Just been told it's £350 to have a large cyst removed

[whataboutbob]

I have a largeish sebaceous cyst high up on my back. It's conspicuous when I go swimming or wear loose tops. I went to my GP today and she said that as it's not causing trauma it was a cosmetic issue and I'd have to have it done privately, those are the guidelines. I have had a look round and couldn t find NICE guidelines on this. But it seems the going rate is £300-350 per cyst. Anyone know if this is right or could i have it removed on the NHS? Thanks for any advice/ insight on this.

[EndodSummerLooming]

Agrees with Boffinmum.

[BombadierFritz]

I have one that grew and grew but when i had antibiotics for a chest infection it almost disappeared. I was considering getting a friend to remove it and stitched in a and e. 350 quid is a stupidly high price. You could also look abroad and combine it with a holiday?

[KoalaDownUnder]

As I said upthread, I paid around £40 - £50 to have my cyst removed last year. This is in Australia (no NHS). Having it sent to pathology for testing was included in that.

So yes, £350 does seem an awful lot.

Additionally, my GP said that it needed to be removed so that it could be checked for malignancy. It wasn't deemed to be purely a cosmetic procedure.

Can any UK doctors on here address that? (Genuinely curious.)

[hunibuni]

Polly FYI type 2 diabetes is not just lifestyle induced, it can also occur secondary to treatment for other conditions or post pancreatic surgery. There are also increased risk factors in certain ethnic groups and within families. Of, and you don't have to be overweight or consume a lot of sugar.

Type 1 is insulin deficiency, the pancreas doesn't produce insulin.

Type 2 tends towards insulin resistance, the insulin receptors don't function properly.
HTH

[WiIdfire]

I'm a surgeon, I've removed plenty of sebaceous cysts in my time. 5 years ago we used to have 'lumps and bumps' lists (that were great for juniors to be trained on) but the funding has completely disappeared for minor procedures. If its not painful or dangerous then it is no longer funded. In some places even things like hernias and varicose veins are no longer funded unless they are painful or causing complications. You can get around it by carefully wording the symptoms, and essentially lying to get it done on the NHS but the question is, should we be doing that?

The NHS is running out of money at an alarming rate, Boffinmums comment about NHS funding shows just how little people really understand about the way the NHS works. There really is no money for cosmetic procedures - if we use it for this then something more serious misses out elsewhere.

If you think £350 is expensive - just ask yourself how much you pay for a lawyer, a plumber, an MOT check, a haircut. The cost has to include: the surgeons time, the scrub nurses time, the use of the operating theatre, disposables (syringes, sutures etc), drugs (anaesthetic), maybe the inital consultation, (room rental, secretarial services for letters), insurance in case of complications, histology, suture removal etc. You really can't pay for all that with £40. Honestly.

What this really demonstrates is how much people take the NHS for granted, and how much people really don't value the skills of their medical staff. So sad. So demoralising.

By the way, I wouldn't bother trying to do it yourself with a needle. It probably won't drain anything (they are filled with cottage cheese like substance) and if you don't remove the capsule it will refill anyway. The people who had them lanced are talking about infected cysts, which are treated differently.

[KoalaDownUnder]

Wildfire, I completely take your point re: surgical procedures.

However, this was done by a GP, in his normal offices (although in a specially-equipped room with a nurse assisting). The £40 charge reflected the normal price of a 'long' appointment (as GP appointments here are charged according to how long they take).

As you say, he injected a local anaesthetic, then removed the entire cyst, including the 'walls', so it wouldn't refill. He then closed the incision with a few stitches (which have healed almost invisibly), and sent the cyst to be tested.

I did pay for another appointment to have the stitches removed, tbf - but that would have been another 20 or 30 quid (short appointment).

I certainly wouldn't expect a surgeon to do all this for the same price, but I also don't think it required a surgeon. So my question is, can't a GP do it in the UK, for less than £350?

[WiIdfire]

Yes, There are GPs who do minor ops - since they have their own procedure rooms anyway I guess it would be cheaper. I still think that for £40 they aren't getting much left over after costs - you got a good deal there! Did you pay separately for the inital consultation too?
I think GPs doing minor ops will go out of fashion - as someone earlier said, they are doing less moles now as there were too many not being done 'properly' and it is hard to keep your skills up if you only do one or two operations a week. That said, its not a hard procedure so you would get a perfectly good job done by a GP, if you can find one to do it.

I just find it sad that people would want to pay more for their haircut or electrician than for an operation. We're really not valued at all highly.
(And no I don't play golf!)

[KoalaDownUnder]

Actually, fair point - I did pay for the initial consult. Although I had an appointment for something else anyway, and basically said at the end of the appointment 'Can you remove this some time?' And he took a quick look and booked me in.

I completely agree with you re: people begrudging paying for surgical skill, though. A good surgeon (heck, even just an average one) is worth his/her weight in gold. Which is why I think they should probably not be 'wasted' on minor procedures that can be handled by a GP!

As a lawyer, I can't resist pointing out that I recently paid a handyman (not a qualified tradesman) more per day to lay paving in my courtyard than I'm earning myself!

[EndodSummerLooming]

I think the problem is wildfire that the NHS is free at the point of delivery unlike in most of Continental Europe and that has caused entitlement issues on both sides. Partial or full privatisation is always compared to the US system but there are other more socially based models that work really well. We have a home in France and standards there are better and a lit of it is about mutual respect. Not to say there isn't mutual respect in the UK but you have only to hop on a thread in childbirth and see how many women have suffered from inappropriate, unkind comments to know there are parts of the NHS that really have to shape up.

In the last year it so, I've had both fabulous and frankly disgraceful care from the NHS mostly stemming from a couple of accidents and one thing led to another - hence a lot of NHS. The tiny break, the automatic referral for a dexa scan, the osteoporosis, the second fall and severe wedge fracture, etc. On the whole the doctors have been superb but it's the disorganisation and heavy handedness, born of a culture that has an embedded idea it's doing people a favour (mostly at the admin but sadly to a degree at nursing level too).

Neurologist - absolutely fabulous - if I'd gone ahead with the op, I'd have done it privately.
A%E - (once for me, once for DD) absolutely horrific (issues with nursing and communication)
Ortho clinic, dire - rude, dirty, late, but the consultant was excellent.
Rheumatologist - consultant fabulous, some if the support around her - shocking
Breast clinic (a Cpl of years ago - absolutely shocking, very rude consultant, seven hour delays, women herded like cattle, and the lady who had bad news was left to wait on her own back in the waiting room). I've another apt tomorrow but at a different hospital - if it's as bad and if it's bad news, we will probably pay.
Gynae (dd, one consultant was v rude over just booking an apt, the next was delightful - this was private £2,200 fir quite a simple procedure)
Oh, and let's not forget dd's MH issues over the last year or so. There is no NHS help or support out there at all for vulnerable young people. The bill is running at just shy of £4,500! From what I've seen of NHS MH services the right hand doesn't know what the left is doing, nothing is joined up, as much time goes on complaining about resources as it does on working and there is a whole lumbering and bureaucratic culture designed to arse cover instead of doing anything useful.

[PollyPerky]

GPs used to remove moles etc if they were trained. I had one done this way and DH had several. I agree that if it's an option, take it. However, I also agree that something which is 'vanity' should not be within the remit of the NHS given the dire financial difficulties there are. Moles that are possibly malignant as fast tracked to a dermo - no hesitation there. Anything else like cysts that look 'ok' aren't. Moles that look normal aren't. I had a mole removed from my face and TBH I'd not have let a GP near it. No offence to GPs but a plastic surgeon did it and there is not even the hint of a scar. I was 'happy' to pay £500 which included being gowned up for the theatre - seemed completely OTT- and face stitched, and return appt to remove stitches.

I made this point before and will again- what you pay is not ALL going to the surgeon. As with all private work , there are overheads. I am s/e and my hourly fee has to cover my premises, professional memberships, insurances, travelling costs, website, stationery, etc etc. And then of course it's taxed.

I think in general people undervalue health care because it's 'free' and the vast majority of the population (earning under £39K) are not net contributors- only a few percent are. And don't forget that the fee you pay to drs for private treatment is eventually taxed, and that money is used to provide NHS treatment for anyone who can't afford private!

[BoffinMum]

Ah, the haircut cost argument. Much beloved of dentists as well.

"lawyer, a plumber, an MOT check, a haircut"

You can represent yourself in court or arrange a no-win-no-fee form of representation. Or do an online small claims action for £30. You don't have to wheel out a QC.

You can get a handbook on plumbing and fix things yourself (as I did recently with our blocked sink). If you need a CORGI engineer for gas-related issues that's a bit different, but even then you aren't looking at £350 for 20-30 minutes' work.

In terms of MOT checks, they take an hour or more, involve trained, insured and certified mechanics, use extensive workshop facilities, and cost south of £60. Hardly a good comparison. And if you can't afford a car you can sell it. So optional.

And so we move to haircuts. If you don't want to pay a hairdresser you can trim it yourself, grow it, or in extremis, shave it off. Haircuts are optional in life.

However if you have a cyst on your arse or under your bra strap that is driving you nuts you are pretty much stuck with regard to doing it yourself because of the type and location of problem. Therefore surgeons and surgically trained GPs think holding you hostage for £350 is just fine. That's probably £700 an hour. I just don't see how that can be justified, sorry.

[PollyPerky]

Bunkum Boffin! Unless you are being sarcastic?

You can use Money Claims Online (formerly the Small Claims Court) for debt. You can't use it for anything else or for criminal cases. Not a valid comparison.

MOTs. They are 'in the business' a loss leader, but the garage does stand to make a profit if they find faults. One main dealer wanted £1K for fixing 'faults' post-MOT- I drove it away, took it to another smaller garage who did some minor repairs and said other things weren't even necessary. The average hourly rate of a main dealer is £100 and sometimes more.

And- this is the point- how can you possibly compare the education / cost/ skills of a car mechanic to a plastic surgeon???? The former has studied for 2 years post-GCSE, the latter for possibly 20 years.

Likewise a hairdresser- a couple of years in further ed as an apprentice/ trainee with very few GCSEs. How can you possibly compare that to a dr?
Of course you can cut your own hair. But does anyone want to take a knife to their own body and do surgery?

You are also missing the point that all medics have to be insured, pay for premises if they are working privately (either directly, annually, or as a percentage of their fee per patient) , fund their CPD, their staff (PAs) and everything else running a business includes.

You are also paying for the histology of lumps removed . So £350 is in fact a bargain because around 1/3 to 1/2 will go to the lab, and the dr will get 50% minus all their expenses.

[BombadierFritz]

I pay a tenner for a haircut, about 30 quid an hour for plumber or similar. Removing a cyst looks pretty easy on youtube ;) its surely a qualified nurse type skill? Having said that, i dont know how the nhs can say cosmetic without histology. Its a risk to leave something that could be for example non pigmented nodular melanoma

[Hockeydude]

I have found recently that nhs treatment is only available if you have something life threatening. The lack of staff and cash is mind blowing.

My autistic 9yo on floor screaming in pain crying on floor. Told 18 weeks wait as not life threatening We've paid, seem specialist got treatment all fine.

I know a teacher who paid £500 for some strange back door nhs doctor for an operation that had a 3 month wait (which would have caused a pain killer addiction and had already caused an inability to work)

Mil in so much pain had to call ambulance couldn't move. Had been to gp at least 10 times over this pain and dismissed. They only found a broken back .

[MapleandPear]

Hmm. Thing is op, if you needed a lawyer, accountant, even an undertaker, would you object to paying towards their children's school fees as well.

You don't need to go to private school to enter any of these professions.

[Mrsmorton]

Do you need to go to private school to be a Dr or a dentist?

[BoffinMum]

As I keep saying, £350 is not a bargain and it compares unfavourably to, say, endontics. And as I said, all the other things are optional. Oh, and the surgeon who trained for 20 years will have done it with a mandatory grant for university covering all costs and no student debt, all that having been met by the taxpayer.

This from the profession who routinely trouser £70 bunce for filling in a few boxes on crematorium 'ash cash' forms.

[Mrsmorton]

boffin a lot of my friends are consultant Drs/surgeons who were at university at the same time as me. None of us got "mandatory" grants and we all graduated with tens of thousands in debts. You're so certain of all of these things, I'm sure you think if you say them with enough confidence that people will believe you.

How very odd because you're talking absolute bollocks.

[Mrsmorton]

Ps it's endodontics. Looking at £750 for a couple of hours there, you may want to do a bit more research before you make declarations. Evidence based is where it's at.

[KoalaDownUnder]

Tbh, BoffinMum just sounds like she has an axe to grind.

I can't even begin to start comparing surgeons to hairdressers (no offence to the latter), because the levels of skills, training and responsibility means it's apples and oranges.

Quite depressing that she has such a low opinion of surgeons, though. It's a highly respected profession for a good reason.

[giraffesCantReachTheirToes]

On GP behind closed doors there there was there was a boy with multiple fairly large and troublesome verrucas on his feet. GP advised they used to do freezing treatment but don't anymore all they could offer is same as otc treatments.

[justneedsomehandholding]

GPs behind closed doors recommended I took my ds to a local, excellent chiropodist about 15 years ago. Had him sorted in no time.

I have no issue with how much other people earn. I do have an issue with being made to feel grateful for a service that is only free at the point of delivery.

The plain fact is that the NHS is no longer functioning in a sustainable way.

[RattataPidgeyRattataPidgey]

GP advised they used to do freezing treatment but don't anymore all they could offer is same as otc treatments.

Bad example - I read up on this recently (thought I'd acquired a verruca) and the evidence for freezing (or doing anything, really) no longer seems to stand up. That would explain it no longer being offered.

[BoffinMum]

University fees only began in 1998. This was 18 years ago. If you spent 20 years training you would have started university in 1996 you would have been in a cohort that was not charged fees. Fees were £1000 a year for roughly the first decade, then £3000, and then the neoliberal Tories whacked them up to £9000 and rising, and stopped lots of working class kids applying. There are now places in UCAS Clearing for medical school for the first time.

What did you pay per year?

[BoffinMum]

I was not the person who started comparing surgeons to car mechanics and hairdressers, I was in actual fact the one who pointed out what a stupid and pointless comparison that was.m, and how it was lazily trotted out by certain professions when overcharging.