This topic has been archived, and won't accept reply postings.
Thinking about the idea of private health vs the NHS...
So, say I had been to my GP and was suffering from a prolonged undiagnosed painful problem of several years' duration, and they'd run some tests that came up abnormal. Say I had been referred to a specialist, but due to some screw-up, my waiting time had been extended from 3 months to 6 months.
Then chuck private health into the equation. Say I don't have total cover, but a basic cover of a policy that gives me the equivalent of 2 or 3 outpatient consultations per year, but I have to pay the first 100 pounds as excess. And say I consider £100 to be a fair sum of money - not something I'd go bankrupt over, but money that could possibly be better spent elsewhere.
So, would you trade in the appointment in a few months' time for a private appointment in maybe 2 weeks' time for which you'd have to pay 100 quid? Bearing in mind you've waited 3 months already. Or do you operate under the premise that if it were that important, you'd have been fast-tracked in the first place? (The doc has already tested you, but seeing as these took place last year, the specialist appointment might well consist of repeating these tests and paying 100 quid for the privilege.) Is that worth it?
Would you pay 100 quid for peace of mind, or would you trust in the doctors in their assessment of your case as non-urgent? Is there a price at which you would pay, or a price barrier that would prevent you from paying? Is there something unethical about private health and 'jumping the queue', or is it actually taking the strain off the NHS in a small way? And... when serious health matters come into the equation, are ethics even relevant?
Thoughts?
So, say I had been to my GP and was suffering from a prolonged undiagnosed painful problem of several years' duration, and they'd run some tests that came up abnormal. Say I had been referred to a specialist, but due to some screw-up, my waiting time had been extended from 3 months to 6 months.
Then chuck private health into the equation. Say I don't have total cover, but a basic cover of a policy that gives me the equivalent of 2 or 3 outpatient consultations per year, but I have to pay the first 100 pounds as excess. And say I consider £100 to be a fair sum of money - not something I'd go bankrupt over, but money that could possibly be better spent elsewhere.
So, would you trade in the appointment in a few months' time for a private appointment in maybe 2 weeks' time for which you'd have to pay 100 quid? Bearing in mind you've waited 3 months already. Or do you operate under the premise that if it were that important, you'd have been fast-tracked in the first place? (The doc has already tested you, but seeing as these took place last year, the specialist appointment might well consist of repeating these tests and paying 100 quid for the privilege.) Is that worth it?
Would you pay 100 quid for peace of mind, or would you trust in the doctors in their assessment of your case as non-urgent? Is there a price at which you would pay, or a price barrier that would prevent you from paying? Is there something unethical about private health and 'jumping the queue', or is it actually taking the strain off the NHS in a small way? And... when serious health matters come into the equation, are ethics even relevant?
Thoughts?
In reply to Nao: I think in that situation I would be playing merry hell with my local hospital trust.
In reply to Nao:
I would NOT trust the NHS to have 100% decided that it was perfectly fine to wait that extra time.
The NHS is such a big institution (if you can call it that) cock-ups happen. If there is a chance that it is certain things including cancer, I would not wait.
I would make sure I saw my medical notes asap though to see why they thought you could wait 3 months longer than normal.
I would NOT trust the NHS to have 100% decided that it was perfectly fine to wait that extra time.
The NHS is such a big institution (if you can call it that) cock-ups happen. If there is a chance that it is certain things including cancer, I would not wait.
I would make sure I saw my medical notes asap though to see why they thought you could wait 3 months longer than normal.
In reply to Pinky:
I have heard a lot of people say that private health is unethical and one should not queue jump. I guess my question is - if it's something potentially quite serious (say if it's been going on for a long time, and causes a lot of pain, and hasn't been diagnosed yet, despite tests showing abnormalities) then is it then okay to queue jump? Should you queue jump - are you taking pressure off the NHS? Or is it bad in some way because not everyone can afford to do it?
Also as you said, should you trust the NHS that it is not serious enough to warrant an urgent appointment? (Then again, 'urgent' in NHS terms probably is 6 months...)
I have heard a lot of people say that private health is unethical and one should not queue jump. I guess my question is - if it's something potentially quite serious (say if it's been going on for a long time, and causes a lot of pain, and hasn't been diagnosed yet, despite tests showing abnormalities) then is it then okay to queue jump? Should you queue jump - are you taking pressure off the NHS? Or is it bad in some way because not everyone can afford to do it?
Also as you said, should you trust the NHS that it is not serious enough to warrant an urgent appointment? (Then again, 'urgent' in NHS terms probably is 6 months...)
In reply to Nao:
Without wanting to pry into your condition, it depends on your definition of 'non-urgent'.
Tell me more about this 'cock-up' which left you waiting potentially six months for first OP appointment. GP's or hospital's? The maximum waiting time for first OP appointment is approximately three months from referral letter, and most Trusts are quite capable of delivering that or much better. If it's their cock-up, and even if it's the GPs, you might be able to have a pleasant conversation with the central appointments office at the Trust, explain your predicament and worry, and ask if you could be slotted into a clinic sooner if a cancellation happens. You might also get a 'computer says no' type person, but you don't know until you try - some of them are quite helpful types.
Having said that, £100 is not going to break you, and if you're desperate to get seen, and can afford it, you should do it. If it turns out that you have something that needs to be corrected urgently, you're straight back into the NHS as an urgent case.
On the scale of things, the ethical arguments about forgoing private care are irrelevent b*llocks.
Without wanting to pry into your condition, it depends on your definition of 'non-urgent'.
Tell me more about this 'cock-up' which left you waiting potentially six months for first OP appointment. GP's or hospital's? The maximum waiting time for first OP appointment is approximately three months from referral letter, and most Trusts are quite capable of delivering that or much better. If it's their cock-up, and even if it's the GPs, you might be able to have a pleasant conversation with the central appointments office at the Trust, explain your predicament and worry, and ask if you could be slotted into a clinic sooner if a cancellation happens. You might also get a 'computer says no' type person, but you don't know until you try - some of them are quite helpful types.
Having said that, £100 is not going to break you, and if you're desperate to get seen, and can afford it, you should do it. If it turns out that you have something that needs to be corrected urgently, you're straight back into the NHS as an urgent case.
On the scale of things, the ethical arguments about forgoing private care are irrelevent b*llocks.
In reply to Nao:
How is shortenning the NHS queue by removing yourself from it queue jumping, It's NHS queue shortening!
Though you will be seen more quickly I would expect that in 99% of the time this will NOT make the rest of the people on the NHS queue have to wait any longer than before, maybe even helping them be seen earlier. (didn't put 100% as there could be ocasions where NHS and private overlap but if you are feeling very moral then you could ask).
How is shortenning the NHS queue by removing yourself from it queue jumping, It's NHS queue shortening!
Though you will be seen more quickly I would expect that in 99% of the time this will NOT make the rest of the people on the NHS queue have to wait any longer than before, maybe even helping them be seen earlier. (didn't put 100% as there could be ocasions where NHS and private overlap but if you are feeling very moral then you could ask).
In reply to Nao: If during the time you are waiting the problem is or could be getting worse then you need ask how much damage could be done to you health and potential recover or possibility of treatment if the problem is left untreated for this period of time. A very hard question to answer, £100 could well be worth the peace of mind.
In reply to Jamesclimb:
Also if it gets worse it could end up costing the NHS even more to sort out, so going private could save the NHS even more money.
Also if it gets worse it could end up costing the NHS even more to sort out, so going private could save the NHS even more money.
In reply to Nao:
I don't think it is unethical as long as you continue to go private from then on! Some people pay for an initial private consultation then ask for the rest of their treatment to be on the NHS, thus getting NHS treatment early because they have paid for one private appointment - I don't think that is fair!
MOST of the time if something is clinically urgent you WILL be seen soon - but mistakes do get made, so I would chase it up.
> (In reply to Pinky)
>
> I have heard a lot of people say that private health is unethical and one should not queue jump. I guess my question is - if it's something potentially quite serious (say if it's been going on for a long time, and causes a lot of pain, and hasn't been diagnosed yet, despite tests showing abnormalities) then is it then okay to queue jump? Should you queue jump - are you taking pressure off the NHS? Or is it bad in some way because not everyone can afford to do it?
>
> I have heard a lot of people say that private health is unethical and one should not queue jump. I guess my question is - if it's something potentially quite serious (say if it's been going on for a long time, and causes a lot of pain, and hasn't been diagnosed yet, despite tests showing abnormalities) then is it then okay to queue jump? Should you queue jump - are you taking pressure off the NHS? Or is it bad in some way because not everyone can afford to do it?
I don't think it is unethical as long as you continue to go private from then on! Some people pay for an initial private consultation then ask for the rest of their treatment to be on the NHS, thus getting NHS treatment early because they have paid for one private appointment - I don't think that is fair!
> Also as you said, should you trust the NHS that it is not serious enough to warrant an urgent appointment? (Then again, 'urgent' in NHS terms probably is 6 months...)
MOST of the time if something is clinically urgent you WILL be seen soon - but mistakes do get made, so I would chase it up.
In reply to AliceW:
What about the scenario when your private cover will only cover 2 or 3 appointments per year? Does that mean you think you should only use private if you can afford to go private for the duration of treatment? In this scenario the level of private cover is low, with an excess to pay, so really the question is asking about jumping the queue for this appointment rather than continuing to use private.
> I don't think it is unethical as long as you continue to go private from then on! Some people pay for an initial private consultation then ask for the rest of their treatment to be on the NHS, thus getting NHS treatment early because they have paid for one private appointment - I don't think that is fair!
What about the scenario when your private cover will only cover 2 or 3 appointments per year? Does that mean you think you should only use private if you can afford to go private for the duration of treatment? In this scenario the level of private cover is low, with an excess to pay, so really the question is asking about jumping the queue for this appointment rather than continuing to use private.
In reply to AliceW:
How is it not fair if the person in question has paid for private health insurance that covers the cost of the queue jumping?
Considering that, I guess, the majority of people with insurance don't use it, does that mean that they should avoid using it at all if they can't pay for all of the treatment? Surely even using it for one appointment takes the strain off the NHS on a very small level?
> getting NHS treatment early because they have paid for one private appointment - I don't think that is fair!
How is it not fair if the person in question has paid for private health insurance that covers the cost of the queue jumping?
Considering that, I guess, the majority of people with insurance don't use it, does that mean that they should avoid using it at all if they can't pay for all of the treatment? Surely even using it for one appointment takes the strain off the NHS on a very small level?
In reply to Nao:
Anyhow, I would discuss your situation with your GP.
> (In reply to AliceW)
> [...]
>
> How is it not fair if the person in question has paid for private health insurance that covers the cost of the queue jumping?
>
Because I'd still be waiting for my outpatient appointment, whilst you were on the waiting list for treatment already?
> [...]
>
> How is it not fair if the person in question has paid for private health insurance that covers the cost of the queue jumping?
>
Anyhow, I would discuss your situation with your GP.
In reply to LizzieLou:
And yet... taking my hypothetical self out of that queue surely means that someone else, who isn't going to go private, will move up a space in the queue? If I don't take the NHS appointment, then that means that it's free for someone else to take sooner, isn't it?
> (In reply to Nao)
> [...]
> Because I'd still be waiting for my outpatient appointment, whilst you were on the waiting list for treatment already?
>
> Anyhow, I would discuss your situation with your GP.
> [...]
> Because I'd still be waiting for my outpatient appointment, whilst you were on the waiting list for treatment already?
>
> Anyhow, I would discuss your situation with your GP.
And yet... taking my hypothetical self out of that queue surely means that someone else, who isn't going to go private, will move up a space in the queue? If I don't take the NHS appointment, then that means that it's free for someone else to take sooner, isn't it?
In reply to Nao:
Obviously I don't know how drastic the potential problem could be but I would say go private. I've heard enough horror stories to know that people slip through the net all the time and you shouldn't assume that they'd fast track you if it was really serious. If you can afford the 100 quid, what price is your health worth?
Obviously I don't know how drastic the potential problem could be but I would say go private. I've heard enough horror stories to know that people slip through the net all the time and you shouldn't assume that they'd fast track you if it was really serious. If you can afford the 100 quid, what price is your health worth?
In reply to Nao:
Hypothetically, you could get some nice handles for your coffin for the £100 you saved in waiting for the NHS.
You've got private health insurance, use it, otherwise don't bother having the cover and use your premiums on something else.
Hypothetically, you could get some nice handles for your coffin for the £100 you saved in waiting for the NHS.
You've got private health insurance, use it, otherwise don't bother having the cover and use your premiums on something else.
In reply to Nao:
Sorry havent read the other posts but no ethical considerations really.
Going private or pushing for a faster appointment depends on how your quality of life is being affected as a consequence of your problem.
If you feel that this is significantly reducing your quality of life it may (only may) be possible to up the list or alternatively do it privately. Perfectly reasonable thing to do but be aware how much it may cost for a full round of treatment that may involve numerous tests/consultant appointments.
Sorry havent read the other posts but no ethical considerations really.
Going private or pushing for a faster appointment depends on how your quality of life is being affected as a consequence of your problem.
If you feel that this is significantly reducing your quality of life it may (only may) be possible to up the list or alternatively do it privately. Perfectly reasonable thing to do but be aware how much it may cost for a full round of treatment that may involve numerous tests/consultant appointments.
In reply to Nao: In reply to Nao: I'd go private for peace of mind and get it checked fast, but that is if it were a life threatening condition like say cancer, because that is likely to worsen the longer it's left untreated, and what could be potentially controlled and treated, might end up terminal if left unchecked or treated. I'd favour my health before money, so if it cost me £100- so be it.
In reply to Nao:
Go private. I've had several minor injuries that have been correctly diagnosed by private specialists quickly that would have hotten a lot worse without their early advice and therefore cost the health service more in the long run.
Go private. I've had several minor injuries that have been correctly diagnosed by private specialists quickly that would have hotten a lot worse without their early advice and therefore cost the health service more in the long run.
In reply to Nao:
Hey up luv....
How much do you value your health?
How much does the average person in the UK waste / spend on unnecessary things each year?
Beer, fags, latest gadget, another pair of shoes etc, more important than your health?
Peace of mind or knowing the worst and getting something done about PDQ for less than the cost of an IPod. No contest for me.
The cost of private health care does make it difficult for a lot of people, but not impossible. However I do understand that for some 100 quid is totaly out of reach. It is criminal that people cannot get proper treatement, but that is how it is with the NHS.
As for the ethics debate, would the outcome of the tests make a difference?
Nothing much wrong, umethical to jump the queue?
Serious illness that requires urgent treatment, thank god I spent 100 quid and got in quick.
JH
Hey up luv....
How much do you value your health?
How much does the average person in the UK waste / spend on unnecessary things each year?
Beer, fags, latest gadget, another pair of shoes etc, more important than your health?
Peace of mind or knowing the worst and getting something done about PDQ for less than the cost of an IPod. No contest for me.
The cost of private health care does make it difficult for a lot of people, but not impossible. However I do understand that for some 100 quid is totaly out of reach. It is criminal that people cannot get proper treatement, but that is how it is with the NHS.
As for the ethics debate, would the outcome of the tests make a difference?
Nothing much wrong, umethical to jump the queue?
Serious illness that requires urgent treatment, thank god I spent 100 quid and got in quick.
JH
In reply to Nao:
Does this really need answering? Don't you read your own news?
I as yet don't live in the UK yet but have read and know from Brits I'm close with that NHS horror stories are becoming common.
I'm not at liberty to share the tale I know best....
but the man tragically died unecessarily.
Your call.
Does this really need answering? Don't you read your own news?
I as yet don't live in the UK yet but have read and know from Brits I'm close with that NHS horror stories are becoming common.
I'm not at liberty to share the tale I know best....
but the man tragically died unecessarily.
Your call.
In reply to Nao: My dad lived by that 'private health care in unethical' ethos, how so? I have private treatment, get treated in private hospitals, there is no NHS waiting list in private hospital, if it has any relation to a life threatening illness go private.
In reply to ICE:
Well if you don't know what it is because it hasn't been diagnosed yet, how do you know if it's a life threatening illness?
Let's say in this hypothetical situation it is not a life threatening illness... more a quality of life diminishing illness. Does that make a difference anyway? Should you only go private for something that's potentially fatal?
> if it has any relation to a life threatening illness go private
Well if you don't know what it is because it hasn't been diagnosed yet, how do you know if it's a life threatening illness?
Let's say in this hypothetical situation it is not a life threatening illness... more a quality of life diminishing illness. Does that make a difference anyway? Should you only go private for something that's potentially fatal?
In reply to JH:
Hey chuck
I value my health a fair bit but obviously not enough to be entirely healthy!
My question is relating to all aspects of this - whether it has to be a life-threatening prospect to make it ethical to jump the queue, or if it is always unethical. Also in reply to Alice about continuing private treatment - is that somehow wrong, if you can't afford to continue it?
Hey chuck
I value my health a fair bit but obviously not enough to be entirely healthy!
My question is relating to all aspects of this - whether it has to be a life-threatening prospect to make it ethical to jump the queue, or if it is always unethical. Also in reply to Alice about continuing private treatment - is that somehow wrong, if you can't afford to continue it?
In reply to Nao:
How is it unethical, that you are paying for a service?
Consultants make money from private consultations, think how much more the NHS would have to stump up for consultants if the solely worked for the NHS.
Whether it or is not life threatening is beside the point, if you can afford it, then ethically it's better to reduce some of the stresses on the NHS service so that people who can't afford PMI get a better service in the long term.
How is it unethical, that you are paying for a service?
Consultants make money from private consultations, think how much more the NHS would have to stump up for consultants if the solely worked for the NHS.
Whether it or is not life threatening is beside the point, if you can afford it, then ethically it's better to reduce some of the stresses on the NHS service so that people who can't afford PMI get a better service in the long term.
In reply to Nao:
I ended up in hospital twice in the week before Christmas 2005 due to gallstones. Both times I was discharged without seeing the consultant and without an ultrasound scan as I would have had to wait in hospital for 3-4 days for the scan to confirm diagnosis. I was told verbally that there was a 4 week outpatient waiting list for a scan. I went on a virtually zero fat diet but suffered constant pain, nausea & lack of sleep. I was taking Tramadol like sweets. When I had heard nothing about an appointment for a scan after 2 weeks I contacted my GP who chased up the Ultrasound Unit in Burnley. When after another week I hadn't heard anything I phoned my GP again and he suggested I phoned the Ultrasound Unit myself. I phoned them and they said that the waiting list was 28 weeks. My GP kicked up a stink and I was scanned within a week and the diagnosis confirmed. The radiographer who scanned me told me I had gallstones and an inflamed gall bladder. I then went back to my GP who wrote to my consultant asking for an early consultation. I got a letter back within a week offering an appointment 17 weeks later. I then went to see my GP because at this stage I could only work for 2 or 3 days a week and, as I am self-employed, I don't get sick pay. I also don't have Private Health Insurance out of misguided principal. By this stage I was cracking up due to lack of sleep and was throwing up at least twice a day so my GP wrote another letter. Two days later I got a phone call from the East Lancs PCT call centre offering me a choice of 5 hospitals all off which with 17 week waits for a consultation, some choice. I then bit the bullet and asked my GP to organise a private consultation with a consultant, 2 hours later I got a phone call saying I was to see the consultant the next day for £100. I saw the consultant who said I needed an urgent operation as the scan showed lots of gallstones, the gall bladder was extremely inflamed, I was in pain and running a temperature. I had the operation 4 days later for £3700.
I was devastated by the experience. I was ill, unable to work and the NHS had let me down. At my check up 4 weeks after the operation the consultant reckoned the gall bladder would only have lasted another few weeks before it would have ruptured triggering peritonitis necessitating a big operation and potentially weeks in hospital. A gallstone had embedded in the gall bladder wall.
The process of being assessed was rigged to ensure I wouldn't be treated for a year; 28 weeks waiting for a scan, 17 weeks waiting to see a consultant and 17 weeks waiting for an operation. My GP warned me at one point to never let on when I would be on holiday or I would be magically called for an appointment when I was abroad and as I couldn't attend they would be allowed to push my appointment out by the maximum time allowed. This wouldn't have affected me as I was in no fit state to go on holiday! The whole system is rigged to stop you seeing a doctor or consultant who can decide if you are an urgent case or not. If you are then deemed urgent, my consultant complained that the PCT in East Lancs were sending his patients to a private hospital with inexperienced surgeons who were cocking up the gall bladder operations. He was spending a disproportionate amount of his NHS operating time sorting out the botched operations.
To answer your question Nao, pay the £100. The decisions as to whether you are urgent or not are not made by doctors but by penny counting f*cking bureaucrats.
I ended up in hospital twice in the week before Christmas 2005 due to gallstones. Both times I was discharged without seeing the consultant and without an ultrasound scan as I would have had to wait in hospital for 3-4 days for the scan to confirm diagnosis. I was told verbally that there was a 4 week outpatient waiting list for a scan. I went on a virtually zero fat diet but suffered constant pain, nausea & lack of sleep. I was taking Tramadol like sweets. When I had heard nothing about an appointment for a scan after 2 weeks I contacted my GP who chased up the Ultrasound Unit in Burnley. When after another week I hadn't heard anything I phoned my GP again and he suggested I phoned the Ultrasound Unit myself. I phoned them and they said that the waiting list was 28 weeks. My GP kicked up a stink and I was scanned within a week and the diagnosis confirmed. The radiographer who scanned me told me I had gallstones and an inflamed gall bladder. I then went back to my GP who wrote to my consultant asking for an early consultation. I got a letter back within a week offering an appointment 17 weeks later. I then went to see my GP because at this stage I could only work for 2 or 3 days a week and, as I am self-employed, I don't get sick pay. I also don't have Private Health Insurance out of misguided principal. By this stage I was cracking up due to lack of sleep and was throwing up at least twice a day so my GP wrote another letter. Two days later I got a phone call from the East Lancs PCT call centre offering me a choice of 5 hospitals all off which with 17 week waits for a consultation, some choice. I then bit the bullet and asked my GP to organise a private consultation with a consultant, 2 hours later I got a phone call saying I was to see the consultant the next day for £100. I saw the consultant who said I needed an urgent operation as the scan showed lots of gallstones, the gall bladder was extremely inflamed, I was in pain and running a temperature. I had the operation 4 days later for £3700.
I was devastated by the experience. I was ill, unable to work and the NHS had let me down. At my check up 4 weeks after the operation the consultant reckoned the gall bladder would only have lasted another few weeks before it would have ruptured triggering peritonitis necessitating a big operation and potentially weeks in hospital. A gallstone had embedded in the gall bladder wall.
The process of being assessed was rigged to ensure I wouldn't be treated for a year; 28 weeks waiting for a scan, 17 weeks waiting to see a consultant and 17 weeks waiting for an operation. My GP warned me at one point to never let on when I would be on holiday or I would be magically called for an appointment when I was abroad and as I couldn't attend they would be allowed to push my appointment out by the maximum time allowed. This wouldn't have affected me as I was in no fit state to go on holiday! The whole system is rigged to stop you seeing a doctor or consultant who can decide if you are an urgent case or not. If you are then deemed urgent, my consultant complained that the PCT in East Lancs were sending his patients to a private hospital with inexperienced surgeons who were cocking up the gall bladder operations. He was spending a disproportionate amount of his NHS operating time sorting out the botched operations.
To answer your question Nao, pay the £100. The decisions as to whether you are urgent or not are not made by doctors but by penny counting f*cking bureaucrats.
In reply to Nao: This is an interesting debate. The cost issue I don't think in itself is a consideration - either you can afford to go private (to whatever degree that means) or you can't.
The real ethical issue is - who is treating you 'privately'? In reality most private doctors/surgeons/medics have duel roles - they will be NHS consultants 3 or 4 days a week and do private practice on the other day or two. Now there are rules, under the new consultant contract, as to the balance of this, but should we be encouraging private healthcare more generally if this is essentially taking resources away from the NHS.
I think Pinkys point about queue shorting is rubbish and doesn't see the whole picture. There is definitely a case to say that by going private you are queue jumping (i.e. you are paying to see the same person in a shorter period of time), but more importantly, if we continue to encourage consultants to do private practice, the queues will automatically get longer as there are only a finite number of specialists that can see you.
There is also a second issue, to which I can only give a metaphore, which may not be appropriate in your situation, but a lot of people choose to have their baby in a private setting, which is all well and good - takes the pressure off NHS maternity services etc (ignoring the debate in the last paragraph obviously), however most private institutions don't have the capacity when things go wrong, so as soon as there is a complication with the birth, the mother and baby get shipped out to the nearest A&E/specialist maternity service, which are obviously the most expensive and difficult to staff areas. Now you have not only an ethical issue (wasting NHS resources which could have been saved if the whole thing had been done in house and there wasn't a transfer etc), but also a genuine health concern that private providers can't always provide everything.
Don't think that I have anything against private practice per se - I think that in the right circumstances (e.g. cosmetic surgery, The Priory etc.) it has it's place, after all where else would people with more money than sense spend it ... just trying to open the debate up a bit.
G
The real ethical issue is - who is treating you 'privately'? In reality most private doctors/surgeons/medics have duel roles - they will be NHS consultants 3 or 4 days a week and do private practice on the other day or two. Now there are rules, under the new consultant contract, as to the balance of this, but should we be encouraging private healthcare more generally if this is essentially taking resources away from the NHS.
I think Pinkys point about queue shorting is rubbish and doesn't see the whole picture. There is definitely a case to say that by going private you are queue jumping (i.e. you are paying to see the same person in a shorter period of time), but more importantly, if we continue to encourage consultants to do private practice, the queues will automatically get longer as there are only a finite number of specialists that can see you.
There is also a second issue, to which I can only give a metaphore, which may not be appropriate in your situation, but a lot of people choose to have their baby in a private setting, which is all well and good - takes the pressure off NHS maternity services etc (ignoring the debate in the last paragraph obviously), however most private institutions don't have the capacity when things go wrong, so as soon as there is a complication with the birth, the mother and baby get shipped out to the nearest A&E/specialist maternity service, which are obviously the most expensive and difficult to staff areas. Now you have not only an ethical issue (wasting NHS resources which could have been saved if the whole thing had been done in house and there wasn't a transfer etc), but also a genuine health concern that private providers can't always provide everything.
Don't think that I have anything against private practice per se - I think that in the right circumstances (e.g. cosmetic surgery, The Priory etc.) it has it's place, after all where else would people with more money than sense spend it ... just trying to open the debate up a bit.
G
In reply to Nao: IMHO (and to my relative impoverishment)as a jobbing NHS consultant private medicine Is entirely unethical. I've neither the time nor inclination to get in to a protracted joust with professional forumites over the issue but my / our side of things is explained here if you're interested:
http://www.keepournhspublic.com/index.php
cheers, Paul
http://www.keepournhspublic.com/index.php
cheers, Paul
In reply to Nao:
I was brought up to think the NHs is a hallowed institution that mustr be protected nad defended at all costs. My mum until she retired was a paediatrics sister so we had asomething of a "brand allegiance".
however, I have an excellent private health policy at work and after years of Helen being pissed about in the NHS for her brittle knees we have opted to go private.
The result is a referall straight to a decent physio, a recovery programme and the option of bionic knees if necessary.
Do I still think that the NHS should be supported and that private healthcare creates a duplicate system, to the detriment of the NHS - yes, but i love my wife and I want to see her fully mobile.
however, even with plastic knees she will still come last in the KIMM because she is malingerer.
I was brought up to think the NHs is a hallowed institution that mustr be protected nad defended at all costs. My mum until she retired was a paediatrics sister so we had asomething of a "brand allegiance".
however, I have an excellent private health policy at work and after years of Helen being pissed about in the NHS for her brittle knees we have opted to go private.
The result is a referall straight to a decent physio, a recovery programme and the option of bionic knees if necessary.
Do I still think that the NHS should be supported and that private healthcare creates a duplicate system, to the detriment of the NHS - yes, but i love my wife and I want to see her fully mobile.
however, even with plastic knees she will still come last in the KIMM because she is malingerer.
In reply to Paul Atkinson:
Up until a year ago I toyally agreed with you. However, in the situation I was in I needed a cure or, at the very least, I was going to end up without work & un-employable. In that situation your principals melt away and you spend the cash. If the NHS provided the service it's patients need then Private Healthcare would die out due to lack of demand.
Up until a year ago I toyally agreed with you. However, in the situation I was in I needed a cure or, at the very least, I was going to end up without work & un-employable. In that situation your principals melt away and you spend the cash. If the NHS provided the service it's patients need then Private Healthcare would die out due to lack of demand.
In reply to Nao:
Hypothetical example:
Person A is referred to consultant on the NHS, waits 6 months to see consultant, then is told "you need procedure X, I can do it in one month's time" - so waits 7 months in total.
Person B is referred to consultant privately, sees him immediately, is told "you need procedure X - I will put you on my NHS waiting list and it will be done in one month" - so waits 1 month.
Person B has only paid for one private outpatient appointment, yet gets a procedure (which may cost thousands), 6 months earlier than person B.
To me that doesn't seem fair - it is a way of queue jumping without really paying for it.
> (In reply to AliceW)
> [...]
>
> How is it not fair if the person in question has paid for private health insurance that covers the cost of the queue jumping?
> [...]
>
> How is it not fair if the person in question has paid for private health insurance that covers the cost of the queue jumping?
Hypothetical example:
Person A is referred to consultant on the NHS, waits 6 months to see consultant, then is told "you need procedure X, I can do it in one month's time" - so waits 7 months in total.
Person B is referred to consultant privately, sees him immediately, is told "you need procedure X - I will put you on my NHS waiting list and it will be done in one month" - so waits 1 month.
Person B has only paid for one private outpatient appointment, yet gets a procedure (which may cost thousands), 6 months earlier than person B.
To me that doesn't seem fair - it is a way of queue jumping without really paying for it.
In reply to Nao:
I suppose the point is that you might only NEED one outpatient appointment - the consultant might say that you don't need anything else, and you will get the piece of mind earlier?
Personally, though, I don't think I would take out insurance that only covered 2 or 3 appointments a year - it doesn't seem worth it. I would pay out of my own pocket if necessary - I would want insurance to pay for what I couldn't afford, ie the full cost of treatment.
> (In reply to AliceW)
> Considering that, I guess, the majority of people with insurance don't use it, does that mean that they should avoid using it at all if they can't pay for all of the treatment? Surely even using it for one appointment takes the strain off the NHS on a very small level?
> Considering that, I guess, the majority of people with insurance don't use it, does that mean that they should avoid using it at all if they can't pay for all of the treatment? Surely even using it for one appointment takes the strain off the NHS on a very small level?
I suppose the point is that you might only NEED one outpatient appointment - the consultant might say that you don't need anything else, and you will get the piece of mind earlier?
Personally, though, I don't think I would take out insurance that only covered 2 or 3 appointments a year - it doesn't seem worth it. I would pay out of my own pocket if necessary - I would want insurance to pay for what I couldn't afford, ie the full cost of treatment.
In reply to Nao:
BTW I am not opposed to private practice at all (though I dispute that it is safer than the NHS - I have seen many private sector horror stories!) - I don't think it is unethical at all. But I do think paying for a tiny proportion of your treatment in order to queue jump, then getting the rest on the NHS, is a bit unfair.
> Let's say in this hypothetical situation it is not a life threatening illness... more a quality of life diminishing illness. Does that make a difference anyway? Should you only go private for something that's potentially fatal?
BTW I am not opposed to private practice at all (though I dispute that it is safer than the NHS - I have seen many private sector horror stories!) - I don't think it is unethical at all. But I do think paying for a tiny proportion of your treatment in order to queue jump, then getting the rest on the NHS, is a bit unfair.
In reply to featuresforfeet: I've worked for both Nhs and private, and know how they work. Each funds the other.
Same doctors too.
Just seen quicker and treated quicker when private mostly, sadly.
If I had my way it'd all be on the nhs of course.
I have stopped people getting ripped off when I can too (take a private hospital in London, an arab nearly got charged £80 for a box of statin tablets, I pointed out to him it's closer to £7-50 in the chemist via the nhs.
He then declined paying the fee of £80, and thanked me trying to give me some money (which of course I refused), not allowed to do that, plus I was helping him keep his money.
Same doctors too.
Just seen quicker and treated quicker when private mostly, sadly.
If I had my way it'd all be on the nhs of course.
I have stopped people getting ripped off when I can too (take a private hospital in London, an arab nearly got charged £80 for a box of statin tablets, I pointed out to him it's closer to £7-50 in the chemist via the nhs.
He then declined paying the fee of £80, and thanked me trying to give me some money (which of course I refused), not allowed to do that, plus I was helping him keep his money.
In reply to AliceW: I agree, it's not fair.
In reply to AliceW:
If you're paying for private health - a premium every month - then you're paying for it... IMO.
A monthly healthcare premium totals up more than the cost of an outpatient appointment over a year...
> it is a way of queue jumping without really paying for it.
If you're paying for private health - a premium every month - then you're paying for it... IMO.
A monthly healthcare premium totals up more than the cost of an outpatient appointment over a year...
In reply to Anonymous:
So in effect you were saving a private (who presumably could afford it) client money, and moving the cost of treatment to the NHS? Doesn't really make sense, does it?
> If I had my way it'd all be on the nhs of course.
> He then declined paying the fee of £80, and thanked me trying to give me some money (which of course I refused), not allowed to do that, plus I was helping him keep his money.
So in effect you were saving a private (who presumably could afford it) client money, and moving the cost of treatment to the NHS? Doesn't really make sense, does it?
In reply to AliceW:
The premiums typically cover a capped cost of outpatient consultations, but they cover ALL treatment resulting from those. You may only need one specialist appointment, but you may need quite a few (if it takes them ages to figure out what is wrong). Presumably you'd need at least two - one to examine/do some tests and one for results/follow up.
> Personally, though, I don't think I would take out insurance that only covered 2 or 3 appointments a year - it doesn't seem worth it. I would pay out of my own pocket if necessary - I would want insurance to pay for what I couldn't afford, ie the full cost of treatment.
The premiums typically cover a capped cost of outpatient consultations, but they cover ALL treatment resulting from those. You may only need one specialist appointment, but you may need quite a few (if it takes them ages to figure out what is wrong). Presumably you'd need at least two - one to examine/do some tests and one for results/follow up.
In reply to Nao: I think the point Alice is making is that even if you paid for your consultation in cash, which would be maybe £200, it may give you a six month headstart on an NHS operation that might cost £10,000.
You are paying £200 to cue jump, rather than paying £10,200 to cue jump. This does seem unethical to me.
You are paying £200 to cue jump, rather than paying £10,200 to cue jump. This does seem unethical to me.
In reply to Nick B:
I don't see why you would do that... I think if you have some kind of op following on from an outpatient appointment, that is covered privately. It's the follow up appointments which are capped rather than any operations.
I don't see why you would do that... I think if you have some kind of op following on from an outpatient appointment, that is covered privately. It's the follow up appointments which are capped rather than any operations.
In reply to Nao: It's paid for by their insurance company to be honest; they get medical insurance (same as us when we go private) that pays for it.
This prescription, came out of his own pocket (as far as I could tell), but who knows, maybe he claimed it back anyway from his medical insurance?
This prescription, came out of his own pocket (as far as I could tell), but who knows, maybe he claimed it back anyway from his medical insurance?
In reply to Nao: Not everyone uses the insurance route.
In reply to Nick B: That may be a bit more painful (financially), but aok if they're happy with that, and can afford it.
I believe in the US it's more of a concern, people lose their homes don't they to pay for their treatment?.. ouch! Bit harsh.
I believe in the US it's more of a concern, people lose their homes don't they to pay for their treatment?.. ouch! Bit harsh.
In reply to Nao:
I would say that only you can make that decision. How worried are you that the 6 month wait might make the condition worse etc? If it gives you piece of mind, then £100 is money well spent in my view.
In the longer term, the "line" between the NHS and private sector will "melt away" anyway. Currently, the government devolves funding to Strategic Health Authorities etc for individual treatments (e.g. for individual CT scans, X-Rays, prescriptions, operations etc). In future, the givernment will most likely devolve funding to PCTs based on the population in their area. They will work out how much (on average) it costs to treat/manage (say) a breast cancer patient. They will then work out the approximately how many breast cancer patients there are in that area and give the appropriate amount of cash to look after them all to the local PCT(s). The PCTs will then be free to purchase services as they see fit from either the private sector or from NHS Trusts. Waiting times and quality of treatment SHOULD improve, as the PCTs will be measured in terms of treatment "outcomes" i.e. how many patients are "cured" or successfully managed/treated and how long the treatment takes.
In my view the NHS as it stands is inefficient and the private sector wins hands-down both in terms of quality of care and cost effectiveness. Bring on the changes.
This has probably bored you to tears, and I realise doesn't really help much with your current dilemma.
Rant over.
I would say that only you can make that decision. How worried are you that the 6 month wait might make the condition worse etc? If it gives you piece of mind, then £100 is money well spent in my view.
In the longer term, the "line" between the NHS and private sector will "melt away" anyway. Currently, the government devolves funding to Strategic Health Authorities etc for individual treatments (e.g. for individual CT scans, X-Rays, prescriptions, operations etc). In future, the givernment will most likely devolve funding to PCTs based on the population in their area. They will work out how much (on average) it costs to treat/manage (say) a breast cancer patient. They will then work out the approximately how many breast cancer patients there are in that area and give the appropriate amount of cash to look after them all to the local PCT(s). The PCTs will then be free to purchase services as they see fit from either the private sector or from NHS Trusts. Waiting times and quality of treatment SHOULD improve, as the PCTs will be measured in terms of treatment "outcomes" i.e. how many patients are "cured" or successfully managed/treated and how long the treatment takes.
In my view the NHS as it stands is inefficient and the private sector wins hands-down both in terms of quality of care and cost effectiveness. Bring on the changes.
This has probably bored you to tears, and I realise doesn't really help much with your current dilemma.
Rant over.
In reply to Nao: I would go private for all my treatment, but in your position, hard call. I hope everything turns out to be ok for you though. I have had investigation for a couple of issues recently, turned out to be an ulcer and hiatus hernia, not life threatening, but has diminished quality of life a touch.
In reply to ICE: and I'd go private if nothing else for the privacy (own room, can use laptop), room service, and speedy treatment, oh and cleanliness.
But end of day, it's an individual choice to go public or private.. good luck
But end of day, it's an individual choice to go public or private.. good luck
In reply to Nao:
But you are not paying the NHS are you? You are paying an insurance company.
Indeed! Which is why I would question the value of such insurance - I would rather be uninsured and pay for the OP appointment out of my savings than pay insurance for something I might never use, and offers me little anyway!
> (In reply to AliceW)
> [...]
>
> If you're paying for private health - a premium every month - then you're paying for it... IMO.
> [...]
>
> If you're paying for private health - a premium every month - then you're paying for it... IMO.
But you are not paying the NHS are you? You are paying an insurance company.
> A monthly healthcare premium totals up more than the cost of an outpatient appointment over a year...
Indeed! Which is why I would question the value of such insurance - I would rather be uninsured and pay for the OP appointment out of my savings than pay insurance for something I might never use, and offers me little anyway!
In reply to Nao:
Oh, OK.
That is not at all what I understood from your original posting - I thought you were saying that it literally only covered the cost of the appointment.
> (In reply to AliceW)
> [...]
>
> The premiums typically cover a capped cost of outpatient consultations, but they cover ALL treatment resulting from those.
> [...]
>
> The premiums typically cover a capped cost of outpatient consultations, but they cover ALL treatment resulting from those.
Oh, OK.
That is not at all what I understood from your original posting - I thought you were saying that it literally only covered the cost of the appointment.
In reply to Nick B:
That is exactly what I meant!
> (In reply to Nao) I think the point Alice is making is that even if you paid for your consultation in cash, which would be maybe £200, it may give you a six month headstart on an NHS operation that might cost £10,000.
>
> You are paying £200 to cue jump, rather than paying £10,200 to cue jump. This does seem unethical to me.
>
> You are paying £200 to cue jump, rather than paying £10,200 to cue jump. This does seem unethical to me.
That is exactly what I meant!
In reply to Nao:
This now makes sense - and the policy seems more useful. As I said, I thought it meant that you ONLY got the appointment paid for, and any further treatment you would either have to buy yourself or get on the NHS.
> (In reply to Nick B)
> I don't see why you would do that... I think if you have some kind of op following on from an outpatient appointment, that is covered privately. It's the follow up appointments which are capped rather than any operations.
> I don't see why you would do that... I think if you have some kind of op following on from an outpatient appointment, that is covered privately. It's the follow up appointments which are capped rather than any operations.
This now makes sense - and the policy seems more useful. As I said, I thought it meant that you ONLY got the appointment paid for, and any further treatment you would either have to buy yourself or get on the NHS.
In reply to AliceW:
And if any subsequent treatment will be covered by insurance too, then why are you hesitating? Why pay for insurance then not use it?
And if any subsequent treatment will be covered by insurance too, then why are you hesitating? Why pay for insurance then not use it?
In reply to Nao: oh and sadly, it's more likely alot to do with the fact the nhs is overstretched, underfunded (or badly handled by the managers/ admin staff etc) quite likely. So yes private takes away the burden of patients having to wait ages to get seen/treated at least.
Ethics, everything medically has to be done ethically.
Ethics, everything medically has to be done ethically.
In reply to AliceW:
How about another example:
Person A is told to wait 6 months to see a consultant, and dies as a consequence after 2.
Person B pays the fee for an initial consultation, the problem gets accurately diagnosed and then treated on the NHS.
Is person B somehow unethical for not accepting his or her fate to die on a waiting list?
Access to the NHS is (or should be) in order of clinical need. If you're not diagnosed, how can clinical need be assessed?
I wouldn't let any ethical conundrums stand in the way of getting accurately diagnosed or treated. Going private for the consultation is not queue jumping - it's leaving your place in the queue to someone else. Your subsequent potential treatment on the NHS is still in the order of clinical need.
It's a market economy whether you like it or not, sadly.
It's a way of circumventing flaws in the system.
> Hypothetical example:
>
> Person A is referred to consultant on the NHS, waits 6 months to see consultant, then is told "you need procedure X, I can do it in one month's time" - so waits 7 months in total.
>
> Person B is referred to consultant privately, sees him immediately, is told "you need procedure X - I will put you on my NHS waiting list and it will be done in one month" - so waits 1 month.
>
> Person A is referred to consultant on the NHS, waits 6 months to see consultant, then is told "you need procedure X, I can do it in one month's time" - so waits 7 months in total.
>
> Person B is referred to consultant privately, sees him immediately, is told "you need procedure X - I will put you on my NHS waiting list and it will be done in one month" - so waits 1 month.
How about another example:
Person A is told to wait 6 months to see a consultant, and dies as a consequence after 2.
Person B pays the fee for an initial consultation, the problem gets accurately diagnosed and then treated on the NHS.
Is person B somehow unethical for not accepting his or her fate to die on a waiting list?
Access to the NHS is (or should be) in order of clinical need. If you're not diagnosed, how can clinical need be assessed?
I wouldn't let any ethical conundrums stand in the way of getting accurately diagnosed or treated. Going private for the consultation is not queue jumping - it's leaving your place in the queue to someone else. Your subsequent potential treatment on the NHS is still in the order of clinical need.
It's a market economy whether you like it or not, sadly.
> To me that doesn't seem fair - it is a way of queue jumping without really paying for it.
It's a way of circumventing flaws in the system.
In reply to Stefan Kruger:
No one waits months to see a GP - which is why there is a huge responsibility on GPs' shoulders to assess people and prioritise correctly.
In some ways I wish it were! Working conditions would probably be better.
But a way that only the rich can afford.
> (In reply to AliceW)
> Access to the NHS is (or should be) in order of clinical need. If you're not diagnosed, how can clinical need be assessed?
No one waits months to see a GP - which is why there is a huge responsibility on GPs' shoulders to assess people and prioritise correctly.
> It's a market economy whether you like it or not, sadly.
In some ways I wish it were! Working conditions would probably be better.
> It's a way of circumventing flaws in the system.
But a way that only the rich can afford.
In reply to Stefan Kruger:
No it isn't! Person A needed the treatment just as much as person B!
As I said before, I have no problem with people paying for their treatment entirely privately - it is when they use a small amount of money to access NHS resources earlier than others that it feels wrong.
> (In reply to AliceW)
>
> [...]
>
> How about another example:
>
> Person A is told to wait 6 months to see a consultant, and dies as a consequence after 2.
>
> Person B pays the fee for an initial consultation, the problem gets accurately diagnosed and then treated on the NHS.
>
> [...]
>
> How about another example:
>
> Person A is told to wait 6 months to see a consultant, and dies as a consequence after 2.
>
> Person B pays the fee for an initial consultation, the problem gets accurately diagnosed and then treated on the NHS.
> I wouldn't let any ethical conundrums stand in the way of getting accurately diagnosed or treated. Going private for the consultation is not queue jumping - it's leaving your place in the queue to someone else. Your subsequent potential treatment on the NHS is still in the order of clinical need.
No it isn't! Person A needed the treatment just as much as person B!
As I said before, I have no problem with people paying for their treatment entirely privately - it is when they use a small amount of money to access NHS resources earlier than others that it feels wrong.
This topic has been archived, and won't accept reply postings.
Loading Notifications...