Standard website) and see if any worrying news stories come up. How good and how available are the obestricians/ anaesthetists and how good are the midwives?

Make sure any consultant who will be responsible for your care also holds an NHS consultant post. The requirements for holding an NHS post in medicine or surgery are far stricter than those for private practice (although I cannot recall if this general rule applies to obstetrics - maybe all obstetricians in private practice are NHS consultants, but it's definitely worth checked). The way regulation works over here means that the requirements in terms of training and qualifications are MUCH stricter for NHS posts than for private practice.

(I haven't checked recently to see if much has changed, but for e.g., unless there's been a radical shift while I haven't been looking, any old doc can do laser eye surgery in the private sector - even if they are just a GP who has done a course.)

Bingo! Well, that didn't take long.

I'll decipher edam's post for you. About ten years ago, two women died at the Portland.

The Portland, as has been said so many times, and can be easily verified on its website, has both a SCBU and a NICU for babies from 30 weeks.

All Portland consultants have an NHS consultancy post. I think Donald Gibb and Nick Morris are the exceptions. If you have any concerns it is very easy to look them up and check their CVs. Please do not think that just any old general practitioner can get a private obstetrics post in the UK. Edam seems to be insinuating that the qualifications of those in private practice are lesser, but because we do not have wholly parallel systems of healthcare in the UK, the people who work in private maternity have had state training and usually work in the public sector too.

The Portland has an adult HDU. It is true that it does not have an adult ICU, but in a case that justifies that you would be transferred to a private ICU two streets away at the London clinic, not an NHS hospital which would be further away.

If you do consider the Portland, it is easy to get the facts from your consultant and/or the hospital itself - they are very open to providing you with all the information you need.

Adding to the very useful info the others have given, I would say that if you are American, you should definitely go into the private system rather than the NHS (whether you pay yourself or get insurance cover). If you are used to a high standard of care in the US, I think you have the potential to be very disappointed if you rely on the NHS system here. Obviously some NHS hospitals are better than others, but if you can afford it I would definitely say go private. I should add a disclaimer that I am pregnant with my first so haven't experienced either system first hand, so this is all based on talking to friends and reading online.

The Portland is run by an American company, so may be closest to the level of care you are used to in the States. By all accounts from friends who have given birth there, it is absolutely faultless. I was put off by the story circulating that there is no SCBU or NICU, which I subsequently found out to be false (I was going abroad just after I found out I was pregnant and had to make a snap decision, so didn't have time to research it independently).

Instead I opted for the Lindo Wing at St Mary's. Lots of the consultants practice at both the Portland and the Lindo, or the Lindo and the Kensington Wing, so the level of obstetric care is probably very similar across those three hospitals, and I would presume that they would be the three hospitals that you will shortlist (sounds like you live in Chelsea, so they are all within reach).

Lots of people rave about the Kensington Wing, but I had heard that the level of nursing care lets it down. This is just what I've heard on the grapevine and you may want to do your own googling/research into that.

Both the Portland and the Kensington Wing were refurbished a few years ago and the Lindo by comparison was pretty tired. However, the Lindo has just undergone a huge refurbishment and is about to fully reopen any day, so they should all be on level footing in this regard.

As Maples said, there are no birthing pools at the Lindo. Not sure about the other hospitals.

Also worth mentioning that the Portland appears to be considerably more expensive than the others.

As Ghislaine said, once you find out you're pregnant, you need to book a consultant asap, so probably best to make a shortlist in advance! By six weeks you probably won't get your first choice. When you book the consultant that automatically seems to give you a spot at the hospital (i.e. you don't need to separately book with the hospital).

If you want any more info or names of obstetricians that I've heard good things about, then feel free to PM me.

I'd also say that if you want comparable care to the States then you need to go private. For me the main advantages of a private birth were; being treated like an intelligent participant in my healthcare rather than having to accept what others decided with little explanation; guaranteed one on one care at all stages during the birth; being able to choose the consultant that I wanted; and better facilities and support for breastfeeding.

I had my baby at John and Lizzies which has now closed. If i had to do it again now, I'd go to the Portland.

I don't buy the arguments that people make re there isn't a special care baby unit or adult special care because a) it's not actually true and b) even if it were, the same people who spout this line often promote home births where there are neither of those things.

Good luck; why not visit each of the places here and make up your mind based on that?

Just to say I moved abroad when I was pregnant and Bupa told me insurance wouldn't cover my pregnancy unless it was purchased a minimum of 10 months before my due date.

Hi I was in the same boat. I had my last baby in Dubai.
Also under BUPA international care.
How many weeks pregnant are you?

These are the things I considered while decided on hospital NHS vs Private:
-Downside of the NHS is I found is that they don't generally let you choose to have an elective C section if you wanted one.
-Also the aftercare isn't as good in the NHS hosp...they can discharge you as early as 3 hours after birth for a vaginal birth
-Downside of fully private hospitals like the Portland in London is that if there is an emergency you will be transferred to an NHS hospital also the Neo Natal departments are more advanced in NHS hospitals and not all private hospitals or private hospital wings have them or don't have them to the highest grade.
-Private hospitals (not all) have 24 hour nurseries so during your stay the nurses can take your baby away while you rest...doenst always happpen in the NHS
-I was adement on have a consultant lead birth rather than a midwife lead...in the NHS unless you are a very high risk case the midwives deal with your antenatal care and birth...having a obstetrician at my last birth it made me very nervous not to have one this time
-You can choose to go for a midwife lead birth even in private which is a lot cheaper

I chose a private maternity ward within an NHS hospital.
That way in case of an emergency for either myself or the baby no time is lost in transferring us to the NHS.
I also looked at the reputation of consultants.
I live in west London so chose Chelsea and Westminster's private wing.
I chose to go with Keith Duncan for his reputation.
Till week 20 I was seeing a gyno in my local clinic then transferred last week to Keith Duncan who sees his patients at his clinic opposite the hospital.
Your choices in London are
-Chelsea and Westminster's private wing; Kensington Wing on fulham road...not too far from you
-St Thomas hospital's Landsell suite (private ward within an NHS hosp)

• Lindo Wing (private part or an nhs hosp)

-St John's and Elizabeth hospital

There are a few more in central and just out in Kingston and Watford etc.
BUPA at cromwell don't deliver but do have a gynacology dept.

I did go for the nearest private wing as my baby is arriving in the middle of the olympics and most likely we will get stuck in to traffic.

I think it is best to be near just in case have an emergency as all your records should be handy for the hospital staff.

Any other questions please feel free to ask

There are many threads if you do a search on mumsnet reviewing private hospitals and obstetricians

Oh the private hospitals have limited capacity and get booked up fast...so don't wait too long...they will require a deposit which the insurance will not pay up front...my obstetrician works with a package which is also not paid up front by the insurance so we paid the deposit ourselves...but the insurance does cover it and is billed as and when the treatment progresses

Oh just to let you know bout the kensington wing in chelasea and westminster...

all the consultants also have an nhs post

I found that in case of emergency an nhs ambulance will only take you to your nearest nhs hosp so i would go for one that is near!
You can arrange for a private ambulance which is and independent service

I personally know two people who had a really bad experience at portland...they were both severe emergency cases and had to transferred to the nhs in the end and were transferred back for the aftercare once stable...
the hosptial is meant to be much nicer and more hotel like but the only thing putting me off was the experience of my friends and not having an nhs facility next door.

For the aftercare make sure you contact your local GP or if you are in an NHS hospital part of as a private patient that they organize an nhs midwife or healthvisitor to come and visit you at home after the birth ..
i dont think BUPA cover the private aftercare service by the midwife ...just the 6 week postnatal check up.

Be careful when you choose your consultant as most of them work with packages where you pay a lumpsum for any treatment excluding bloodtest that you recieve for the same price...but BUPA will not pay for a package so ensure the admin person working for the doc is willing to bill the insurance detailed and broken down so you get reimbursed...dr keith duncans admin person was very helpful in doing this for me

Also every step of the way I have checked with BUPA if they will cover it because the price per consultation and scan varies hugely between consutlants and I wasnt sure if BUPA would cover any price or would have a limit...
Also ensure you read the smallprint when booking and paying the hospital deposit with is seperate from the doctors fee.
Mine will reimburse me most of the deposit if for medical reasons i dont make it to their hospital to give birth...

I visited a friend yesterday at the Portland who gave birth via ELCS in the morning (and was ready to accept visitors by 1pm!).

She was totally relaxed and very happy with the care she received. She'd had to have the ELCS for medical reasons and had been appalled at her treatment from NHS consultants so took advantage of her health insurance to book herself into the Portland.

Anyway - this is one experience out of many but I found the rooms, staff and atmosphere to be fantastic. Lovely quiet ward, attentive midwives and a very happy and content mum/dad/baby.

I'm having my baby at Homerton Hospital (NHS) so will be an interesting comparison!! Suffice to say I'm not getting my hopes up ;)

Good luck with whatever you choose

ghislaine - I'm not insinuating anything. It is a plain fact that people can get work in the private sector who wouldn't qualify for an NHS post. The regulations are much less stringent. You don't have to be on the specialist register, for starters. That's just the way it is - caveat emptor. If you are going private, you need to do your research. There are plenty of good doctors in the private sector, but you need to check out whoever you are dealing with to make sure you don't get one who isn't good enough to get an NHS job.

Of course sometimes things go wrong in the NHS too, but there's a basic level of quality control that isn't there in the private sector, unless the hospital/clinic/insurer in question imposes its own regulations.

Okay, throwing in my tuppence worth here as a Mum.

First thing to say is that I had my (now 9 year old) DS in an NHS hospital and it was fine.

Even if I could afford private care I would always opt for a private wing in an NHS hospital rather than a stand alone private clinic. Reasons for that is that should anything go wrong then everything is on hand which is not always the case in a stand alone private unit.

I am not up to date about the Portland but DO remember the Laura Touche case and the dreadful care she experienced. From memory though this was due to appalling care by a member of staff and I think a midwife was subsequently struck off. One would hope their procedures have considerably tightened up as a result.

Have a good look round before making a decision.

I seem to recall as a midwife very strict guidelines for managing postpartum care 20 years ago - certainly enough guidelines for me to react with horror when I read about the lack of care Laura Touche received after a caesarean section.

I agree that if there is an emergency ..NHS will take care of you, but it has to be life threatening.
I have severe SPD and fractured my tailbone during last vaginal birth 3 years ago due to long labour...but the NHS refuse to discuss an elective c section for me ...the chances of me damaging further bones around the pelvic area are high according to my private doc and osteopath ..so that is why im choosing to go private...even in case of long labours you can't just request a c section or anything really ...it all depends on the mood of the midwives on the day .
And as for mistakes happening..i am sure they happen everywhere but 3 of my friends gave birth in the last two weeks one of them very satisfied but the other two had horrific experiences all due to the short staffing of hospitals...midwives not being in the room when nessecary and doctors dont get involved on request...only on ground of medical reasons...which again is rarely unless there is a life threatening situation

For comfort and peace of mind i think going private is best...but nhs hospitals attached have their benefit

www.theportlandhospital.com/clinical-outcomes.asp
Data on clinical outcomes. It is from the portland website. It now supplies data to outside independent organisations.

I personally wouldn't judge ANY hospital on an incident, however tragic, based on data and incidences ten years ago. I would however judge them on changes they made in view of those, recent data and how it was audited by independent bodies such as the Care Quality Commission.

Care Quality Commission Website which you can search for reports on NHS hospitals and the Portland

Notably, they do not have cause for concern about the Portland at this moment in time. Unlike several NHS hospitals.

Whilst the cases at the Portland are terrible, they are as bad as similar cases in NHS hospitals (Barrow in Furness springs to mind) and these have all too frequently included systematic failures of management and poor treatment of relatives and patients to cover up problems.

Probably not much consolation but for NHS hospitals I conclude it depends on what day of the week you are giving birth and how stretched the staff is...I have head fantastic birth stories and really bad ones for similar cases...
I suppose with private you have a bit more control as you can choose your consultant and develop a relationship with him...

For me personally the stats of 35% of birth being assisted under midwife care and only 5 percent of them being assisted under consultant care said something...I am sure midwives are perfectly capable of delivering babies in normal straightforward cases...but if any complications occur I am much more comfortable trusting the expert decision of a consultant over a midwife
Again its a personal view