Private vs. NHS

[TransatlanticCityGirl]

I recently visited my SIL in hospital after she had given birth. Even though this was a brand spanking new hospital, I was absolutely horrified and I'm now considering going private.

Does anyone have any experience with both private and NHS?

My main concerns at this hospital were:

• they told her they didn't have any beds available when she arrived (they finally found one, thank God)
• she had to stay in a room shared with 3 others (and their screaming babies) for the duration of her stay so no sleep for 5 days
• there was no natural light on her side of the room
• the nurses were horrible and patronising the way the spoke to the new mothers
• The father could only be with her between 10am-8pm

My other concern about NHS is that I want to be sure an epidural will be available to me if I want it.

I'm also worried about pre-natal care, as when I read information from websites & books from outside the UK the care offered seems a lot more comprehensive. I'm not sure if I should also upgrade my pre-natal care too.

Thoughts?

Depending on where you live it may not be an option.

What would happen if something went wrong and you or the baby needed an emergency operation (or scbu)

Why was she in for 5 days? Did she have a caesarean?

You can come home within hours if you want.

You can get a private room at most nhs hospitals if one is available. Sharing a room can give reassurance and companionship ( I have just been in a private room and it is quite lonely).

Was her baby not screaming?

I think it sounds like you would be happier going private as you will not get your own room or 24hr visiting on the NHS.

If you are in London you can go private within an NHS hospital so the SCBU etc are all accessible

You can buy insurance to cover pg/childbirth if you are from outside the UK - friends paid about £1.5K and that covered their costs which can be up to £15K if you have a C section

I live in London and one hospital near to me is St. Thomas' hospital which has a private wing called the Landsdell Suite. No idea if it's any good however hence the research...

SIL was in for 5 days because the baby needed to be monitored afterward for potential breathing problem.

Yes, her baby was crying too, but I think we all know it's bad enough when 1 baby is keeping you up at night, never mind 3 others who don't even belong to you! :)

She asked for a private room and they didn't have private rooms available, not even if she paid. :(

I hope the below does not come as being obnoxious. Just wanted to share my impressions. I am not a Brit, although I have been living in London for many years, and am married to an American. I was considering either opition, however, after I learned a bit more about NHS, I decided to definitely go private...

Where my husband and I come from, pregnant women do not get treated/monitored by midwives until they give birth (they normally get treated by ob/gyns and insruance covers this unlike the UK!). As nice as midwives might be here, these are still people who have completed a BA (not even a BS) degree at best, and possess no thorough knowledge of medicine... I am sure it is ok to be seen by them if you are in your early 20s and have no family history of illnesses or pre-existing medical conditions... If you are in high risk category, you will be offered an appointment with a doctor after 16-20 weeks (but the situation is helpless if you need assistance asap)... NHS does not offer/ would not do a lot of test one in a high risk category might need. Depending on how things progress during birth such test could be live saving for some people. We find this very disappointing.

Like yourself, we visited a couple of NHS hospitals in London and were frankly shocked by the pre and anti natal unit conditions there... Made us think hard why we pay such high taxes in this country and do not get slightest medical benifits as we would in our homelands...

On the balance, my conclusion is better safe than sorry, and as for money, we can always make more of it...

IF you can afford it why not.
good luck with the birth,x

In my experience the NHS are more bothered with the physical health of the mother & babies than anything else. I think they usually do this pretty well but if you want comforts such as a private room/ natural light etc then you will need to pay privately for this. TBH I think the NHS has more important things to pay for such as SCBU units & cancer care rather than providing these luxuries to patients.

Although I have used private hospitals for other conditions I am happy to give birth using the NHS as I believe they have the best facilities in case of some emergencies.

Good luck whatever you choose!

It has been proven that midwife led care leads to far less need for medical intervention therefore only seeing midwives pre natal is surely a good thing! The birth centre at Huddersfield (nhs) is excellent. Private rooms and bathrooms, hubby can stay overnight, microwave(!!!) meals so you can eat whenever you like. So I'm not sure it's as simple as private or nhs. Also if you go private and doesn't go to plan your costs could quickly spiral.

Hi Lilly,

I think it does rather depend on where you are. There are issues with the NHS, and despite the high level care I'm getting I do have criticisms.

However IF you are high risk (like myself) you will be under consultant led care, and your midwife is really just there for moral support / back-up. My midwife is excellent. I would not expect her to know about the detail of all my health conditions, but she sure knows a lot more about pregnancy and childbirth than I do (I'm 39 and this is my first baby) - she also knows a lot about who are the good, and less good consultants and registrars, the sorts of things I should say to get what I need, and gives me a huge amount of support on the basics (which my various consultants, who deal with my pre-existing medical conditions) don't have the time to deal with.

I also considered private care, but other than the room, the consultant obstetrician that I am under now on the NHS is the exact same one I'd be paying for if I went private. So I'd rather spend my money on my family than on my health care that I've paid into for the past almost 20 years. Saying that, I will try to get a private room if one is available but that's more because I'm a set-in-my-ways 39 year old with complex medical conditions and not keen to share my space!!

Sorry if I've come across as obnoxious, and I do appreciate that you are just sharing your observations. I just wanted to share mine. and if you've seen me on other threads you will see that my frustration with my healthcare has been apparent during my pregnancy, so I do have sympathy. Just felt that the midwives out there needed a little support - I couldn't do without mine.

Good luck

I work in the NHS and am passionate about it and the ideology of healthcare being free at the point of delivery no matter who you are and what you earn. I think we are beyond fortunate to live in a country where this is the case and I will always believe so.

However this does mean everything isn't always as quick, shiny or convenient as the private sector.

If you can pay for private healthcare and feel it will be more 'you'then why not go for it. I would echo another posts advice to go for a private wing in a nhs hospital as then if something does go wrong (GOD forbid) you have the full weight of the NHS expertise and facillities behind you.
In my experience it's when things are really serious that the NHS comes into it's own and outshines the private sector.

Lily13, Midwives may not necessarily have a BSC but they are extremely well qualified and experienced as well as experts at referring to obs when there are complications. UK has a lot lower CS rate than the USA and a lot of this is due to the de-medicalisation of the birth process by midwives (I'm not a midwife btw).

Good luck with all your births, wherever you choose to have them.

Look into the private wings in the very good NHS hospitals like Queen Charlottes and Chelsea and Westminster if you want better quality accommodation and post-birth care, access for visitors etc.... but if you have serious difficulties before or during the actual birth like I did you would end up in the NHS anyway and the care I received with the NHS at QCH was very good indeed. In fact I repeatedly asked my consultant there whether I would get better care if I went privately with him there and he told me not to.

I would also recommend the FMC in Harley St for private scans during the pregnancy as they are so very good at what they do (and in my case picked up the problems).

I am not sure where you would find private ante-natal care but I think there are various private midwife practises around. However, I liked the way my ante-natal care and consultant care was all linked up and at the same hospital.

I have a large number of doctors amongst my friends. We have discussed this. They all had their babies in nhs hospitals and then either transferred to a private room or came home.

The overwhelming view was the last place they would want to be was in a small private hospital if something went wrong with the baby or themselves (they all practise and operate in those hospitals).

I have just spent a few days in a large brand name private hospital. Lovely room, nice food etc. At night only 1 junior doctor in the building. The consultants come and go between the nhs and the private hospital but with no a&e at night there were no experienced doctors in the building.

A private facility linked to a large nhs hospital may be a good option.

Best of both worlds with Chelsea and Westminster private wing - slap bang next to all emergency stuff if something goes wrong, but good support from midwives / camp beds in room for fathers.

Thanks for all the views so far. Really helpful.

MrsBigW, I just want to clarify that I am not for a moment suggesting that funds should be diverted from SCBUs and cancer care. However I do think the NHS is a bit of a mess. I am originally from Canada where healthcare is completely free. We do not even have the option of private healthcare!!!! based on the experiences of my sister and other close relatives who have given birth in free tax funded hospitals, their experiences are significantly better than even the private hospitals that exist in the UK, nevermind the NHS. All I ever hear in this country are horror stories.

But having my husband there to help raise our child in it's first day(s) of life is quite important to me, and it's not a luxury. As he keeps reminding me, we are a team. So even he doesn't understand why he has to stop being a father at 8pm.

I am not worried as much about the quality of the room, etc as I am about the quality of the care provided under NHS during pregnancy and birth... I prefer to be treated by a qualified medical professional (an obstetritian), rather than a midwife, on the basis of my pre-existing medical conditions and family history of illnesses.

I did give NHS a chance while concurrently being treated by a consultant (I really wanted to understand whether I am getting fair value for my money)... And I have discovered that I definitely am... The midwife did not offer me any critical tests (besides a standard package any woman gets) and when I pressed her about one specific condition that I am not aware I have, but I might / might pass onto the baby, her response was "you probably do not, hon". The private ob/gyn was very thorough and immediately had numerous blood tests done...Also, I like the fact that under private care you get more than 2 scans. Having a consultant throughout the entire process is invaluable in my opinion (amazing that this is considered a luxury while in fact this is normal in so many countries of the world, even in some of emerging markets countries!)...

Anyway, these are all very individual choices. If you are worried about complications, then go for a private unit within an NHS hospital such as the Lido Wing at St. Mary's or Kensington Wing at Chelsea & Westminster...

Thanks for your comments, everyone. I think it is probably hard for you to appreciate how one (who has lived in other countries and is accustomed to a very different quality of medical care) feels when being treated by NHS specialists here... So please do not judge...

The key point you are missing is that if one has a job and a basic medical insurace through employer (aka BUPA in this country), one is entitled to a high quality medical care by doctors who studied for a least 8 years (not nurses!). What this means is that quality healthcare is not a luxury in many place of the world as it is considered here (due to its costs)....

It is very good to be proud of your country (and we love UK and many of its wonderful customs and traditions, too!), however, sometimes it is helpful to have an open mind and try to understand what other people (with backgrounds and experiences different than yours) convey to you!

On the point of medicalised US system, I think you really ought to visit a few hospitals in the USA... True, American women prefer to have a lot more elective c-sections. I don't think there is any point of going into lengthy discussions on the pros and cons of diffirent medical systems here...

Without beating the subject to death, it seems that we all walk away with our individual opinions.

I totally appreciate your view Lilly but you're not getting my point - I have consultant care throughout my pregnancy, I see my consultant obstetrician fortnightly (and other consultants regularly) and have scans every four weeks - on the NHS. If I paid privately I would see the same consultant obstetrician that I see now for free. This isn't about me being desperately proud to be British - this is about the fact that if you need it, you can get very good care here - the same as you would get privately. My pre-existing condition was first diagnosed by a neurologist who I paid to see privately - he pointed out that I would see him on the NHS too, so all my follow up care, with him, has been on the NHS. Why pay for it (when i already pay through my tax and NI - and a lot too as I am a higher bracket tax payer) if I'm only going to end up seeing the same professional?
I'm not criticising your opinion, but I am trying to point out that your experience is not necessarily the same as mine. I totally agree with your comment that the best health care should not be a luxury - it should be a right, and I think that it is unfortunate in the UK that it very much depends on the area of the country that you live in.

DancingCat, thank you for your comment. We have slightly different situations. Under the NHS system, I do not meet the high risk criteria, as they do not perform the tests necessary to diagnose my condition, and my pre-existing condition has been corrected pre-pregnancy (but could re-emerge during pregnancy according to private ob/gyns)... all of this combined make me high risk under private care, but not NHS for obvious reasons. I did try the NHS option (with an open mind) and was disappointed with the lack of consultant's availability and general care/attitude. I was also told that I would not been delivered by a consult unless I have an emergency c-section (unfortunately, this is a very risky strategy with my condition and I simply cannot afford to gamble with my or baby's health/safety).

I have heard you well, and am very pleased that there is someone out there having a terrific experience with NHS. I am very happy for you and wish you a successful pregnancy and birth!

To be fair I think this thread has changed a little bit from the OP which was more about non-essential care, although I do think staff should always be polite & I would complain if this was not the case private or NHS.

I would be interested to read any credible statistics or research that indicated private antenatal care has lower morbidity/ mortality rates than NHS care. If you look at the figures the UK actually ranks very well compared to other countries.

A woman's antenatal care is a very personal choice & many women are lucky enough not need consultant care during childbirth. To choose a midwife led service doesn't mean one is making a poorer choice; many people don't agree with medicalisation of childbirth when it is not required.

I think lilly13 your mind is already made up that private is the right choice for you & I hope you have a fantastic birthing experience :)

If you can afford 15k for a private delivery, why not? My first pregnancy resulted in the my baby dying (NHS delivery). I thought I would certainly go for the private option this time around, however, the NHS ante-natal care I have received at the C&W has been absolutely amazing. I see the same mid-wife, have 2 consultants, psychological support every 2 weeks. I wouldn't get anything better paying privately. HOWEVER, sadly, one probably has to have had a disastrous previous preg to receive the care I am now receiving.

I don't believe there is any difference in the quality of NHS and private c-sections. I do worry about post-natal care but I think baby and I will be monitored very closely. Also, should something go wrong, C&W has one of the best NICU facilities in London.

Had I not experienced what I had in 1st preg, I would be going private as the post-natal ward was appalling (Derby). The midwives were not attuned to pick up that something was seriously wrong with my baby.

The NHS facilities are hit and miss depending on where you give birth. There is a useful recent thread in the childbirth section on London hospitals.

Good luck with your choice!

sh77 how truly awful for you & your family.

I am glad you are happy with how things are progressing for you with your pregnancy, I hope that you have the best experience possible x

If you can afford to use the private wing of a hospital or go to a top private hospital, then why not? You're lucky to live in London where there is choice, so if you can afford it, I'd go for it.

I recently spent a night in my local hospital's higher risk ward for observation. Didn't get much sleep in the 4-bed room and the food was crappy, but my care otherwise was excellent. I do understand better now why they have the visiting rules - the NHS can't afford/cope with private rooms for all patients and having visitors 24/7 in a shared room would've been a nightmare.

I've had a great experience with the NHS in this pregnancy (having previously had poor experiences with other stuff), my only negative being that GPs are not equipped to deal with antenatal care. However, my MW has been brilliant, as have the MWs at the hospital. And they've made sure I've seen a specialised doctor quickly when I need to.

We've paid for extra scans for reassurance, which we were happy to do. And I'll ask to pay for a individual room if I have to stay in after the birth, but I know that my hospital doesn't have private rooms, so if the individual rooms are all being used by women who had a clinical need for one (or got there first) then its tough. But I'll cope.

sh77, I'm so sad to hear your first pregnancy ended in such an awful way. if you don't mind me asking, do you believe the result would have been different if you had gone private? best of luck for this time, I really hope the increased care you are getting translates into a healthy & happy baby xx

Thank you transatlantic - I have spent much time asking myself this. The problem is that I was induced on a bank holiday weekend, where staff coverage was not continuous. Also, a newly qualified midwife delivered my baby unsupervised. That probably would not have affected the outcome.

The problem was on the post-natal ward - very busy and not enough midwives. My daughter's temp was consistently low, she looked cold, was not feeding, was very sleepy. These are all signs of infection but apparently, they are normal in newborns also. MWs did not pick up that something was wrong. At the inquest, the coroner asked the paediatrician and obstetrician, given these symptoms, whether NICU staff should have been alerted sooner and they agreed, yes. That was heartbreaking to hear.

So, could the outcome have been different? I can't say for certain. Should MWs have spotted something was wrong - yes.

Whilst quick access to NICU facilities is vital (which is why I think private delivery in an NHS hospital is the optimal scenario), continuity of care by highly trained MWs is crucial. What happened to me was highly rare and so don't be freaked out by my experience.
I am quite sure my obstetricians and ante-natal MW will make sure that we are well looked after on the post-natal ward, so, aside from aesthetics, I won't get much extra privately.

All the best with whatever you decide.

TransatlanticCityGirl, I think the main thing to do is visit various units and see which you prefer. As others have said if you are in London then there is always the opportunity to have a private room even in an NHS hospital. As for consultant care that is often by the same consultant whether you are NHS or private.

I'm afraid rude nursing/midwifery staff can occur anywhere and being private does not necessarily avoid this.

The availability of an epidural can never be guaranteed whether you are in a private or NHS hospital as the anaesthetist may have been called to emergency surgery.

Others on this thread have talked about mistakes being made in NHS hospitals and I think you should bear in mind that paying for treatment does not mean that mistakes cannot be made. There can sometimes be the assumption that the care you will receive and the knowledge/experience of staff will be better if you pay but this is not always the case. I have worked as a nurse in the NHS for many years and unfortunately there have been many occasions when we have had patients admitted to us because private hospitals failed in their duty of care.

Good luck with your decision and I would aim to go with your gut instinct as to where you think you will feel happiest. The NHS often can't run to the nice food, private rooms etc and the private sector can provide this but it is prioritising what is best for you and your baby.