Swapping back and forth between NHS and private treatment

[PositivelyGlowing]

For the past couple of months I've been suffering from a medical condition for which I needed to see a specialist - the waiting list for my NHS (I live in Wales) was over 6 months so I opted to go private. I found somebody suitable, but in England - my GP wrote a letter of referral and the specialist, after seeing me and doing some physical tests, stated that I needed a couple of MRI scans to rule out some of the most likely causes.

So I had the MRI scans and no issues were found. All well and good but the cause of my condition remained unknown.

The specialist then recommended that I have quite a number of blood tests (testing about 12 different things) and he wrote to my GP with this recommendation.

On speaking to my GP he (politely) stated that he couldn't authorise the tests on the NHS because I was 'swapping and changing' between private and NHS treatment, I guess the NHS frown on this even though I am at least partly saving them time and money by seeing the specialist for the initial private consultation and MRI tests ........

I wasn't surprised by my GP's response but it was of course disappointing.

When I told the specialist about this he said that the response from my GP was very rare.

I guess that paying for the blood tests is my only option now? I could write to my GP and politely air my disappointment but I guess that won't get me anywhere.

I suppose they are thinking that you are skipping the queue, rather than them refusing you. Does the private person know that you went to them because of the 6 month wait list?

As someone who works in private healthcare the GP is correct. Swapping & changing between NHS & private care is no longer allowed - we’ve even had NHS GPs refuse to do a basic post-op wound check nowadays. The private consultant is responsible for organising (+ actioning!) the bloods themselves and yes, if you are uninsured you will have to pay.

I'm a GP, I'm a autonomous professional and not the dogsbody of a private consultant. I'm afraid you need to do the privately for all sorts of reasons, including safety ones. Your consultant, who earns more for one appointment than we get funded per patient per year, is welcome to reduce their fee to make it more affordable for you.......

@bluecurtains14 I don’t think any of the private consultants I’ve seen would see nhs gps as dogsbodies. They trained in the same hospitals after all.

Every private consultant I’ve ever seen is as compassionate and cares as deeply about patient care as the nhs patients they’ve seen.

In suggesting patients do certain things where available on the nhs they are just trying to prevent patients paying even more to private services where they have often really stretched themselves financially to go private out of desperation with wait lists.

Op to answer your question, this is definitely getting more difficult to do nowadays. Similar happened to a neighbour.

Could you speak to your gp and explain you are no longer seeing the private consultant and ask if he would agree to do the nhs tests as they are medically needed for you?

This is an awfully tone deaf response. It has nothing to do with caring about patients. It’s about NHS finances, contracts and private consultants not delegating their job upon someone else (who is already over stretched as it is!)

@CantThinkOfAUsername57 it is enlightening though isn’t it? About why these refusals are happening despite patients being asked to wait longer and longer. Compassion for their predicament seems to be really limited among a lot of GPs.

Just to give two examples we’ve experienced locally. A child had a health condition. NHS wait lists for this condition are incredibly long . Parents went private in despair as the child is really struggling at school. The nhs gp refused to carry out simple blood tests.

The parents going private have saved the nhs and taxpayers an enormous amount of money. Why should the tests which are clearly medically needed not be done on the nhs?

Unfortunately no amount of compassion can make up for a lack of time and funding.

I'm having cancer treatment at one of the NHS cancer centres and I am sharing care between NHS and private with no issues. My insurance is paying for drugs that the NHS doesn't provide, my port a cath was fitted privately, yet the NHS is looking after it. Quite frankly the private insurance is filling gaps in my NHS care. And thankfully my GP is more flexible than the poster above, quite frankly he feels my private consultant is saving him work and expense, but is happy to chip in when needed.
It's utterly pathetic that some NHS doctors are putting obstacles in the way of shared care, especially as this is probably going to be the future of the NHS. I pay insurance, tax and NI, so I'm still entitled to NHS care, if that isn't the case then I'll have a refund, thanks.

The second example is a child getting an adhd diagnosis locally. This child has been assessed as being very able but is in fact incredibly far behind academically - years not months. How can the child wait three years for diagnosis and nhs meds?

The parents paid for the child to get the diagnosis saving the NHS and taxpayers enormous sums.

Two years ago the parents would have been able to ask the GPs to prescribe the medication this child needs overseen by the private consultant. Locally now GPs are refusing shared care. This has left the parents paying thousands annually while the child waits the three years in the nhs list.

A significant percentage of the UK population are being forced into private care as the nhs is crumbling.

@CantThinkOfAUsername57 these patients are SAVING the nhs money

Yes. By handing over the work of requesting and following up the bloods to the GP. Who is then stuck if the bloods are unusual and the patient can't or won't pay for the followup.

By 2023 33% of the UK population had used private health care at least once

@bluecurtains14 What would you suggest as a society we do about the two children in my examples above? Do you really think it’s right leaving them to struggle and parents to pay? Of course wholesale reform is needed so the health service isn’t so poor, but in the meantime GPs refusing to provide care is often just cruel

Gosh, this is a harsh attitude, considering the considerable suffering that NHS patients undergo because of the appalling waiting times we suffer. Do you not feel some compassion for that?

Often people scrimp and save to see a private consultant out of sheer desperation because they are in significant daily pain or finding it hard to work.

When patients go private they are freeing up space and resources for others who truly can’t afford to access that. If people can’t swap back in to the system there I’ll be a significant reduction in the numbers going outside the NHS, resulting in more strain on the system and even worse waiting times.

It seems odd that you focus on feelings of resentment against private doctors you feel earn more than you, rather than focus on feelings of empathy for patients.

I think it would help if GPs didn’t suggest it, if this is the case. The surgery we use is dreadful for asking if we have private health insurance and letters are there like a shot. DD has really painful periods and NHS won’t accept a referral for her so we have no choice (she’s crippled two days per month and has GCSEs next year).

I did manage to swap back in, again having gone private at my GP’s suggestion and largely because they were unsure where to refer me. Fortunately, the private endocrinologist I saw is on the local consultant’s team and was therefore able to do this as the test I needed (Water Deprivation) needed to be carried out on the NHS. I am now under a specialist team in the NHS. Which is just as well as my husband moved jobs just before I was diagnosed so this will no longer be covered.

I totally agree with you @RaindropRoseWhiskers and I wish you well with your treatment.

It has nothing to do with empathy - it’s to do with funding. I bet the private consultant is requesting a whole bunch of not-your-bog-standard blood tests that will cost a fortune and aren’t easily justifiable in general practice. GPs aren’t just there to do what the clever consultant tells them too - they’re trying to balance sensible care for all of their patients with rather limited resources. Perhaps the private consultant could refer you to an nhs colleague if they think it’s that important that the tests are done urgently?

My GP's refusal to do the blood tests on the NHS didn't seem to be anything to do with queue jumping, for some reason there must be rules (that are perhaps open to interpretation?) which state that you can't go private then come back to the NHS for other tests/treatment if the latter has been advised by the private specialist.

Yes, the private specialist knows that I couldn't find a suitable specialist in Wales in a timely manner.

As mentioned, it seems farcical that I have actually SAVED the NHS both time and money by going private, only to have them refuse to carry out some blood tests.

The time I spend doing a consultant's work for them is directly harmful.to my NHS patients who I can't see in that time.

I have plenty of ideas to improve things but as we now have yet another health secretary funded by those with interests in provate health, none of them will happen.

I did in fact do some research into the blood tests that the specialist ordered - most of them are pretty standard 'off the shelf' tests (TFT, FBC, B12 and some others), although three of them were a little more 'unusual'.

We have always scrimped and saved to afford private insurance, many times I have wondered if it's really worth it. I always thought naively, that when the shit really hit the fan with a serious illness or accident, then the NHS would be there for me. To a certain extent it has been, and if you don't have any private care, then you may not realise what the NHS doesn't provide.
A close relative was also involved in a serious accident, the NHS's emergency care was second to none and undoubtedly saved his life, but the lack of care on the wards nearly killed him.
The NHS should not be penalising people who are ultimately taking weight off its shoulders. My doctors fortunately see my insurance as an extra resource, not something to be resentful of. I am very grateful for that.

My gp seemed pissed off that I was seeing the cardiologist privately- the same cardiologist who I saw on the nhs just with a 9 month waiting list.

it’s literally the same staff!
pathetic