Alternative to NHS?

[tex111]

OK, can someone educate me please. I'm American and I've been in the UK for 12 years. I've had my ups and downs with NHS during this time but now that I have children I'm finding it very difficult to put up with the long waiting lists for appointments, inability to get seen, overworked and often insensitive staff etc, etc. What are the alternatives?

We're fortunate enough to be able to afford private health and have a policy through DH's work but this only covers treatment. It does not cover 'investigation' or general healthcare. Is there such a thing as private A&E, private GPs, etc and how do I find them? What insurance companies provide such cover?

This has all come to a head after a very long day in A&E with 4 month old DD. She's been having blood in her nappy for ten days, this was my second trip to A&E and I've been disappointed in the treatment (or lack of it). What else can I do?

Hello there, I'm really sorry you have had such a bad experience with the nhs hospital. as far as i am aware there is really an alternative to nhs run A&E. I would say though that maybe a condition such as the one your dd has would maybe have been one that you could have consulted your GP about rather than going to A&E. If it is urgent and especially in the case of a young baby or child you can phone your gp's surgery first thing in the morning and usually get an appointment the same day.

You won't find private A and E's but there are private Gp's, paed's etc once in A and E you could ask to be treated privately if follow-up care is required. Our NHS hospital has a private one attached and gp can refer you privately instead of to NHS for some specialist consultations and investigations. Consultants often work in both areas but it might make a difference to your waiting time for an appointment, continuity of care and environment. The big ones in UK are Bupa and PPP but there are other insuranc eocmpanies which do it, all with different levels of policy and exclusions.

There are some private GP practices. I know of one (or knew at any rate) in London. But it will cost you. I don't think that any insurace policies will cover private GP work....but I would be wrong.

www.privatehealth.co.uk/privatespecialists/specialists-privategp

to search for private gps

tex111 there's a BUPA GP service at Canary Wharf (although I'm not sure whether they see children there). It costs a fair bit but they will sort you out quite quickly. It isn't a private GP as such though, the idea is that you still have your NHS GP and use the BUPA one if you need to be seen quickly, so you would need to ask your own GP for a copy of your notes.

jco, I went to A&E today only after being unable to get an appt with the GP. This is part of my problem too. The GP has a ridiculous way of setting appts whereby you must ring at 8am for an appt on the day. Sounds good in theory but what happens is that you must start ringing a few minutes before 8.00, get a busy signal, hit redial, over and over again and, if you're lucky, you eventually get through and get an appt. I got through at 8.20 and all of the appts had gone and they wouldn't prebook me for tomorrow. So frustrating.

What I would like is to find something similiar to what I experienced in the US and when we lived in Tokyo -

• a GP practice where I can get an appt when I need one and at a time that is convenient

• a practice where I can regularly see the same doctor

• a GP practice with its own lab so that blood tests, urine samples, etc can be tested quickly and results given on the same day

• an A&E where we can be seen within an hour, in a clean environment, by staff who have more than a few minutes to see us and aren't interrupted by beepers during that time.

• a doctor, hospital staff who are ready and willing to investigate a problem before it develops into something more serious. I can't count the number I've times I've been sent away only to come back within a day or two with a very ill child.

• a doctor who places importance on preventative care such as mammograms, annual smears, regular children's check ups, etc, etc rather than waiting for problems to develop.

Am I dreaming or is any of this possible in the UK?

Hi Bran, if that's the practice I found online they only see over 16s. It's always the children that I want seen quickly. I'll keep looking though.

From what I've found so far there doesn't seem to be anything suitable in our area. I have found a very expensive call-out doctor service that I will definitely keep in mind in times of desperation.

For future reference can anyone recommend a good children's A&E in SE London?

I think there is a private A and E opened in London?

'an A&E where we can be seen within an hour, '

I only had that experience ONCE in the US, and that was when I fell whilst abseiling and ripped my head open, suffered a hairline fracture in the skull, and ruptured my eardrum. I had managed to hike out, but my pals insisted on calling an ambulance at the trailhead b/c by the time I got there I was passing out.

\link{http://news.bbc.co.uk/1/hi/england/london/3153592.stm\here}

Jeez, it's not really an A&E though, is it? I can't imagine going to an A&E for most of the conditions listed.

For urgent GP appointments for my daughter, I have always (except one time when I prob should have gone straight to hospital since that's where we were immediately sent) asked to speak to the practice nurse first as my child is ill and I am wondering if I need to bring her to surgery. I have been put through to someone and always been told to bring her down, then put back to switchboard and an appointment is issued, or if appointments are all booked out,asked to come down on a 'wait in the waiting room' basis.

I did find that casualty unit but it's quite far from us. Will be watching to see if they open more of them.

Expat, I know it can be a long wait in the US too but I was always very lucky and found the experience overall to be more reassuring. More time with the doctor, more explanation of the situation, more options for treatments. Neither system is perfect (being asked for a credit card before anyone would see my sister's head injury at a US hospital - not a great experience) but I feel that I must be able to find something more satisfying in the UK.

SueW, I'll try asking for the practice nurse next time. I didn't know that I could do that. Just being able to talk to someone would make a difference.

:) tex.

When I was in the ambulance outside Boulder, I directed my pals to get my ID pouch out of my rucksack, b/c my insurance card was in there. I remember saying, 'I'm w/Kaiser, I need to go to St. Joseph's' And so I did!

tex - have you tried the evelina childrens hospitl? not sure if they have an a&e but it would be a great place to get referred to by your gp (if you ever get to see him/her!!)

you might find this site useful too
www.privatehealth.co.uk/

The Evelina is NHS, though, and doesn't ahve its own A+E (part of St Thomas' IIRC)

tex, I'm not sure exactly how far away from central London you are but both the Cromwell and the Portland have private paeds you can see. I think (certainly at the Cromwell) you can just phone and get an appointment (without a GP referral) however, your insurance will probably need the referral to pay.

Have you tried contacting your medical insurance? Quite often, they will have a list of private paeds that they are happy for you to use.

You can look up private GPs in your local yellow pages normally.

also, I don't know if it is BUPA that you are with but their website is good and you can look up your local services on here. It also explains all the health investigations you can have done.

\link{http://www.bupa.co.uk/\here}

I do sympathise with you - even though I spent my childhood here, I then lived abroad in a country where you had to pay for treatment (through insurance) and I found it quite disorientating coming back here again and finding my way in the NHS!

Don't always assume that private is better. My ds has food allergies and after an appt with his dietician in Nov, she said she wanted him tested to see what he's allergic to. Rather than wait the NHS waiting times to see a paediatrian (8 to 12 weeks in my area....even though he is already under a paediatrician), dh & I decided to pay to see a private paed who specialises in food allergies. It has been a fiasco. His bloods were drawn 19th Dec and told that his results would eb in 1st week Jan (would have been sooner if not for the holidays). When I heard nothing by the 2nd week in Jan, I chased and chased for the results. Evetually they called me in the 3rd week of Jan to say the test had been messed up and had to be repeated . My poor ds was not happy (he was 19 months). We had blood drawn again on 23rd Jan, promised the results for 6th Feb when ds had an appt to see his NHS paed. Low and behold, we are finally going to get the results TODAY and am having to pay for the privilledge. I WOULD have been better off waiting for have them done on the NHS, both in terms of time and monoey.

(yes, I agree heartmum2jamie) personally, I think what makes a big difference is a good GP.

A&E treatment is normally v good - which hospital did you go to tex?

Also, normally once you have an appointment with a NHS consultant, they are good. I have had to go to hospital several times with dd and in all cases, we have been treated brilliantly.

re: your GP, I think you should change surgery, maybe to a single-handed practice, if you are not satisfied or talk to the practice manager about the current system not meeting patients' needs. our surgery has a facility where under-5's are seen every morning at 8.30..you have to ring at 8 but you don't actually need an appointment. I'm really missing this, now dd1 is over 5. your local PCT can give you a list of other GPs or ring NHS Direct

re: waiting an hour in A&E. Very often you do only end up waiting that long, but you have to think of who's in front of you eg someone who cannot breathe, or is actually having a heart attack and could die... the beepers which interrupt your consultation are there for just this reason, not to piss you off. an A&E consultant I spoke to just this week said they try and get the people with the most minor complaints seen asap in order to keep the whole system moving, it's just not in their interests to keep you waiting.

re: prevention. there's plenty of this in the NHS, in fact some would say too much (recent announcement of MOT-style checks for everyone) and the American tendency to check well people is time-consuming and costly. well children are checked - do you have a health visitor? the health surveillance they carry out at key stages can be valuable if you have a good relationship with your hv.

Agree 100% Foxinsocks. I used to live in Canada and had OHIP (insurance I think, but was just a young child) and understand that the NHS can take some getting used to. I really can't complain too much about the NHS. My ds has been under several NHS drs, consultanst and specialists (still under 3), and if it wasn't for them, he would be dead. A good GP, Paediatrician or Consultant is worth their weight in gold, whether they are NHS of private.

I think you're right about a good GP making all the difference, Foxinsocks. When I was confident in my GP, I had much more confidence in the whole NHS process. The problem at the moment is that I like the GP with whom we're registered it's just so hard to get to see her. I think I'll investigate other practices in the area. I've noted the Cromwell and will keep that in mind.

I think we need to reassess our private cover too. It's through DH's work and, until we had children, it was just there and not something that we ever thought about using. From what I've been reading I think we could find a more suitable policy. BUPA does sound quite good.

The A&E we went to was the Children's A&E at Lewisham Hospital. I would guess that it's probably a pretty good A&E on the whole. I've certainly been to much worse but it's the waiting and waiting and then the disinterest of the doctors that gets me down. I feel like I'm fighting to get their attention, to get them to take our situation seriously. Drives me crazy.

HeartMum, I know you're right. Private is definitely not always better and we've had excellent care on NHS with some serious problems before. I just want to know all my options and feel that I have a choice.

poor you - I know how frustrating it is. I have just had to get an appointment for dd and I had to sit by the phone for half an hour and then couldn't get to see the doctor I wanted (but luckily got a great one who I never even knew was there!).

It is a very annoying system brought on by the need to meet the target of being seen in a certain time - I see you can pre-book appointments (not useful if your child is ill on the day, I know!). Have you found out what their policy is for this?

I know how you are feeling and I do really sympathise. We had a fantastic GP in our last practice and it made such a difference. I also think it's worth using the nurses at your practice - quite often they can make sure you get seen by the doctors etc. although getting an appointment with a nurse can be just as trying as getting one with a doctor.

I'm sorry that I only know the hospitals in the west and south west London area otherwise I'd try and think of other ones for you.

Tex, if you find a way to replicate the US medical system here in the UK, by all means let me know!

I think there are some things the NHS does well. But, overall, the service is far beneath the US system. And I am criticising the NHS, not the individual doctors. The doctors are good, but the system holds them back.

uwila, I strongly dissagree, the NHS is a good system, and is not cpomparible to the american system in any way, God forbid. The loopholes and get out clauses for companies providing in american health insurace are getting rediculous.

The problem with the NHS is not neccesarily to do with the system, it is a victim of its own sucess. The more it fixed people the more illnesses it found was avalible to fix

When it was origionally set up after the war it was thought that by providing health care free at the point of use, the nation would become healthier. The opposite has happened. Not enough people take responsibilty for their own healt. People drink and smoke and eat high fat diets all theri life because they can take a 'pill' that may 'fix it'

The attitude of health in this country seems to be one of interviention rather than prevention. Now I know some people are very conscious of health, and even the healthiest peroson can be unucky. I am not talking about everyone here!

I am not trying to imply that the NHS shoud not treat people who abuse their own health but they are a major reason that the NHS is so clogged up.

If people stopeed expecting the NHS to fix them and started using it for the injuries and illnesses it origionally was intended for perhaps things would imrove