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.

[BoffinMum]

Mrs Morton, the procedure with the cyst takes 15-20 minutes, so I worked out what 15-20 minutes of an endodontists's time might be. Obviously it's a bit daft to compare a 15 minutes procedure with a two hour one.

I am so intrigued to see all the medical types piling in here justifying their charges given anyone going to medical school before 2010 will have benefited from a taxpayer funded training subsidy of just south of £100k.

[Jecan]

I had a cyst on my back but since I'm in Germany the whole thing went slightly differently.
I went to my GP who agreed it should be removed to check it wasn't cancerous. He gave me a referral to a dermatologist.
I asked friends if they knew a good one, called a practice & they gave me an appointment for a consultation a few weeks away. Had the consultation, had the cyst removed 2 weeks later & returned to get my stitches removed. Was given a letter to take back to my GP.

At no point did any money change hands. For the last few years healthcare has been mostly free at the point of care here to the majority of the population who have the state health insurance plan. My dh has his contribution taken out his wages & that covers the whole family.

The NHS cannot carry on in the way it is & there are many other options that are not private healthcare that need to be investigated but the NHS is so entrenched in its way of working & people are so use to it that there would be uproar if the system was fundamentally changed.

[PollyPerky]

As I keep saying, £350 is not a bargain and it compares unfavourably to, say, endontics.

Boffin you can keep saying these things as often as you like, but it doesn't mean you or the points you make are right! Maybe you ought to think about changing your username because it's not truly representative.

Tuition fees may have begun in 1998 but before that there were grants. Not all students qualified for the full grant; their parents had to make up the shortfall. I went to uni in the early 70s, so maybe I know a bit about this? If parents chose not to make up the difference, (based on means testing) students had to take part time jobs. So it wasn't the doddle you make out.

I don't know how much more I need to spell it out because however many times I post, you aren't listening!

The surgeon does not get the whole fee. Read again and digest.

They pay for premises if it's a private hospital (the fee goes to the nursing staff and for the theatre uses) They pay for their PA. They pay for their professional registrations and insurance. The procedure does not take 15 minutes. The dr has to arrive before that, get scrubbed and gowned up (if it's in hospital) and complete paperwork, follow up and interpret the histology results when they are sent, with more follow up even if it's just dictating a letter to their PA.

This is not 15 minutes' work.

[BoffinMum]

Pollyperky, I was talking about fees, which were paid by mandatory grants for all degree courses validated by the Burnham Committee and later incarnations, and it was only maintenance grants that were means tested (students could also claim housing benefit in the vacations in some situations). You could also get discretionary grants for things like music diploma courses ballet, music, drama and so on, but that was up to the Local Education Authority. So none of the £9000 fee business. As you well know.

I agree about the German thing. Most GP surgeries here are very limited in their ability to do tests and deal with small procedures and this is a big factor in sending people to NHS and private hospitals for minor things, right, left and centre. We also don't have many small local clinics, just huge hospitals, so people are corralled into edifices of health and the concomitant costs are astronomical. Very user-unfriendly.

[PollyPerky]

Yes, and someone had to pay those maintenance fees- either the trainee drs themselves or their families. Some surgeons would have trained in 1998- almost 20 years ago now. The fact is, being a surgeon is a highly skilled job requiring intellectual skills and manual dexterity . Not everyone can do it. That's partly why they charge what they do- supply and demand.

You appear to put no value on their skills but worse, you make no attempt at all to acknowledge the fact that what someone pays them doesn't all go into their pockets.

There are a group of people who are happy to pay for: (choose one or more) childcare, cleaners, private education, holidays overseas, new cars, clothes, meals out etc etc but they baulk at the notion of paying for minor health care procedures which are purely cosmetic which the NHS can't afford.

[Genvonklinkerhoffen]

I think boffinmum'is less interested in dialogue and more interested in what she thinks are facts perky you know what they say about arguing with people who can beat you with experience...

[whataboutbob]

When I started this thread it was to express surprise that a largeish cyst wasn 't going to be removed at the GP practice or my local hospital. I was basically given the option of going on the net and ringing round private clinics, which surprised me. I never wanted for things on this thread to escalate to this level of accusations and personal abuse.
I made a rather tart comment about not wanting to contribute t a surgeon's kids' school fees or golf club membership, which in retrospect was ill advised. Surgeons are people too and some are even on mumsnet! For that I have been called envious, comments such as "I bet you're great to work with" were made, I have had it explained to me I'm not a high enough earner to justify bothering the NHS for free treatment (not a "net contributor" anyway) , while being told £350 is plenty fair for a 30 minute procedure because there are overheads. As I mentioned, i earn that in 3 days' work. FWIW I have benefitted from highly skilled surgery and anaesthsia on the nHS and I have respect and gratitude to the surgeon who operated on me.
However I do believe that I and other contributors here are entitled to question whether simply pulling a service (no matter how "cosmetic" it might be deemed to be) and telling people to pay whatever private medicine asks for is the best way forward. Maybe there could be a middle way with nhs charging partly subsidised rates for non essential/ curative etc surgery. Finally, many of today's surgeons will have studied with full grants and some have chosen to convert their medical degrees into a lucrative business, and it should be OK to say that without being shouted down .

[PollyPerky]

It's utterly pointless OP to keep going on about 'free tuition' that some surgeons may have had yonks ago. The same could be said for accountants, lawyers, dentists, and almost anyone who has a degree pre-1998 and who now runs a private business or earns a good salary. (I don't hear anyone judging what footballers spend their millions on, yet spectators are happy to shell out shed loads for season tickets, as an example. ) Maybe you should think about the hours of study surgeons put in over decades to reach the top of a profession, which you didn't, we assume, so you earn what you do. It's easy to criticise people who earn more than you, but the question is 'okay- if you are envious, why didn't you train as a surgeon?'

It's really shocking that for someone in the NHS as you are, you show so little respect for surgeons and go as far as comparing your income to theirs. Not sure what you do- nursing, physio, admin- whatever. It's also shocking you seem unaware of how broke the NHS is when people can't get treatment for cancer and waiting lists are growing for all kinds of serious illnesses. If something is purely cosmetic and is covered by clothes most of the time anyway, then it seems reasonable that people pay to have it removed, just as they would pay for any other cosmetic procedure or treatments like braces.

[PollyPerky]

I do now see you say you respect surgeons and their skills- so apologies for missing that- but there is still envy coming over about how they can earn a lot of money in some instances. You need to put it in perspective- there are millions in the UK who have benefited from 'free degrees' but there aren't many of them who are surgeons.

[whataboutbob]

I think we're going to have to agree to disagree on this one PollyPerky. I never said my sebaceous cyst should be treated with the same degree of priority as cancer, IVF, varicose veins, I said high up on the thread that those were a lot more significant. Yes surgeons study for a long time but in my view that does not legitimise the high prices they charge in private practice. True I did not go to medical school and I am not a surgeon, as you are fond of pointing out. But is their labour worth about 30 times mine? I don't see why I shouldn't "go as far as comparing my labour to theirs" , this is not the 19th century and I think maybe you take the concept of deference a little too far.

[PollyPerky]

No one is talking about deference. you are STILL unwilling to accept the notion that the fee of £350, or whatever it is, covers everything including the lab fees in most cases. Is this so hard to understand? Most drs working in private practice lose 20% or thereabouts for their room fees. I have used hospital premises and lost that amount straight off for room hire. I've mentioned the other costs they meet out of their fees and am not going to repeat it.

If you earn £100 a day gross, that's just over £12 an hour if it's an 8hr day. This is what a cleaner can earn unless £100-ish a day is net income. Of course you can compare your labour to theirs, but only if you are happy to post your CV or at least give some idea of what you do, so we can compare properly.

[PollyPerky]

Basically, austerity seems to have passed you by! There is not enough money in the kitty! Something has to give- and it's minor ops for cosmetic procedures. Life in the NHS must be very sheltered if you can't understand this. It's not a case of your needs not being at the top of the list- it's your needs are OFF the list due to lack of cash. Just suck it up instead of whining.

[BoffinMum]

The problem is that during a period of huge economic growth from 1997-2008, the financial cutback argument was invoked again and again, so it has weakened the currency of making that claim. Meanwhile the BMC negotiated six figure salaries for GPs leading many of them to go part time, and a 48 hour week for junior doctors, and now we have a doctor shortage. What a mess. I repeat, it is not a user-friendly service and the wider medical profession has become awfully greedy, contributing to the problems. Don't be surprised if people call you out in that.

[BoffinMum]

FWIW I think there's a case for doing some stuff at cost price and arranging for this to relate to the living wage. Like the OP says, £350 is massive money for many people and this isn't fully understood by white collar professionals on regular salaries.

[PollyPerky]

Some of what you have posted is an opinion. Not facts. One of the main reasons for lack of money in the NHS is nothing to do with drs' salaries but the overburdening of the system with lifestyle -related chronic illness as well as the sheer waste of resources and inefficiency. This includes the diabetes epidemic, the cost of which is billions annually. No amount of money or drs will keep up with the increasing demand.

[BoffinMum]

Rrriiiiiight, so it's primarily the patients' fault then, for getting ill? Living too long? Being Asian more often and getting diabetes? Having sedentary Information Age jobs and knackering their metabolisms? Not the fault of drug companies flogging expensive treatments, over-medicalising normal life events with concomitant side effects that also need treating? Not the fault of poorly regulated businesses compromising the work-life balance of employees? Not the fault of doctors not being able to lead the system efficiently enough? Nooooo, it's the fault of the patients. I'll make a note of that.

[WiIdfire]

I went to uni in 1999. No grants. Used student loan, which over 5 years added up. Also had a weekend job to earn a bit of money. I've only just this year paid off my student loan - took me 12 years. So don't tell me I had it all handed to me for free.

OP - I do take your point that it is a high cost for a minor procedure. What do you think a surgeon should earn for this? As in, how much should they take home personally? Then we can add on costs and work it out the other way. Assume 2 per hour, once all the associated paperwork and preperation is done.

There is an interesting point regarding top-up fees. At the mo its NHS or private. No middle ground. You can't skip back and forwards. Maybe there is an arguement for top-up fees - pay to upgrade to a private room. Pay to hurry up the lab results. Pay to reduce the waiting time. Trouble is, its hard to do that without delaying those who cant pay - it would only work if it didnt slow down the NHS list, and I dont see how that can be realistically done.

[PollyPerky]

Boffin no need for the sarcasm or racist comments! Don't know where you got that from but it's crass.

The facts are that 70% of hospital treatment and admissions are for lifestyle-related conditions. A consultant told me this. Drugs for diabetes cost almost £9 BILLION a year. Most of this could be avoided by a massive public health campaign and a change in how we manage health.

In Japan, you have your salary docked if as a man your waist goes over 33 inches. You are expected to look after yourself. There is a stigma attached to being unhealthy and financial consequences are a consequence.

Compare this to the UK where almost 70% of men are overweight or obese.

This is one of the biggest drains on the NHS so yes, patients are to blame.

I'm not the only one saying it- drs and public bodies are saying it too- hence the sugar tax.

So simple maths tells you that if this was controlled there would be more money for removal of cysts- or better still, cancer drugs and operations done more quickly for those in serious need.

Going back to the original point about the cost of £350, unless you and the OP take on board the fact that the surgeon only receives some of that, and the rest goes on overheads, this is a pointless discussion.

It's a bit like saying why should we pay £30 for a main course in a restaurant when you can buy the steak for £5 in Tesco (and ignoring the fact you are paying for the building, the staff and everything else that is included and not just the chef's time.)

[PikachuSayBoo]

Boffin isn't being racist. It's a medical fact that Asian people have a higher risk of diabetes. It isn't all about obesity.

[PollyPerky]

Boffin's comments are not exactly accurate. I don't see how someone can be 'Asian more often' - the mind boggles! I am sure that if you look at the actual stats for diabetes, the 'Asian element' will be very small in terms of cost to the NHS, proportionally. It's also rubbish to blame people's sedentary jobs as an excuse for being unfit. It might make it harder to keep active compared to when we all lived in caves and ran around hunting woolly mammoths for dinner, but if people want to be active they can be. My DH has a sedentary job as do I, but he goes cycling for 8 miles 3 days a week before a 25 mile drive to work, plus gym after work 3 times a week and he's mid 60s.

[LunaLoveg00d]

I was the poster who said a nurse had removed my cyst and it's true ;-) I've had two removed, first time by a doctor and second time by a nurse practitioner. Both times in an operating room at hospital though and not at the GP surgery.

My GP practice doesn't offer any surgery or other procedures - they don't even do things like Mirena coil insertion.

[PollyPerky]

Wildfire just FYI you can mix and match NHS and private and have been able to for ages. Many years ago a relative of ours had a private room in an NHS hospital. You can see a consultant privately then go onto their NHS lists if you need further treatment which you'd not be able to afford privately. This may or may not result in queue jumping- they decide how urgently you need treatment. Again, family members did this as long ago as 40 years. You can also see a consultant privately and have any blood tests they suggest at your Gps or NHS hospital, to save money as some can cost over £600 . You also probably know it works the other way- private hospitals take NHS patients for operations to relieve the burden/ backlog on the NHS. Friend of mine has had 2 ops this way.

[theredjellybean]

you have a good service provision Luna :) as it was a secondary care service ( i.e. in hospital ) then it is looked at/audited etc differently ( and funded differently ) to primary care.

for those discussing fees...do not forget that the surgeon will also be paying substantial medical defence union fees.

To give you an idea , as a GP working 2 days a week i pay £5000 / yr in defence fees. Private obstertricians pay up to £80,000 / yr in these fees....i am sure private cosmetic surgery would attract a hefty defence fee

[hunibuni]

Polly the Japanese thing is not true in general (but can be specfic to certain jobs) but it is true that we take a more preventative view and it's considered the norm to have an annual health MOT, usually for insurance purposes, once you start working for a company and/or reach a certain age/ life stage.

While I agree that diabetes needs better public health education, people need to know that not all diabetes is lifestyle induced and referring to it as a lifestyle issue is doing a disservice to type 1 patients as well as those who have developed it secondary to other health conditions. It annoys me because my friend has diabetes because she had a pancreatic tumour removed, which has resulted in the remainder of the pancreas not functioning properly. Another has beta cell failure as a result of a viral infection and DH developed diabetes in his early 30s despite being an uber fit gym goer who was very careful about his diet (still is). It's true that being of South East Asian or Afro Caribbean descent is a higher risk factor.