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I've always been a bit wary of private health insurance as it seems to be a form of queue jumping, and perhaps draws resources away from the NHS.
Work are just about to start enrolling staff with BUPA. I can see a good business argument for that, and I'm glad it's a taxable benefit - but my old worries persist - does the use of Private Healthcare damage the NHS or supplement it?
Work are just about to start enrolling staff with BUPA. I can see a good business argument for that, and I'm glad it's a taxable benefit - but my old worries persist - does the use of Private Healthcare damage the NHS or supplement it?
In reply to Dr.S at work:
I think it supplements it. It's one of the ways surgeons are paid, for example. The beauty of our system being that, of course, everyone is treated in exactly the same way in the operating theatre (a surgeon will never know, or want to know, if the patient is private of NHS – or at least, that's what I was told years ago by a surgeon friend of mine). In other words, the level of excellence wouldn't be possible without the extra private funding. As I say, I don't know whether this is still true, but I suspect it's truer than ever as funds get ever tighter.
I think it supplements it. It's one of the ways surgeons are paid, for example. The beauty of our system being that, of course, everyone is treated in exactly the same way in the operating theatre (a surgeon will never know, or want to know, if the patient is private of NHS – or at least, that's what I was told years ago by a surgeon friend of mine). In other words, the level of excellence wouldn't be possible without the extra private funding. As I say, I don't know whether this is still true, but I suspect it's truer than ever as funds get ever tighter.
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In reply to Dr.S at work:
Both.
> does the use of Private Healthcare damage the NHS or supplement it?
Both.
In reply to Dr.S at work:
If you feel really strongly about this then use your private healthcare for anything you personally consider urgent (cancer diagnosis being the very obvious one) and just use the NHS route for anything that you need that may be considered non urgent.
If you feel really strongly about this then use your private healthcare for anything you personally consider urgent (cancer diagnosis being the very obvious one) and just use the NHS route for anything that you need that may be considered non urgent.
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In reply to Dr.S at work:
One thing that bothers me is how much (if at all) the system may have become corrupted, e.g. those on BUPA get preferential treatment when it comes to positioning on waiting lists etc. I'm sure there must be an expert here who knows the answer.
One thing that bothers me is how much (if at all) the system may have become corrupted, e.g. those on BUPA get preferential treatment when it comes to positioning on waiting lists etc. I'm sure there must be an expert here who knows the answer.
In reply to Gordon Stainforth:
My surgeon was well aware that I was going private when he visited me in pre-op. So they definitely know.
I am of the belief that using private healthcare services releases resources that would otherwise be treating you on nhs back to the nhs for other patients.
Undoubtedy it injects some extra ash into the system.
However we keep hearing about these over tired surgeons being pushed to the limit, yet my surgeon was doing shifts in the NHS wards, as well as private consults and surgery...
My surgeon was well aware that I was going private when he visited me in pre-op. So they definitely know.
I am of the belief that using private healthcare services releases resources that would otherwise be treating you on nhs back to the nhs for other patients.
Undoubtedy it injects some extra ash into the system.
However we keep hearing about these over tired surgeons being pushed to the limit, yet my surgeon was doing shifts in the NHS wards, as well as private consults and surgery...
In reply to Gordon Stainforth:
I'm not sure if you can call it corrupted. one of the main reasons people use private is that you don't have to wait.
How fair this is is another thing.
In my case I had a suspected heart issue (at the age of 30). after amazing emergency treatment on the nhs I was left with a heavy dose of beta blockers and told to do no exercise until I got the all clear after various tests. 6 weeks later I was going batshit crazy still eating the pills, and decided to go private to speed up the remaining tests. If I hadn't then the NHS would have had to pay for the tests (CT, stress Echo, exploratory surgery) as well as the endless supply of drugs I was on. As it turned out nothing was wrong and I was able to dump the drugs and get out doing stuff again. Speeding that up was priceless
I'm not sure if you can call it corrupted. one of the main reasons people use private is that you don't have to wait.
How fair this is is another thing.
In my case I had a suspected heart issue (at the age of 30). after amazing emergency treatment on the nhs I was left with a heavy dose of beta blockers and told to do no exercise until I got the all clear after various tests. 6 weeks later I was going batshit crazy still eating the pills, and decided to go private to speed up the remaining tests. If I hadn't then the NHS would have had to pay for the tests (CT, stress Echo, exploratory surgery) as well as the endless supply of drugs I was on. As it turned out nothing was wrong and I was able to dump the drugs and get out doing stuff again. Speeding that up was priceless
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In reply to Dr.S at work:
I believe it damages it, on many levels. 1) The ability to queue jump reduces the incentive for some of the most powerful and influential people to improve the system. 2) It reinforces the idea that the NHS is a second class service, and therefore automatically increases dissatisfaction, whether justified or not. 3) It *must* take resources away from the NHS - if there only finite number of operating theatres and teams then the ability to buy a higher place in the queue must move others further down. 4) Privatised medicine has a built in incentive to increase demand for healthcare, - more demand = more revenue = more profit. So they promote, for example, ridiculous and counter-productive 'screening programs', creating a whole strata of worried well who then demand treatment.5) The existence side-by-side between a nationalised service and a for-profit sector inevitably opens up avenues of low level market distortion and corruption, which inevitably costs the taxpayer dear. I see it in my own small subset of the NHS every day.
I believe it damages it, on many levels. 1) The ability to queue jump reduces the incentive for some of the most powerful and influential people to improve the system. 2) It reinforces the idea that the NHS is a second class service, and therefore automatically increases dissatisfaction, whether justified or not. 3) It *must* take resources away from the NHS - if there only finite number of operating theatres and teams then the ability to buy a higher place in the queue must move others further down. 4) Privatised medicine has a built in incentive to increase demand for healthcare, - more demand = more revenue = more profit. So they promote, for example, ridiculous and counter-productive 'screening programs', creating a whole strata of worried well who then demand treatment.5) The existence side-by-side between a nationalised service and a for-profit sector inevitably opens up avenues of low level market distortion and corruption, which inevitably costs the taxpayer dear. I see it in my own small subset of the NHS every day.
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In reply to Dr.S at work:
My thoughts:
1) Short term it saves the NHS money.
2) It leads to a different employment landscape for medical staff. I am not well enough informed to say if this is good or bad for the NHS.
3) It funds corporate entities (private providers) some of whose long term vested interests may be very detrimental to the NHS.
My thoughts:
1) Short term it saves the NHS money.
2) It leads to a different employment landscape for medical staff. I am not well enough informed to say if this is good or bad for the NHS.
3) It funds corporate entities (private providers) some of whose long term vested interests may be very detrimental to the NHS.
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In reply to Dr.S at work:
I wouldn't want anything that could lead to complications to be done in a private hospital* but I think it works for "quality of life" procedures.
*My wife is an NHS doctor and has received patients in an ambulance form private hospitals due to complications and then not having the facilities and staff to deal with it. The good thing about a DGH is that there is usually specialists with experience in pretty much everything.
I wouldn't want anything that could lead to complications to be done in a private hospital* but I think it works for "quality of life" procedures.
*My wife is an NHS doctor and has received patients in an ambulance form private hospitals due to complications and then not having the facilities and staff to deal with it. The good thing about a DGH is that there is usually specialists with experience in pretty much everything.
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In reply to Dr.S at work:
Arguable, but what I am sure of is that waiting for the NHS to consider I was worth treating rather than going private would have damaged me.
> does the use of Private Healthcare damage the NHS
Arguable, but what I am sure of is that waiting for the NHS to consider I was worth treating rather than going private would have damaged me.
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In reply to galpinos:
I've done paediatrics surgical shifts in private hospitals. Darn right dangerous in my opinion. Surgeon comes in, does the procedure and clears off leaving a very junior doctor to deal with any problems. When things go wrong they are whipped off to a NHS hospital.
It's amazing how guidable parents and patients are. They think a private room, fluffy towel and toiletries equate with good healthcare. Little do they know.......
I've done paediatrics surgical shifts in private hospitals. Darn right dangerous in my opinion. Surgeon comes in, does the procedure and clears off leaving a very junior doctor to deal with any problems. When things go wrong they are whipped off to a NHS hospital.
It's amazing how guidable parents and patients are. They think a private room, fluffy towel and toiletries equate with good healthcare. Little do they know.......
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In reply to Dr.S at work:
When you start looking into what BUPA offers it's usually basically next to nothing. To call it "medical cover" is frankly misleading. Their standard package doesn't cover much at all, in fact pretty much next to nothing from the look of it.
Basically the idea is that you pay them and then they send you to the NHS, and they keep the money.
> I've always been a bit wary of private health insurance as it seems to be a form of queue jumping, and perhaps draws resources away from the NHS.Work are just about to start enrolling staff with BUPA. I can see a good business argument for that, and I'm glad it's a taxable benefit - but my old worries persist - does the use of Private Healthcare damage the NHS or supplement it?
When you start looking into what BUPA offers it's usually basically next to nothing. To call it "medical cover" is frankly misleading. Their standard package doesn't cover much at all, in fact pretty much next to nothing from the look of it.
Basically the idea is that you pay them and then they send you to the NHS, and they keep the money.
Post edited at 11:12
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In reply to RomTheBear:
Interesting - I was under the impression BUPA was a not for profit organisation, so in what sense do they keep the money?
Interesting - I was under the impression BUPA was a not for profit organisation, so in what sense do they keep the money?
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In reply to Dr.S at work:
As profit is assessed after the board of directors have been paid, not before, the term "not for profit" is potentially obfuscatory.
As profit is assessed after the board of directors have been paid, not before, the term "not for profit" is potentially obfuscatory.
Post edited at 14:34
In reply to Dr.S at work:
I'm not sure how electing to pay for a procedure done by a NHS doctor in a NHS surgery is taking money away from the NHS.
Surely this is supplementing money they receive from the government?
I'm not sure how electing to pay for a procedure done by a NHS doctor in a NHS surgery is taking money away from the NHS.
Surely this is supplementing money they receive from the government?
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In reply to BnB:
Coouldn't u say that of every charity?
> As profit is assessed after the board of directors have been paid, not before, the term "not for profit" is potentially obfuscatory.
Coouldn't u say that of every charity?
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In reply to Postmanpat:
Certainly not. You can't say that of any charity.
Directors of charities are specifically prohibited in law from receiving any remuneration beyond actually incurred expenses. All time is given voluntarily. (I am a charity director by the way).
Out of interest I checked on the Charity Commission website. BUPA itself is not listed as a charity. It does lend its name to a small grant-giving charity supporting medical research but this is not the BUPA referred to in this thread. I believe it may be possible for a company to register as non-profit making without registering as a charity though.
Martin
> > As profit is assessed after the board of directors have been paid, not before, the term "not for profit" is potentially obfuscatory.
>Coouldn't u say that of every charity?Certainly not. You can't say that of any charity.
Directors of charities are specifically prohibited in law from receiving any remuneration beyond actually incurred expenses. All time is given voluntarily. (I am a charity director by the way).
Out of interest I checked on the Charity Commission website. BUPA itself is not listed as a charity. It does lend its name to a small grant-giving charity supporting medical research but this is not the BUPA referred to in this thread. I believe it may be possible for a company to register as non-profit making without registering as a charity though.
Martin
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In reply to Dr.S at work:
I wouldn't worry. I work for both sectors and the private sector is full of NHS pts on waiting list initiatives. There aren't enough private pts to fund the private companies so the NHS pay them to reduce their lists. Everyone's a winner!
I wouldn't worry. I work for both sectors and the private sector is full of NHS pts on waiting list initiatives. There aren't enough private pts to fund the private companies so the NHS pay them to reduce their lists. Everyone's a winner!
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In reply to Martin Hore:
Yes yes, I was in a hurry. but my point is that charities, or more generally non-profit organisations, can and often do pay their executive employees. So does BUPA. Sometimes those executive employees will also be directors.
The practical difference seems just to be that the five non execs of BUPA also get paid
> >Coouldn't u say that of every charity?Certainly not. You can't say that of any charity.Directors of charities are specifically prohibited in law from receiving any remuneration beyond actually incurred expenses. All time is given voluntarily. (I am a charity director by the way).Out of interest I checked on the Charity Commission website. BUPA itself is not listed as a charity. It does lend its name to a small grant-giving charity supporting medical research but this is not the BUPA referred to in this thread. I believe it may be possible for a company to register as non-profit making without registering as a charity though. Martin
Yes yes, I was in a hurry. but my point is that charities, or more generally non-profit organisations, can and often do pay their executive employees. So does BUPA. Sometimes those executive employees will also be directors.
The practical difference seems just to be that the five non execs of BUPA also get paid
Post edited at 16:48
In reply to Dr.S at work:
The NHS does see an immediate benefit simply in that it doesn't have to expend its own resources to treat the individual who has chosen to go private but would have been entitled to NHS treatment had he/she not done so.
But in the greater scheme of things I fear that if we ever arrived at a situation where anywhere near a majority of members of the public started to use private health care then the political will to fund a decent standard of care on the NHS would evaporate.
How we fund good quality of health care for every citizen in an economic environment when the cost of this, for large sectors of the population, will increasingly exceed their entire tax contribution, is a really tricky problem. It's good to see a few politicians (eg Norman Lamb) beginning to face up to this rather than just hiding behind slogans along the lines of "we're promising more cash to the NHS than ever before, and it's not going to cost you any more in taxes".
Martin
The NHS does see an immediate benefit simply in that it doesn't have to expend its own resources to treat the individual who has chosen to go private but would have been entitled to NHS treatment had he/she not done so.
But in the greater scheme of things I fear that if we ever arrived at a situation where anywhere near a majority of members of the public started to use private health care then the political will to fund a decent standard of care on the NHS would evaporate.
How we fund good quality of health care for every citizen in an economic environment when the cost of this, for large sectors of the population, will increasingly exceed their entire tax contribution, is a really tricky problem. It's good to see a few politicians (eg Norman Lamb) beginning to face up to this rather than just hiding behind slogans along the lines of "we're promising more cash to the NHS than ever before, and it's not going to cost you any more in taxes".
Martin
In reply to Dr.S at work:
Its not just BUPA, I ended up in hospital with a suspected heart attack a couple of years ago. After a couple of days I was released with a bag load of pills and a place on the angina waiting list. The wait to see a consultant was about 3 months, I decided I'd rather shell out and see someone sooner. £250 later I was talking to a consultant within the week.
Its not just BUPA, I ended up in hospital with a suspected heart attack a couple of years ago. After a couple of days I was released with a bag load of pills and a place on the angina waiting list. The wait to see a consultant was about 3 months, I decided I'd rather shell out and see someone sooner. £250 later I was talking to a consultant within the week.
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In reply to JimR:
Did he change your treatment plan?
> Its not just BUPA, I ended up in hospital with a suspected heart attack a couple of years ago. After a couple of days I was released with a bag load of pills and a place on the angina waiting list. The wait to see a consultant was about 3 months, I decided I'd rather shell out and see someone sooner. £250 later I was talking to a consultant within the week.
Did he change your treatment plan?
In reply to Dr.S at work:
Having private cover over here is not mandatory, but highly desirable, (esp from a tax perspective.) The systems work well together.
Having private cover over here is not mandatory, but highly desirable, (esp from a tax perspective.) The systems work well together.
In reply to Dave the Rave:
Well, the consultant I paid to see was probably the exactly the same consultant as I would have waited for over 3 months to see on the NHS. So I paid my money to jump the queue. In reality I helped the NHS as I left the NHS queue. The consultants have NHS sessions and also conduct private sessions when not on NHS duty.
Well, the consultant I paid to see was probably the exactly the same consultant as I would have waited for over 3 months to see on the NHS. So I paid my money to jump the queue. In reality I helped the NHS as I left the NHS queue. The consultants have NHS sessions and also conduct private sessions when not on NHS duty.
In reply to Dr.S at work:
A couple of the shrinks I work with do 2 days a week for the health service, and a day a week private. Would they do 3 days for the health service, I really do not know.
A couple of the shrinks I work with do 2 days a week for the health service, and a day a week private. Would they do 3 days for the health service, I really do not know.
In reply to JimR:
I agree with you. My only misgiving is that NHS Consultants private time should be limited so as not to develop too much of a 2 tier system? Maybe it is limited? Not sure on that.
> Well, the consultant I paid to see was probably the exactly the same consultant as I would have waited for over 3 months to see on the NHS. So I paid my money to jump the queue. In reality I helped the NHS as I left the NHS queue. The consultants have NHS sessions and also conduct private sessions when not on NHS duty.
I agree with you. My only misgiving is that NHS Consultants private time should be limited so as not to develop too much of a 2 tier system? Maybe it is limited? Not sure on that.
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In reply to Dave the Rave:
How are they paid by the NHS? A salary, which must surely come with specified hours outside which they do private work, which provided it has no impact on their wakefulness etc during NHS work I see no issue with? Or is it on contract paid hourly, in which case it makes no difference to the NHS as such either?
The one thing I have a bit of disquiet about is that if things go wrong in a private operation they get palmed off on the NHS - my view is that if this happens it should be paid for to the NHS as private treatment.
> I agree with you. My only misgiving is that NHS Consultants private time should be limited so as not to develop too much of a 2 tier system? Maybe it is limited? Not sure on that.
How are they paid by the NHS? A salary, which must surely come with specified hours outside which they do private work, which provided it has no impact on their wakefulness etc during NHS work I see no issue with? Or is it on contract paid hourly, in which case it makes no difference to the NHS as such either?
The one thing I have a bit of disquiet about is that if things go wrong in a private operation they get palmed off on the NHS - my view is that if this happens it should be paid for to the NHS as private treatment.
In reply to Neil Williams:
I agree. the NHS should be compensated by the private sector for private ops that requiring the acute setting.
> How are they paid by the NHS? A salary, which must surely come with specified hours outside which they do private work, which provided it has no impact on their wakefulness etc during NHS work I see no issue with? Or is it on contract paid hourly, in which case it makes no difference to the NHS as such either?The one thing I have a bit of disquiet about is that if things go wrong in a private operation they get palmed off on the NHS - my view is that if this happens it should be paid for to the NHS as private treatment.
I'm resonantly sure that their private hours are paid per op/consultation.I agree. the NHS should be compensated by the private sector for private ops that requiring the acute setting.
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In reply to Neil Williams:
Why is that a problem. Presumably the Private Sector doesn't operate on people where there is unreasonable risk of this happening.
A guy at work was refused private treatment due to the high likelihood of complications producing an emergency situation that they wouldn't be able to cope with.
How often do people need to be patched up? Is there a mechanism to recover this cost easily? And more importantly what happens if the patient can't afford it?
Why is that a problem. Presumably the Private Sector doesn't operate on people where there is unreasonable risk of this happening.
A guy at work was refused private treatment due to the high likelihood of complications producing an emergency situation that they wouldn't be able to cope with.
How often do people need to be patched up? Is there a mechanism to recover this cost easily? And more importantly what happens if the patient can't afford it?
Post edited at 13:01
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In reply to DancingOnRock:
I don't know, but this thread is by no means the first time I heard of it.
Billing the private provider would be the best way, they then have to pass it on.
That's a matter between them and the private operator / their insurance. Presumably it would be a consumer debt like any other, and it's possibility would be part of the contract. Don't like the contract? Don't sign it.
> How often do people need to be patched up?
I don't know, but this thread is by no means the first time I heard of it.
> Is there a mechanism to recover this cost easily?
Billing the private provider would be the best way, they then have to pass it on.
> And more importantly what happens if the patient can't afford it?
That's a matter between them and the private operator / their insurance. Presumably it would be a consumer debt like any other, and it's possibility would be part of the contract. Don't like the contract? Don't sign it.
Post edited at 14:42
In reply to Dr.S at work:
Never mind the moral dilemma, I want to be treated and advised within a reasonable period, medical insurance allows me that choice.otherwise I could be stuck in a queue for god knows how long .
I agree with the observation that for major surgery NHS is easily the best but to get to that point it can often be quicker to go private for all the preliminary advice.
Never mind the moral dilemma, I want to be treated and advised within a reasonable period, medical insurance allows me that choice.otherwise I could be stuck in a queue for god knows how long .
I agree with the observation that for major surgery NHS is easily the best but to get to that point it can often be quicker to go private for all the preliminary advice.
In reply to neilh:
That's the privilege of the wealthier of society? Why should they be treated different to the rest?
> Never mind the moral dilemma, I want to be treated and advised within a reasonable period, medical insurance allows me that choice.otherwise I could be stuck in a queue for god knows how long .I agree with the observation that for major surgery NHS is easily the best but to get to that point it can often be quicker to go private for all the preliminary advice.
That's the privilege of the wealthier of society? Why should they be treated different to the rest?
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In reply to Dave the Rave:
Not necessarily! It might be what you choose to spend your limited resources on.
> That's the privilege of the wealthier of society? Why should they be treated different to the rest?
Not necessarily! It might be what you choose to spend your limited resources on.
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In reply to Dave the Rave:
The wealthier in society have all sorts of other privileges, too, many of which are far more damaging than a queue-jump in healthcare. That's a much wider issue than the NHS.
> That's the privilege of the wealthier of society? Why should they be treated different to the rest?
The wealthier in society have all sorts of other privileges, too, many of which are far more damaging than a queue-jump in healthcare. That's a much wider issue than the NHS.
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In reply to Dave the Rave:
I'm not sure about 'the wealthier' of society. I'm very lucky that my employer pays my family cover, though I do get taxed on the benefit.
All members of my family have benefited from being seen that bit quicker, but also, at a convenient time. Getting an appointment outside school and work hours is well worth the cost of the excess in reduced stress if nothing else.
I've had a number of private operations, mostly routine, but being pain free a few weeks quicker may be selfish, but i can't say I regret it. Similarly for my family members. I also swear by private physiotherapy which I use extensively.
Was it not for very quickly having a particular op, I'd have been very much worse off, probably using a wheelchair by now. Going private got me under the knife very quickly, which I think gave me back almost full functionality. The operation was high risk, and I'm told needed the full resources of the NHS so I was operated on in an NHS hospital, so, yes, I did jump the queue. For this I do feel conflicted, but I can still walk and climb and do these things with my kids. Every day I'm grateful that the op was a success and I put this down to speed from gp to consult to knife, something that sometimes the NHS isn't always good at. If only it were different.
I'm not sure about 'the wealthier' of society. I'm very lucky that my employer pays my family cover, though I do get taxed on the benefit.
All members of my family have benefited from being seen that bit quicker, but also, at a convenient time. Getting an appointment outside school and work hours is well worth the cost of the excess in reduced stress if nothing else.
I've had a number of private operations, mostly routine, but being pain free a few weeks quicker may be selfish, but i can't say I regret it. Similarly for my family members. I also swear by private physiotherapy which I use extensively.
Was it not for very quickly having a particular op, I'd have been very much worse off, probably using a wheelchair by now. Going private got me under the knife very quickly, which I think gave me back almost full functionality. The operation was high risk, and I'm told needed the full resources of the NHS so I was operated on in an NHS hospital, so, yes, I did jump the queue. For this I do feel conflicted, but I can still walk and climb and do these things with my kids. Every day I'm grateful that the op was a success and I put this down to speed from gp to consult to knife, something that sometimes the NHS isn't always good at. If only it were different.
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In reply to markAut:
Interesting - especially as their are some things there like physio that i would probably just pay for anyway. Similarily I already pay for dentistry privately. hmmm.
Interesting - especially as their are some things there like physio that i would probably just pay for anyway. Similarily I already pay for dentistry privately. hmmm.
In reply to JimR:
That is true. But a lifetime of inequality and no hope could affect people's judgement in making that decision?
> Not necessarily! It might be what you choose to spend your limited resources on.
That is true. But a lifetime of inequality and no hope could affect people's judgement in making that decision?
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In reply to wintertree:
Short-term it may save the NHS money, but medium term it is costing the NHSLA (litigation authority) a fortune.
Sorry if I'm repeating something, but due to the wording of most of the agreements, if a private contractor is negligent, the NHS foots the bill. A trainee paramedic just told me of a case where a private ambulance (+ "technician") was sent to a suspected cardiac arrest, chest pains, the works...
The technician says equivocally NO, you are not having a heart attack, going to hospital is a waste of your time and leaves. Of course, it was a heart attack, the patient died and now the NHS is footing the negligence bill.
This is not an isolated incident, private practices have no reason to improve as the NHS picks up the tab, every single time they make a mistake!
Edit, just reread the OP, going private as an individual is fine, it's the providers of privatised NHS contracts that are screwing the system...
Short-term it may save the NHS money, but medium term it is costing the NHSLA (litigation authority) a fortune.
Sorry if I'm repeating something, but due to the wording of most of the agreements, if a private contractor is negligent, the NHS foots the bill. A trainee paramedic just told me of a case where a private ambulance (+ "technician") was sent to a suspected cardiac arrest, chest pains, the works...
The technician says equivocally NO, you are not having a heart attack, going to hospital is a waste of your time and leaves. Of course, it was a heart attack, the patient died and now the NHS is footing the negligence bill.
This is not an isolated incident, private practices have no reason to improve as the NHS picks up the tab, every single time they make a mistake!
Edit, just reread the OP, going private as an individual is fine, it's the providers of privatised NHS contracts that are screwing the system...
Post edited at 22:56
In reply to Dr.S at work:
Quite. I'd never go to my GP over a sports injury. Their first line of treatment is always rest and wait and come back in three weeks.
Quite. I'd never go to my GP over a sports injury. Their first line of treatment is always rest and wait and come back in three weeks.
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In reply to Dr.S at work:
Why on earth should it be a taxable benefit? Sorry, your employer is investing in your well-being, and hopefully prompt and speedy recovery and return to work as a valued asset of the company, but you have to pay tax on something you already pay a shed load of tax for but fortunately don't have to use. Makes total sense when you put it that way.
D
Why on earth should it be a taxable benefit? Sorry, your employer is investing in your well-being, and hopefully prompt and speedy recovery and return to work as a valued asset of the company, but you have to pay tax on something you already pay a shed load of tax for but fortunately don't have to use. Makes total sense when you put it that way.
D
In reply to Dauphin:
The private firms for not training their staff. But due to the contract, the NHS trust is responsible as they dispatched the ambulance.
The private firms for not training their staff. But due to the contract, the NHS trust is responsible as they dispatched the ambulance.
In reply to Dave the Rave:
In my case I had suspected cancer of the arse*.
I had the choice to go private to get the camera rammed up there in one week rather than wait 3 months. That's what we pay $370 pcm for, on top of our medicare payments.
What would you choose?
*Turned out to be a bad case of the Emma's, plus polyps. Though I did get to see how pretty I look on the inside.
> That's the privilege of the wealthier of society? Why should they be treated different to the rest?
In my case I had suspected cancer of the arse*.
I had the choice to go private to get the camera rammed up there in one week rather than wait 3 months. That's what we pay $370 pcm for, on top of our medicare payments.
What would you choose?
*Turned out to be a bad case of the Emma's, plus polyps. Though I did get to see how pretty I look on the inside.
In reply to Dr.S at work:
The question of private vs NHS becomes irrelevant when faced with a condition that might radically change quality of life, or may become more acute with delay.
The choice for private is not exclusive and the clientele is a broad spectrum.
But it's like the M6 toll road, if everyone chose it, the congestion would be the same.
The question of private vs NHS becomes irrelevant when faced with a condition that might radically change quality of life, or may become more acute with delay.
The choice for private is not exclusive and the clientele is a broad spectrum.
But it's like the M6 toll road, if everyone chose it, the congestion would be the same.
2
In reply to Dauphin:
Interestingly, my employer considers this to be a staff 'bonus' rather than sensible business investment. He had not considered the buisiness advantages until I pointed them out.
I'd like to pay more tax anyway, so glad it's taxable.
Interestingly, my employer considers this to be a staff 'bonus' rather than sensible business investment. He had not considered the buisiness advantages until I pointed them out.
I'd like to pay more tax anyway, so glad it's taxable.
1
In reply to DancingOnRock:
The major bonus of private hospitals is they are usually fairly close to a real hospital for when anything goes wrong - assuming it is noticed. At that point, the NHS takes over and provides all emergency care FoC. As stated above, for anything even remotely hazardous they are absolutely the last place you would wish to be treated, but for private health providers raking it in for doing production-line type surgery it's a great model for the free market...
I think a minority of consultant work is in the private sector, and relatively few consultants have private > public work. Private sessions should not (and I believe very rarely are) subsidised by NHS pay inappropriately.
Conditions of work in the private sector for consultants are often unrecognisably better - and it is some time out of the constant sh*tstorm of NHS Acute care...
b
The major bonus of private hospitals is they are usually fairly close to a real hospital for when anything goes wrong - assuming it is noticed. At that point, the NHS takes over and provides all emergency care FoC. As stated above, for anything even remotely hazardous they are absolutely the last place you would wish to be treated, but for private health providers raking it in for doing production-line type surgery it's a great model for the free market...
I think a minority of consultant work is in the private sector, and relatively few consultants have private > public work. Private sessions should not (and I believe very rarely are) subsidised by NHS pay inappropriately.
Conditions of work in the private sector for consultants are often unrecognisably better - and it is some time out of the constant sh*tstorm of NHS Acute care...
b
In reply to ben b:
Yes. It's not as if the Private hospitals are deliberately skimping on aftercare and shipping the patients off to the NHS on a routine basis.
If the NHS starts refusing patients who've had private elective surgery unless they pay, what else do you start refusing patients for.
Yes. It's not as if the Private hospitals are deliberately skimping on aftercare and shipping the patients off to the NHS on a routine basis.
If the NHS starts refusing patients who've had private elective surgery unless they pay, what else do you start refusing patients for.
In reply to Oliver Houston:
Presumably you have heard about Service Level Agreements? Reminds me of a story I heard about a southern ambulance trust a couple of years ago using St John's Ambulance to respond to motorway RTAs, any mistakes wholly the responsibility of the ambulance trust in any sane world...
D
Presumably you have heard about Service Level Agreements? Reminds me of a story I heard about a southern ambulance trust a couple of years ago using St John's Ambulance to respond to motorway RTAs, any mistakes wholly the responsibility of the ambulance trust in any sane world...
D
Post edited at 10:15
In reply to DancingOnRock:
I don't think anyone is suggesting the NHS not taking the patients. God help them if they didn't get to a proper hospital. However, the cost of the care is not borne by the insurers, even when it should be by rights. For example, a well described episode where a number of cataract patients had substandard care in the private sector and required extensive remedial work.
The private company made a lot of money out of their demonstrably poor care. The NHS picked up the tab. Similarly if a patient in a private hospital has a complication as a result of inadequate care or neglect then at present there is no penalty or incentive to reduce the risk of recurrence.
b
I don't think anyone is suggesting the NHS not taking the patients. God help them if they didn't get to a proper hospital. However, the cost of the care is not borne by the insurers, even when it should be by rights. For example, a well described episode where a number of cataract patients had substandard care in the private sector and required extensive remedial work.
The private company made a lot of money out of their demonstrably poor care. The NHS picked up the tab. Similarly if a patient in a private hospital has a complication as a result of inadequate care or neglect then at present there is no penalty or incentive to reduce the risk of recurrence.
b
In reply to DancingOnRock:
You have a one size fits all NHS that's barely adequate in many parts of the country which doesn't allow you to purchase extra or additional services or treatments and or use private medicine. Doesn't make any practical, ethical or financial sense unless you live in some soviet utopian hallucination.
In which case pass me the pipe.
It's not 'the best in the world' it's just cheap.
D
You have a one size fits all NHS that's barely adequate in many parts of the country which doesn't allow you to purchase extra or additional services or treatments and or use private medicine. Doesn't make any practical, ethical or financial sense unless you live in some soviet utopian hallucination.
In which case pass me the pipe.
It's not 'the best in the world' it's just cheap.
D
1
In reply to ben b:
Inadequate care or neglect is one thing but really how much is down to that. How much is just down to complications?
In the first case, is there a mechanism for recovering the costs that is easy to implement? My guess is that trying to account for the actual spend on any individual patient within the NHS is practically impossible without introducing masses of extra paperwork. It must be a similar issue to trying to fully recover costs from patients outside of the EU.
Inadequate care or neglect is one thing but really how much is down to that. How much is just down to complications?
In the first case, is there a mechanism for recovering the costs that is easy to implement? My guess is that trying to account for the actual spend on any individual patient within the NHS is practically impossible without introducing masses of extra paperwork. It must be a similar issue to trying to fully recover costs from patients outside of the EU.
In reply to Dauphin:
'It's not 'the best in the world' it's just cheap.'
You're as wrong as can be. It's not perfect - well, no sh*t Sherlock. But a lot of the time it's pretty bl**dy good.
I don't know if you've watched someone die in an NHS ward - well where my mum was, the care was extraordinary. When my son had chest pains there was a para medic on site with 1o minutes fully equipped with all the gear to resuscitate. When I bashed my elbow I had been seen by a GP, had an X-Ray and had the diagnosis confirmed by a consultant between 8:00am and 11:00 am.
I could go on.
'It's not 'the best in the world' it's just cheap.'
You're as wrong as can be. It's not perfect - well, no sh*t Sherlock. But a lot of the time it's pretty bl**dy good.
I don't know if you've watched someone die in an NHS ward - well where my mum was, the care was extraordinary. When my son had chest pains there was a para medic on site with 1o minutes fully equipped with all the gear to resuscitate. When I bashed my elbow I had been seen by a GP, had an X-Ray and had the diagnosis confirmed by a consultant between 8:00am and 11:00 am.
I could go on.
3
In reply to Dr.S at work:
I have private via work but having gone through this dilemma of what effect does it have on the NHS, I had an NHS procedure last year that went well and quite slickly. Then 6 months later my problem has reoccurred and my GP stuffed up my referral meaning I'm now 4 months behind a detailed check. Its likely not serious but it could be.
As a result I've used my private insurance and am due an appointment next week.
I do worry though that by going private I contribute to the downfall of the NHS as the resource (and funding) is focused on the private sector rather than the NHS.
Surely the more people that go private mean less use the NHS and it shrinks further?
I have private via work but having gone through this dilemma of what effect does it have on the NHS, I had an NHS procedure last year that went well and quite slickly. Then 6 months later my problem has reoccurred and my GP stuffed up my referral meaning I'm now 4 months behind a detailed check. Its likely not serious but it could be.
As a result I've used my private insurance and am due an appointment next week.
I do worry though that by going private I contribute to the downfall of the NHS as the resource (and funding) is focused on the private sector rather than the NHS.
Surely the more people that go private mean less use the NHS and it shrinks further?
In reply to DancingOnRock:
I'm pretty sure a hospitals funding is linked to what patients they get, their aliments and the procedures done so the logging of this is already done to some extent. Some hospitals do it far better than others (an off-topic side affect being they then get better funding than other hospitals in the area) but it's not that difficult a task.
> Inadequate care or neglect is one thing but really how much is down to that. How much is just down to complications?In the first case, is there a mechanism for recovering the costs that is easy to implement? My guess is that trying to account for the actual spend on any individual patient within the NHS is practically impossible without introducing masses of extra paperwork.
I'm pretty sure a hospitals funding is linked to what patients they get, their aliments and the procedures done so the logging of this is already done to some extent. Some hospitals do it far better than others (an off-topic side affect being they then get better funding than other hospitals in the area) but it's not that difficult a task.
Post edited at 13:47
In reply to galpinos:
Looks like it is just based on average cost.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/5...
Looks like it is just based on average cost.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/5...
In reply to balmybaldwin:
Absolutely. And the consultant will be paying the theatre staff out of their fee. Given that a lot of private work is won by recommendation, I would expect to get better treatment if going through BUPA/ going 'private'.
The main reason companies pay BUPA subs etc for their employees is not however to let them jump a queue, it is to be treated when it's convenient for the company, not for the NHS (A colleague of mine has fitted her treatment for a knackered knee around work commitments - she's off at the moment).
> My surgeon was well aware that I was going private when he visited me in pre-op. So they definitely know.
Absolutely. And the consultant will be paying the theatre staff out of their fee. Given that a lot of private work is won by recommendation, I would expect to get better treatment if going through BUPA/ going 'private'.
The main reason companies pay BUPA subs etc for their employees is not however to let them jump a queue, it is to be treated when it's convenient for the company, not for the NHS (A colleague of mine has fitted her treatment for a knackered knee around work commitments - she's off at the moment).
As someone who has worked in the NHS and Private sector for 15 years there are some interesting opinions in this thread.
For completeness, here are some facts which may help:
- All healthcare Providers (Private OR NHS) pay for indemnity insurance. This insurance has to have a minimum level of cover and is provided by either the NHSLA or another insurer. The organisation I worked for at the time moved from NHSLA cover a few years ago when the costs spiralled.
- Consultants are salaried when working for NHS Providers and paid per session with private providers. Their rotas are carefully monitored, and Medical Advisory Groups work across whole health economies to prevent any dangerous practice (and ensure consultants aren't practising at a private provider during salaried hours).
- Transfers from Private Providers to NHS under emergency conditions are rare. There are always exceptions, and at times things do go wrong and that is exactly why there are negotiated Service Level Agreements in place and emergency transfer protocol. There are levers within the standard NHS Contract which recoup the cost of any care associated with any patient readmitted or returned to theatre within 30 days from the provider who delivered the original episode of care.
- More on transfers from Private to NHS; all patients should be thoroughly triaged before being admitted to any hospital to ensure they are safe to treat.
- There are VERY clear rules around switching from private to NHS and vice versa. Patients who have had private treatment and switch the NHS funded pathways must not have any preferential treatment. If you're interested, have a look at "Defining the Boundaries". Having NHS treatment in a private provider (yes, that is possible, and yes they are paid exactly the same as the local NHS Trust so cost neutral to the NHS) may mean you wait less time.
- The number of people with private medical insurance (PMI) *and* using it has reduced significantly over the last 10 years. Funding for the NHS was based on growth forecast through HES and other public health data, which didn't take into consideration this unexpected additional pressure. There's a limited pot of funding for each Clinical Commissioning Group area, as a result many are negotiating 'block' contracts (i.e. they pay their local NHS Hospital £xm a year for everything). This means, you go to your local NHS Trust, they're having to cover the cost of your care from that £xm. Go private, the funding is coming from your insurer.
In summary: Using PMI can save the NHS money. The source of the funding is the insurer, not the NHS.
For completeness, here are some facts which may help:
- All healthcare Providers (Private OR NHS) pay for indemnity insurance. This insurance has to have a minimum level of cover and is provided by either the NHSLA or another insurer. The organisation I worked for at the time moved from NHSLA cover a few years ago when the costs spiralled.
- Consultants are salaried when working for NHS Providers and paid per session with private providers. Their rotas are carefully monitored, and Medical Advisory Groups work across whole health economies to prevent any dangerous practice (and ensure consultants aren't practising at a private provider during salaried hours).
- Transfers from Private Providers to NHS under emergency conditions are rare. There are always exceptions, and at times things do go wrong and that is exactly why there are negotiated Service Level Agreements in place and emergency transfer protocol. There are levers within the standard NHS Contract which recoup the cost of any care associated with any patient readmitted or returned to theatre within 30 days from the provider who delivered the original episode of care.
- More on transfers from Private to NHS; all patients should be thoroughly triaged before being admitted to any hospital to ensure they are safe to treat.
- There are VERY clear rules around switching from private to NHS and vice versa. Patients who have had private treatment and switch the NHS funded pathways must not have any preferential treatment. If you're interested, have a look at "Defining the Boundaries". Having NHS treatment in a private provider (yes, that is possible, and yes they are paid exactly the same as the local NHS Trust so cost neutral to the NHS) may mean you wait less time.
- The number of people with private medical insurance (PMI) *and* using it has reduced significantly over the last 10 years. Funding for the NHS was based on growth forecast through HES and other public health data, which didn't take into consideration this unexpected additional pressure. There's a limited pot of funding for each Clinical Commissioning Group area, as a result many are negotiating 'block' contracts (i.e. they pay their local NHS Hospital £xm a year for everything). This means, you go to your local NHS Trust, they're having to cover the cost of your care from that £xm. Go private, the funding is coming from your insurer.
In summary: Using PMI can save the NHS money. The source of the funding is the insurer, not the NHS.
5
In reply to Rob Exile Ward:
We can all do anecdotes. I've got plenty of great ones from working in tertiary referral centres in major cities up and down the county. Unfortunately I've also got plenty of bad ones from working in St Bumf*ck in the back of beyond, no one's questioning the 'loveliness' or can do attitude of the staff, just the range of treatment available and the training / competence of the lovely and 'can do' hardworking staff. Postcode lottery, oh Yes!
But apparently private healthcare is a sort of pariah in the U.K. and the NHS the last word in world class medicine. No it ain't.
D
We can all do anecdotes. I've got plenty of great ones from working in tertiary referral centres in major cities up and down the county. Unfortunately I've also got plenty of bad ones from working in St Bumf*ck in the back of beyond, no one's questioning the 'loveliness' or can do attitude of the staff, just the range of treatment available and the training / competence of the lovely and 'can do' hardworking staff. Postcode lottery, oh Yes!
But apparently private healthcare is a sort of pariah in the U.K. and the NHS the last word in world class medicine. No it ain't.
D
2
In reply to blurty:
Not a lot different in the NHS. If you work for the NHS you can get seen and treated quicker if you choose the Trust where you work. Its part of the sickness and attendance policy. Gets staff back to work quicker.
Not a lot different in the NHS. If you work for the NHS you can get seen and treated quicker if you choose the Trust where you work. Its part of the sickness and attendance policy. Gets staff back to work quicker.
1
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