NHS or Private

[NewYorktoLondon]

My husband and I have recently moved to London from New York. We're also are just over 8 weeks pregnant.

We are trying to sort out the whole NHS system or deciding to just go private. It is extremely expensive to go the private option, but if we think it is worth it then we think we can manage this.

So I have two questions for anyone who is out there ...

1. Private. Where's the best place to go for a private birth. Is the Portland a safe option - and has anyone done the Midwife Led service through them? Are there consultants that you think are just great?

2. NHS. Of St. Mary's, Chelsea and Westminister, and Queen Charlotte's which would you recommend?

thanks for any advice. we are desperately trying to sort through all of the options, and honestly just looking for the best one out there?

Thanks.

pressed for time and haven;t read all the comments. My feelings about this are that I wouldn't contemplate a private hospital at all. The Portland has a poor reputation and when it comes to problems (not just pg-related) I know I would rather be in the hands of the NHS any day. Having said that, the NHS, in some parts of the country, is pushed when it comes to maternity care and - as you can see by reading other threads on here - I think this has had quite a bit to do with difficult experiences people have had. there are a couple of things I think can make a really positive contribution to your birth and which are - unfortuntately - rarely available on the nhs - those being, continuity of mid-wife care from ante-natal through to labour and birth, and continuity of care during labour itself. If you think these are important to you I'd go for the independent midwife option. Anotehr option, which I can't recommend enough, is the Birth Centre at Tooting. It's like having an independent midwife but with the added option of having the baby at the birth centre (small, homely, birthing pools, no rules) and - if you're at all nervous - it has the benefit of being less than 100 yards from St Greorge's hopsital if you decide you need an epidural, or if anything should go wrong. If you want to spend money on havnig a baby I can think of no better way of doing it.

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Hatter, the Portland wouldn't be my first choice, but I think "poor reputation" is exaggerated and probably not quite accurate. There were 2 well-publicized deaths, but I've never heard 'poor reputation' used in conjunction with the Portland; indeed, some of London's finest consultants practice there, and I'm sure they wouldn't ally themselves with a hospital which had a "poor reputation." True, I worry about the lack of back-up, but of course the lack of back up is also a problem if you have a baby at home with a private midwife or at a birthing centre like Edgware or even at a more alternative private hospital like John & Lizzie's--places that people have raved about on other threads. They make serious blunders at John & Lizzie's too. . .only we don't hear about them. I've come to the conclusion that there's something about the Portland that gets people's backs up.

I think it's also worth mentioning that NewYorktoLondon is coming from America, where the system is different. Think about it: if you had just moved to a new country where you haven't even figured out ANYTHING yet, AND you're pregnant for the first time (two scary positions to be in at once) it might be comforting for you to go for a system that seems familiar, i.e. consultant led care. Or it might not.

I understand that there can be a certain social conscience-driven devotion to the NHS in this country, but the NHS might not be the right choice for everybody, for reasons that might be hard to fathom by people who are used to the system, and I think it's important to acknowledge that. And, frankly, if someone goes for private care--it's better for the NHS. It's one less patient burdening an already strapped system.

(By the way, I'm a fan of the NHS! Again: I went privately because I have unusually good health insurance. If you could have a private birth for free or an NHS birth for free, which would you choose?)

expatkat I'm afraid I have to disagree. Amongst the medical community in London the Portland DOES have a poor reputation. Some of the finest consultants do run their private practices from there, when they are not also doing excellent work on the NHS, but so do some of London's greatest charlatans. Some of them do not have and never have had an NHS post, and the sensible London GPs that I know personally (including my mother) think that is because they wouldn't be offered one. I have some horrific stories of Portland births among my friends, and even those who really rate it almost all get Caesared (fine) and end up with post operative infection (unacceptable). It ISN't just gossip I'm afraid. And the two deaths you are talking about happened AT the Portland - ie were considered to be fine there, not the really terrible cases that they ship off to other London hospitals for the NHS to pick up the pieces of. You should speak to the people at UCH about some of their Portland transfers.

I think Charlottes (with or without doula) on NHS, Lindo wing under Teoh if private, at home with independent midwife if you can but I probably wouldn't do it for a 1st baby (did with my 3rd and it was wonderful) although plenty of people do....

Thanks pph! I was deliberately - I thought - quite cagey - in that I didn't say it was "poor" I said it had a poor reputation. Two different things. As an interested member of the public, and not in any way a professional, I have heard enough stories - ie the two deaths, which I have read about, not just picked up rumours, to make me think poorly of the place - like many other members of the public. That's a poor reputation. Perhaps it is an ill-deserved poor reputation, but, pph seems to be aware of it having a similarly poor reputation amongst certain professionals too.

What I am about to say will be of no use whatsoever to you, newyorktolondon, but I recently moved from London to the US and almost immediately became PG - I then spent ages trying to replicate the UK system!!! I managed in the end to have a midwife led hospital birth and it was wonderful. We also employed a doula (WONDERFUL!) as I was very keen not to end up with an epidural (which I quickly discovered is the norm here). I ended up having a marvellous birth.
One thing that is certainly better in the UK is the support of early labour - there is no gas&air here and my nurse had never heard of a tens machine. So I had to go 100% drug free, which thankfully was OK, but I was looking forward to trying the gas&air.......oh well, next time, if we're back home.
I, personally, would have either an NHS birth with a doula (though your insurance will most likely not pay for her) or a homebirth with NHS midwives and again, a doula.
Good luck!
mit x

all this difference of opinion probably doesn't help. But my experience was this: great first birth at John and Lizzie's in London - appalling second one on the NHS out of London (Chichester). I would do anything to have done it differently and have positive feelings/ experiences about number two. I was trying to save money and really wish I hadn't. I think I was unlucky the way it all turned out. But I would urge anyone who could almost afford it to give John and Lizzie's a visit... however I also agree in theory with all the pro NHS stuff in this discussion - lots of friends would attest to its brilliance. Just didnt' work out for me...

A friend made the point that the back up for private hospitals in the UK is the NHS in other words, if things go desperately wrong, you could end up being carted off in a critical condition to another hospital much less likely if you're in the NHS to start with.

I'm another transplanted Yank, but have only gone with the NHS (which has been very good re maternity services, for me).

I agree with PPH re the Portland. I looked into going there but I had placenta praevia (a potentially deadly condition for myself and my baby) and my consultant (private, female, very, very highly thought of) strongly warned me against it. So my insurance paid for her to do my section at Kings, and very nice it was too, but she would have done it on the NHS just as well. The difference was a got a room on the private ward afterwards, so there was better food and unlimited visiting (an absolute lifesaver) but agency midwives who weren't much cop and, yes, I did feel a bit ignored and cut off.

newyorktolondon

Cngratulations on your pregnancy!
I am also an ex-pat and when I moved over here certainly never thought I'd have my children here too. I knew nothing about the NHS really, or antenatal care, GP, OB-GYN's the lot.....and it really is a lot different here than in Canada (and the US too) I only knew how things were done in Canada and had all the questions you did when I did become pregnant. Scared of having a midwife (What!! A midwife!! Aren't they kinda earthy and fringey??!) deliver the baby and not an OB-GYN.....scared of lots of things, but that was the biggy.
It's great that you're doing all the research now - and it looks like you're getting lots of great advice and followups.
I have had one daughter on the NHS and can't fault the care I recieved before or (especially)during her actual birth. I had the same midwife with me throughout my labour and I still rave about her! The aftercare wasn't as brilliant - an extremely busy labour ward and post labour ward with not enough midwifes to support the new mums. But I didn't stay long, and then the care and support from the health visitors was very good too.
I'm expecting a second and although we now have the option to go privately through insurance, I've chosen the NHS again.
Good luck with your decison, it is a hard one especially because it is all foreign to you and not what you have always known. Best of luck for a wonderful pregancy as well!

PPH is quite right about the Portland, it does have a bad reputation amongs medics. Stand-alone private hospitals which provide maternity care don't have the emergency back-up facilities. I hope you don't need them. But is it worth taking the risk of a delay while you are transferred to an NHS hospital if anything does go wrong?
If you are visiting private hospitals, question this on this. What procedures do they have in place if you or your baby need emergency care? Where would they take you and how long would a transfer take? Worth noting that the private sector is not as well-regulated as the NHS. In fact was hardly regulated at all until very recently. The NHS has established procedures governing the qualifications and abilities of different members of staff; a junior doctor wouldn't be allowed to do procedures that a consultant would normally perform. In the private sector you are left overnight with a resident medical officer covering the hospital who is guaranteed to be a junior doctor (junior over here equals not a consultant yet and therefore not qualified to work independently, although some junior doctors are close to consultant status IYSWIM). Ask private hospitals about this. Are you guaranteed a consultant (if that's what you want) for your care and will there be a consultant available if required during your whole stay? As PPH said, private hospitals employ some people who the NHS wouldn't touch with a bargepole because the NHS has strict procedures about employing staff. As with any huge organisation (more than a million people work in the NHS), things do go wrong. But there is far more room for things to go wrong in the private sector. That's not emotional bias towards the NHS, that's just a statement of fact. (I have some professional involvement in monitoring the NHS but hold no brief for it as such and have been responsible for pointing out and publicising its failures. But they are far fewer than the failures of the private sector. I would only go private for routine surgery or procedures that aren't available on the NHS.)
HTH

expatkat....I am by no means a defender of the nhs. I personally think it's awful for the majority of people. However, I didn't choose the portland, not because of the bad reputation and the deaths, but because I didn't think it looked like it was worth all the money they were asking for. The medical care I received pre and post cs at St. Mary's was everything that people accuse the Portland of. I was not checked every 15 min., the emergency call button in my room was broken and the place was filthy. Anyway, I did try the Lindo wing for both my pregnancies and despite calling when I was only 6 weeks pregnant, I was told it was booked full for the month I was due. The limited experience I have had with private medical care in the uk has been extremely expensive (much more than in the usa) and disappointing in terms of efficiency, courtesy, cleanliness and attention to detail.

aloha-was that Maggie Blott? She delivered both my boys (2xCS) and I too think she's fab. You didnt lose out much on the aftercare, I had a private room on the NHS ward and was totally ignored for the duration of my stay (36hrs)too. Wasnt affected by limited visiting time, but that may be more to do with my dh being an ex KCH doc himself, and my mum having travelled from Somerset. Food was sh*t but had regular picnics brought in by dh and mum. Smelly cheese sandwiches to die for...yummy! They did try to OD me on heparin tho', not v impressive. Think communication between the staff was crap.
I'd agree with the Portland rep, did the odd bit of agency work there a long time ago.

Hi, I don't know if I should say in case she gets sued by the Portland! So you were kind of ignored too? How interesting! I too relied on food parcels - I was in there for six weeks in total, so probably would have died of malnutrition otherwise...

Have the best of both worlds! Book an independent midwife from the Birth Centre, they are fantastic.
You will get a very experienced team, can have antenatal appointments at home if that is what you want, but you will still be under the care of the NHS if you need consultant input. You can have the baby at home, in their birth centre, or in your local NHS hospital or somewhere private. They will go wherever you want to go.

It is also reassuring to see the same people, especially if you are in a new country.

Private hospitals here can be better at the "hotel services" than the emergency services and do not always have the best doctors.

I had my first child in an NHS hospital and all was fine, but I had three different midwives over the course of the labour, none of whom I had met before.

Baby number two I had at home with the Birth Centre midwives and I felt much more confident and in good hands.