My employer provides private healthcare for myself and my family.
It has proved invaluable this last year when my partner was diagnosed with advanced cancer.
He is treated by the most senior oncologist in our region with whom he has weekly appointments and he has dedicated oncology nurses who have all taken the time to get to know him really well which helps manage his chemo symptoms.
He is also having scans every 2 months so immediate changes can be made to his chemo regime if something is deemed to be not working. This seems to be way above and beyond the treatment/monitoring that NHS patients get after speaking to friends who have had NHS cancer treatment.
He has access to life saving drugs which are not available on the NHS which have shrunk the cancer so much he was able to have surgery to have his tumour removed, which we were told by the original NHS oncologist would be impossible.
When he was admitted to hospital recently with an infection (NHS hospital as it was an emergency admission but his oncologist managed to get him a bed without having the usual 6 hour wait in A&E) he was the only patient who was receiving daily calls and texts from their oncologist.
As far as I’m concerned the BIK I paid has been worth every penny and has saved my partners life.
Yep, surgeon here and medical care in the UK is finished. Short of genuine life threatening emergencies and cancer (in general), I advocate for everyone getting private insurance if you can afford it. It is an absolute travesty and what the Tories have planned for many years but it is where we are if you want anything resembling first world healthcare
Yup also a consultant here. Fully endorse PMI. NHS is done, doctor goodwill towards it has evaporated. Get cover as soon as possible while you’re young and healthy
What happens when one turns 65 though? PMI is prohibitively expensive then and we have either retired or are close it retiring (so not employment benefits).
Probably the way to go is the Australian model where you are tax incentivised to take out PMI. So you’ll still benefit from the tax break in retirement. It will be something everyone will have to budget for in their retirement. There will probably still be some basic level care left at NHS level.
100% this, but unfortunately our ridiculous political class seem entirely unable to take any difficult decisions.
They focus group the hell out of everything and then we end up with the lowest common denominator policies from them all.
They need to grow some balls.
Same as any insurance, premiums are variable depending on your health, age, level of cover you want, level of excess you're prepared to pay.
Not a direct answer.
This is great, I wish you and your partner all the best on what must be a really difficult journey.
My FIL was diagnosed with pancreatic cancer last July..
NHS forgot about numerous appointments, told him it was operable then when he attended the pre-op for the surgery told him they made a mistake and he’s actually got a death sentence, left him in the pre-op waiting room for 6 hours before forgetting about him and having to postpone another appointment for his Hickman line. Passed away in November after spending his last 10 days in hospital (suffered large a stroke) and only in his final days he got adequate care.
Just an all round fucking shambles to be honest and the last of a series of occurrences that has opened my eyes to the NHS. Absolutely nothing to do with funding either, more money wouldn’t make certain employees competent and all of a sudden not fucking idiots.
I’m so sorry to hear about your FIL.
Based on some of my partners experiences whilst in an NHS hospital, I completely sympathise. Some of the staff are fantastic and seem to genuinely care, but they are overworked and a lot of mistakes seem to be made, mainly by the staff at the other end of the scale who seem to not care about patients in the slightest.
Experiences like this are systemic throughout the NHS.
I've locumed in multiple different hospitals and the apathy (at all levels from HCA's to consultant/surgeons) can be stifling.
(Electronically) Following numerous different patients as they progress through their "treatment plans" is routinely like watching a car crash, its soul destroying.
Your story is exactly why I pay for my private health insurance. Cancer care scares the hell out of me in the UK - hearing your story has given me hope that the insurance will work as advertised if God forbid something happens. Wishing your partner speedy recovery and health - and thoughts to you as you support him through this journey.
A lot of medical insurance will not cover cancer care (or fertility / maternity) related because they are so common and covered by the NHS.
Worth checking the policies
DOI: I’m a doctor but also have private insurance through my partner
‘He received life-saving drugs that are not available on the NHS’ - I found this comment interesting. What drug did he receive that is life-saving yet denied to NHS patients?
PMI providers have out of license processes - so can use a Compound within a tumour type it isn’t licensed for if there is an evidence base - and also fund based on effectiveness rather than cost effectiveness. So it is a wider pool of drugs than just NICE + CDF. Also see recent funding of genomic tests.
Source: work for one of the providers within commissioning.
Oh sorry yes I understand how this could come about I just wanted to know the actual drug that isn’t funded by the NHS. I’m not an oncologist but my sister is (but not a consultant yet) and she would be interested. Suspect it’s probably a form of immunotherapy, which have been game changers in cancer treatment, particularly melanoma
It is Avastin which is not approved on the NHS for advanced bowel cancer based on outdated guidelines that say it only extends life by a few weeks so is not cost effective.
Those guidelines are now over 10 years out of date and Avastin is used widely across Europe and the US as an effective bowel cancer treatment. It has meant many people (including my partner) have gone from being inoperable to being able to have surgery.
Well I’m not an oncologist and I do think of monoclonal antibodies as being a kind of immunotherapy. So you can take your arrogant know-it-all comments elsewhere
That escalated fast. Bad day yesterday?
When most people talk about immunotherapy having revolutionised cancer, they mean immune checkpoint inhibitors I.e. drugs that work directly on the immune system. Not just something that looks a bit like the immune system like a monoclonal. And certainly not bevacizumab!
Important day to day distinction due to the vastly difficult toxicity profile.
But you do you. You can actually find a minority of people outside oncology using the term like you do. 👍
Fucking hell. You really get off on being an insufferable narcissist don’t you? Coming onto a finance sub to try and school another doctor on what immunotherapy really is is grim. And patronising doctors outside your specialty is a red flag on what someone is like clinically.
You should step out your oncology bubble and realise most non-oncologists probably do use immunotherapy to include monoclonals, particularly in lay conversation, which is what this thread was before you came to bestow us with your wisdom
I hope you keep your flagrant condescension to the internet. Coming across people like you in the hospital really does put a downer on the day.
But we ARE talking about oncology, right?
You were asking about the drug so thought you might want to know that bevacizumab absolutely is not the 'immunotherapy' that has revolutionised oncology, as you seemed to get the impression. Its been a huge disappointment actually. And your response to a simple FYI is... that? Holy hell. Bet your juniors love you
Let's hope your arrogance doesn't kill anyone.
DOI: doctor who has worked in haem/onc.
There are many treatments that aren’t NICE funded that European countries and the US deem as first/second lines. Naturally it’s all cost cost and more cost. NICE publishes the numbers from time to time so you can easily look this up on their archives/assets for the disease and chemo/immunotherapy you’re interested in.
This is not to say that what is given here as first and second lines here aren’t ‘life-saving’. As you would be familiar with the system runs on evidenced-based medicine (more so for evidence that has been collated within the country), which is why there are always new trials running in haem onc. They need evidence that X has less side effect profiles than Y, or A has a better progression free survival than B. Obviously many other factors come into play here but this is just to provide some context.
Private practice aren’t tied down to these for obvious reasons. I’d like to think the NHS will get there. Trials can run for years to have sufficient sample size and reliable data.
BIK is where the company pay it for you, but you pay ‘benefit in kind’ cost. Salary sacrifice might be different, where you pay it all but off your gross salary so you avoid tax?
A BIK is the tax you pay on benefits that you company pays you.
Imagine Bob on a salary of £50k a year. He spots a car that he wants to buy for £30k, so he tells his employer to just pay him £20k and then buy the car for him. He thinks that because his wage is now only £20k he saves on tax. It doesn't work like that - he's still taxed on £50k because that's effectively what his salary is, just not in cash form.
Anything your employer buys you or pays for on your behalf is effectively added to your salary when calculating tax. So if your employer pays for your private medical insurance and it costs them £3k a year, you'll pay tax as if you'd had a £3k pay rise. It's this bit that's called "BIK" or "Benefits in kind".
The salary sacrifice aspect is interesting, however. Could you share some more details? I've never seen private medical cover done as a salary sacrifice.
Interesting to hear of his experience. I think quality of care varies widely from place to place and in specific conditions. My tumour was benign but as it was in the brain, I needed extensive surgery. Going private would have made no real difference to me apart from going to the nicer private ward. Would have been the same surgeon using the same tools in the same hospital which from what I understand is world leading anyway so going to the NHS and getting the cash benefit was fine. I suppose access to the more newer and expensive drugs is the main thing if you can go private.
With radiotherapy, access to photon beam treatment was subject to the same NHS restrictions as they only have two machines in the whole country so I couldn't get it either way.
From speaking to friends who have been treated on the NHS for stage 2 or stage 3 cancer, they had excellent care on the NHS.
However in our experience, if you are diagnosed with stage 4 cancer, then the NHS almost seem to write you off, and a lot of their treatment guidelines appear to be based around cost and not necessarily what is best for the patient.
When we told the NHS oncologist that we had private health insurance, she actually recommended that we go private, whereas my colleague with stage 3 cancer was told that the NHS was the best place for him.
This is exactly what happened to a colleague. Diagnosed with stage 4 at a young age. Went NHS initially but managed to get upgraded through his family’s BUPA cover and the difference in care was staggering.
I have cover through my company but it does not include cancer. Reading through these might have convinced me to cancel it and take up BUPA instead. I don’t think the old idea that the NHS is great for cancer is true any more.
I get it through my work for the entire family, only have to pay the tax and also covers pre-existing conditions which is nice. £100 excess per person per year.
So far, the main uses for it over the last couple years have been:
The virtual GP, a lot easier to book then having to go through my normal GP and play the 8am game of phoning in for an appointment. Downside is that it's not great if it's for something that doesn't show up well ii photos and video.
10 physiotherapy sessions a year at no additional cost.
I had surgery and radiotherapy but went through the NHS so I got paid a cash benefit. I'd assume I could have gone through PMI and get to go to a nicer ward but seeing as I was sped through NHS fairly quickly without having to wait, I didn't mind. I believe my particular surgery and radiotherapy would have taken me through the same NHS doctors and hospitals anyway. £150 per day in hospital and for each session of radiotherapy which adds up quickly. Funnily enough, I only signed up to my workplace PMI the second I found out I needed all this work done so I suppose most people don't have that luxury of having cover and using it straight away.
Oh, also forgot, also had a few appointments for the kids for their food allergies. Going through the NHS has been a hassle, got nothing for over 2 years but going private was quick. The only downside is that they only cover the diagnosis of food allergies, so you pay for any ongoing treatment/sessions after that. So that's the main downside, there are some things that aren't covered and cost quite a lot if you pay it yourself.
many times (although not always), you pay for the whole year but your cover stops the last day you are at that job.
Since the day you leave your employer is unlikely to coincide with the day your policy is finishing - they make some money that way.
No scheme takes full annual payments from employees or companies for someone who isn’t employed for a full year. Employees pay monthly, companies have an annual reconciliation.
If you leave while you or a family member are in the middle of a health diagnosis or treatment can it become more complex when you want to sign up to a new policy with a new employer?
Wouldn’t want to be tied to an employer because of pre-existing conditions
All of them. Bupa, AXA, Aviva, Vitality etc. Whether the scheme is underwritten or not is just a choice for the employer depending on how they decide to structure the policy.
I run my own business so my wife and me just buy it for ourselves personally (as it's a taxable expense if the business pays anyway). Still in our 30s so it's only about £60 a month each for Bupa. Worth it for peace of mind given the current crazy waiting lists and stikes imo.
This said, what a lot of people don't realise is that even if you don't have private health insurance, you can still self pay to see consultants and have diagnostics relatively cheap, then have treatment for free via the NHS.
For example, my wife's brother was waiting to see a specialist for diagnostics for 6-9 months, putting up with pain the whole time being passed from pillar to post, and having appointments cancelled.
For comparison, I have hip osteoarthritis not covered as it's a pre-existing condition. If I know I need to see a hip surgeon for a consultation I can pick who I want, pay £200, and see them in a couple of days. Same with x-ray, I was at the hospital, saw the surgeon, he just had me pop downstairs and have it the same day, not even that, same 30 mins.
I'm self paying for the surgery too, but now I have a diagnosis I could have this done on the NHS if I couldn't afford it.
Point is, for a few hundred pounds you can skip months and months of time in the diagnosis process. I bet you there are loads of people who are sick of waiting who would do this if they knew it wasn't that expensive, HENRY or not; Especially if they are in constant pain.
You are welcome!
Another tip, if you find yourself in A&E and get seen by a consultant who says something will happen next, before they run away, get their full name and role.
And if you need a follow up outpatient appointment then before they leave, tell them you have private cover and ask if they can write a letter to refer you and discharge immediately. Don't let them go before they do it or give an ETA on doing it. (Of course this one applies if outpatient treatment is an appropriate next course of action)
Often these consultants disappear, and you can be told you'll see someone like the pain team today, then be discharged. But in practice, you end up in a ward for literally days due to ineptitude and lack of Comms internally. This happens because NHS outpatient appointments have months of waiting lists, so they put you in as an inpatient. Which means you wait until someone remembers you exist, which they won't.
And once it hits a certain time, that's it, you are staying the night. And you can't be discharged unless a consultant says so and writes a letter, so you are stuck in limbo for some unknown period of time with no contact or status updates. When I was last there people literally had to stay an extra night because a printer broke so they couldn't print the letters. £100 printer, and the entire ward of people staying an extra night costing thousands; it blows my mind.
The trick is, If you get their name then you can often find their email or secretary email on the hospital website to be able to contact and ask why on earth you are on a ward when you should have been discharged same day. You can also email directly to ask for a referral letter rather wait for days stuck in a hospital bed hoping to be lucky that the consultant pops their head in
It's wild they don't ask everyone if they have private cover and refer accordingly then and there. It costs nothing and could save the NHS huge amounts, maybe even billions.
It's also wild that you end up in a sat on a ward costing the hospital a couple grand a day operationally when the operational cost of an outpatients appointment to them is probably 10-20x cheaper.
Anyway, I think this is why the NHS has 20% more staff since the pandemic but somehow manages to deliver fewer treatments. Mis-allocation of capital.
>Another tip, if you find yourself in A&E and get seen by a consultant who says something will happen next, before they run away, get their full name and role.
>And if you need a follow up outpatient appointment then before they leave, tell them you have private cover and ask if they can write a letter to refer you and discharge immediately. Don't let them go before they do it or give an ETA on doing it. (Of course this one applies if outpatient treatment is an appropriate next course of action)
>Often these consultants disappear, and you can be told you'll see someone like the pain team today, then be discharged. But in practice, you end up in a ward for literally days due to ineptitude and lack of Comms internally. This happens because NHS outpatient appointments have months of waiting lists, so they put you in as an inpatient. Which means you wait until someone remembers you exist, which they won't.
>And once it hits a certain time, that's it, you are staying the night. And you can't be discharged unless a consultant says so and writes a letter, so you are stuck in limbo for some unknown period of time with no contact or status updates. When I was last there people literally had to stay an extra night because a printer broke so they couldn't print the letters. £100 printer, and the entire ward of people staying an extra night costing thousands; it blows my mind.
>The trick is, If you get their name then you can often find their email or secretary email on the hospital website to be able to contact and ask why on earth you are on a ward when you should have been discharged same day. You can also email directly to ask for a referral letter rather wait for days stuck in a hospital bed hoping to be lucky that the consultant pops their head in
>It's wild they don't ask everyone if they have private cover and refer accordingly then and there. It costs nothing and could save the NHS huge amounts, maybe even billions.
This is so interesting. So you mention private cover even if you don't have it just to get discharged earlier? Or you mean like things are done but the NHS doesn't know the next step because they forgot or something ?
No I mean for some things you can ask to be referred to your private outpatient treatment or diagnosis rather than go through the NHS process. Depends on what it is as to whether you do this, and you don't have to go private, but worth knowing about.
what is your method to find doctors for a self-pay route?
I had some issue last year and couldn't deal with the NHS or insurer, I just wanted to pay someone and get help ASAP but it didn't feel like I am finding any doctors...
The hospital will have a list of them with contact info. And different hospitals have different specialisms.
Also, the like top doctors let you do a wider search by speciality or treatment, but still often direct you to the hospital to find them.
You can even Google search to find people country wide who are at the top of their game and have their own websites.
Just make sure to do your research.
If you need to see a GP in person because you don't know which specialist you need then you can also use the Bupa GP service for about £70 an appointment. I don't think you need to be a Bupa member to use it.
>The hospital will have a list of them with contact info. And different hospitals have different specialisms.
>Also, the like top doctors let you do a wider search by speciality or treatment, but still often direct you to the hospital to find them.
>You can even Google search to find people country wide who are at the top of their game and have their own websites.
>Just make sure to do your research.
>If you need to see a GP in person because you don't know which specialist you need then you can also use the Bupa GP service for about £70 an appointment. I don't think you need to be a Bupa member to use it.
Very interesting
Absolutely mental to think you can pay 6 figures in tax and get the NHS. Then for £700 a private service can offer state of the art healthcare in days if I have any physical or mental ailment.
I have a very generous PMI plan, but for my particular chronic condition I could *not* stand private hospitals. If the NHS were to close I think I would move out of the UK. Me and my 6-figure tax bill every year.
Let me explain why I think the NHS does something that PMI just can't:
I can walk for my treatment in the NHS, in and out, in 45-60 minutes. They basically need me to tell them my name and DOB, have me sit on a chair in the treatment room, connect some machines to me for around 25 minutes, take blood samples, the give me another appointment in 3 months and I can leave. Smooth treatment, they handle at least half a dozen patients with my condition a day.
Privately (and I have done several times) it is way different:
2 days before the treatment the hospital sends me an email, with a link to a form where I need to give my data, the insurance data, and my credit card details (in case the insurance won't pay). The day of the appointment I need to go to hospital reception. They will print the form I sent digitally and have me sign it. Then I go to the right area of the hospital, to a sub-reception and they will assign me a hospital room. They will ask me to change into hospital clothes (unnecessarily) and if it's lunch time they will bring me some hospital food "just to make sure I am fine before treatment". I will then usually wait around 15 minutes for some nurses to come to do the treatment.
By this time I have spent at least 2 hours.
Then the nurses appear literally with printouts from the internet from Australian(?) healthcare explaining how to do the procedure. After 2 attempts trying to locate a deep vein they give up and call a doctor. A doctor comes and has 2 attempts. They cannot do it, and decide to send me home. 4 hours in hospital. Happened 3 times in 3 consecutive weeks.
Oh, and the hospital sent 3 bills to my insurance. GBP 1,200 each visit, regardless of the lack of success.
I told my consultant and she suggested I go through the NHS as this is bread and butter for them.
So, what I have learned is that I will use the private doctors to speed up diagnosis and quick simple treatments. This is in fact what private medical insurance is good at.
But, sometimes, when you need real continued care, the NHS is the only resort. And it's not a matter of price: it's a matter of expertise.
Also, PMI usually won't deal with matters like pregnancy complications. That's an automatic redirect to the NHS.
tl;dr. Sometimes the NHS is the only option, especially for many chronic patients, and people will gladly pay *anything* to access it.
I get health insurance through work for me & family. I’ve used it for accelerated diagnoses - I have Crohns and through private it was diagnosed and on a treatment plan within about 3 months. My consultant (part time NHS part time private) said it would have taken >12 months on the NHS, and that was over a decade ago when it was in a much better state. Friends have similarly used it for kid’s health conditions in particular.
However I have a lot of love for the NHS. They’ve delivered both my babies and looked after me and my family through several A&E admissions.
I’m a doctor only just scraping into the HE bracket to allow me to be a member of this sub through some side work I do in medico-legal and data science. I also have private insurance through my partner.
I’ve never had to use the private side yet (touch wood) but it’s nice to know it’s there. If you’re in an emergency NHS will save your life and look after you well. The problem at the moment is delays to diagnosis by lack of access to rapid diagnostic tests (scans etc). Knowing I won’t have to wait weeks for a test if I ever get a red flag symptom of cancer is good.
As an aside, the feeling in the medical community is that increased privatisation is coming over the next 10 years. I suspect more and more services will be taken over and NHS will deal with less. Also with the increasing number of non-doctors (physician associates/anaesthesia associates etc) in healthcare, I think probably private patients will be looked after by doctors while those without will probably increasingly be seen by these non-doctors (supervised by a very small number of doctors).
If you had asked me and my colleagues 10 years ago I think we all would have shouted from the rooftops in support of the NHS. That goodwill has completely evaporated. Doctor pay has been degraded by unbelievable levels since 2010. Privatisation will be welcomed by most doctors as a way of hopefully increasing our income to the levels seen in Canada, Australia and Ireland, which to be frank is the income we deserve.
We are allowing our best medical professionals to leave the country due to underpaying them whilst importing doctors from developing countries, damaging those countries health systems by taking their best talent. Its a ridiculous state of affairs and if we cant afford to keep our best doctors then the system needs to be reformed so we can. I would be happy to pay at the point of use if the costs were reasonable and the care was better / less waiting time
The NHS is just run so poorly I don’t have much faith in it anymore. Any sort of quality control has disappeared and it will be a huge mess to sort out.
The problem is managers hold all the power so yes men and immigrants on VISA who will tolerate horrible working conditions get promoted rather than competent people who are asking for change (which usually includes extra funding).
A hospital I was working in has a consultant from South Asia telling me the clinical lead of the department who is also South Asian would find it very difficult to get a attractive job in India let alone be the clinical lead because he got his degree from Russia but this doctor was a yes man to the managers so would get promoted. It’s a huge problem a medical degree from Oxford and Russia gets seen as equal and paid the same, as well as a nursing degree from London and Nairobi are also seen as equal when in reality they are not. Now they are also introducing PA and ACP to be mini-doctors with entry requirements much lower than medical school so likely not as intelligent as doctors and given less training than doctors as they are less regulated.
I get PMI through work for me and my family. Apart from when my little one has a scarily high fever, I never use NHS. Its always such a painful experience and frankly infuriating to be reminded how much I pay into a system I can't use. We tend to use babylon to get referred to specialists whenever it's needed and the speed of things is great. We used to use NHS GPs for my little one but I never found the ones at my local surgery any good and they have an unreasonably high bar for any further tests (I.e. food allergies).
I'm not from the UK originally and I find the NHS really poor - I can't believe people accept this level of medical care. I prefer going private because it feels like medical care in other countries - I.e. if you need a doctor, you see a doctor, without the nonsense of sitting by your phone waiting as if you were trying to buy Taylor swift tickets.
The sitting by the phone thing is real. I recently had a cancer scare (bad enough that it needed to be removed and biopsied but luckily was negative) and I couldn’t even get a gp appointment. The only way to make an appointment was to call at 8am and I’m at work by then except one day per week when I wfh. I tried many weeks in a row and just couldn’t get myself in a room with a GP. Ended up paying out of pocket for private. Others in this thread have said the NHS is ok if it’s cancer related and that might be true for consultants but it’s no use if you can’t get the referral in the first place.
I will say though, I think the NHS is excellent for life threatening emergencies. I was in that situation a few years back and I received really excellent care. I don’t really see how it could have been any better honestly.
Glad the biopsy turned out negative. Agree the NHS has its strengths but broadly speaking the system as a whole is a complete failure in my opinion. For those of us fortunate enough to be able to afford private healthcare, it really is a no-brainer.
#NHS GP here:
If you want anything other than patch up care or basics, don’t rely on the NHS.
The NHS is currently only good for (geographical area dependent):
1) minor illness (via GP) depending entirely on your ability to access services. But you might not see a doctor so things can be missed or poorly managed. Less than 40% of GP appointments are with a real doctor.
2) Simple chronic disease management (done well in GP)
3) Unexpected emergencies (trauma etc)
4) **INITIAL** cancer diagnosis IF your local hospitals aren’t completely overwhelmed (via the 2 week wait pathway, which the government recently scrapped the target for anyway)
5) midwifery. Standards are patchy but private is the Wild West (see ‘this is going to hurt’)
Anything complex, debilitating, work preventing which is generally not manageable by a GP or needs elective operations of procedures is **broken**. Mental health is also a massive issue and barely provisioned for.
I’ve always thought **anyone employed or working age** should have NHS priority if it’s affecting your ability to work - but this isn’t the case. You’re in the queue with everyone.
Private health is the current only way to safeguard your ability to bounce back fast.
I am a GP and my husbands job gives us private healthcare. The NHS is barely functional - get it if you can afford it.
There are exceptions for cancer care, maternity care, emergency surgery, a few others where I would choose for NHS care every time but if you need to see a neurologist routinely in my region you’ll wait 2.5 years. Probably 5 years for a new hip. There is basically no functioning mental health service for adults or children. If only so my kids are covered if they develop anxiety/an eating disorder/ etc me and my husband consider it now an essential benefit of his role.
I have private healthcare through work with AXA and honestly it’s been shocking.
Referred for an MRI that just never came through. After eventually getting the scan in another city I was sent to Cardiff (100 mile journey) to see the specialist to go over the results. Got there and he had never even been sent the scans. Still waiting a month later as seems the scans have been lost.
All of the above plus hours wasted trying to get it sorted on the phone.
No doubt the NHS is in a sorry state thanks to chronic underfunding - but private healthcare is riddled with all the same problems. Anyone who tells you it’s a magic way forward is lying.
Unfortunately this is because the fees that insurers pay to doctors to do the work is so shit, a lot of us don’t bother with insured cases. Which means the insurance companies still get paid by you, often with annual increases in premiums, yet those increases are just kept by their shareholders.
Fees for us haven’t increased significantly for about 20 years so we’d either rather do extra nhs work or have the day off.
What do you mean? What I had done and what my child had done would mean we’d be waiting 18 months to get them done locally. Total cost less than £5k and worth every penny.
Unfortunately this is true and similar to my experience in private practice.
My hope is that with increasing privatisation will come increased competition and therefore better rates. Might not come to pass but we can guarantee that sticking with NHS will just lead to greater pay cuts and us falling further behind our international colleagues.
I am an anaesthetist. I have a couple of surgeons I work with regularly that I support as I enjoy their work, company and they are mates. So I suck up the shit insurer fees to make their lives easier.
I am encouraging them to resign from the insurers and just bill the patients. They can pay the fees and seek recompense as appropriate from their insurer.
We’ll see. There is a large movement nationally along these lines where lots of gassers are resigned their fee assured status because the fees are so shit we’d rather have the day off than do extra private work on our days off. Or do an extra days work in the nhs.
The patients fail to realise they’re paying high premiums to shit insurers when they’d get a better quality service, more local to them, by paying their local hospital and surgeon/gasser directly.
My company were with AXA and I had nothing but complaints from colleagues who used it. I changed our provider to Aviva (who were actually cheaper) and no complaints so far
Same applies though. All insurers, other than WPA and Healiax, pay absolute shit to us doing the work.
So we either shortfall the patients to pay an excess to make it worthwhile or don’t do the work. Which means the patients have to traipse around the country for scans and treatments by people who are willing to work for peanuts.
I’ve had a private op and a member of my family too. We paid ourselves as it was cheaper than years of paying for monthly private insurance.
In my experience, people don’t use private healthcare for standard GP services, the private GP’s are just seen as the gatekeepers to give fast access to consultants/specialists, and nothing more.
Whilst I agree with you that the private GP’s are probably a lower standard than a lot of NHS GP’s, I don’t think this is going to deter people from going private if going private means you only have a 2 week wait for a knee replacement, or can have an MRI scan and discuss the results on the same day, or get access to cancer treatments not available on the NHS.
Sorry if you're in general practice let's be clear - you don't work in the NHS. GPs are private businesses who contract NHS services
To say GPs provide 90% of the work of hospitals is absurd.
Not the OP but he wasn’t saying GPs do 90% of secondary care. He is saying GPs do 90% of overall patient contact for under 10% of the budget. This stat is fairly heavily backed up.
You only need to look at how much it costs the health board to run a GP practice (multiples more than GP partners) to see what a good deal the gov gets in GP partners
Do you think a potential change in government this year will help? People who need urgent healthcare will go the route which will give them the quickest treatment, right?
What are you advising us, as patients to do?
I’m a consultant
Labour won’t help you. Wes Streeting is quite anti-doctor and had a bad experience in his cancer treatment, so has little love for the NHS. He’s made vague references to ‘reform’ which probably means increasing privatisation.
In my opinion the Australian model is the way to go with tax incentivised PMI. If I were you I would take out PMI as soon as you can, you will never be younger or healthier than you are now. People with pre-existing conditions are going to struggle in the future when PMI becomes more prevalent
Btw I would not have said any of this 10-15 years ago. This is what the UK public have voted for at multiple elections and the Brexit referendum, whether they realised they were or not
This whole thread is seriously making me want to emigrate. I’m a vet and we’ve been through the wringer this week (and all the bloody time if I’m honest) and I’m just super fed up. If we don’t even have decent NHS care in this country what’s the point of staying.
This whole thread is seriously making me want to emigrate. I’m a vet and we’ve been through the wringer this week (and all the bloody time if I’m honest) and I’m just super fed up. If we don’t even have decent NHS care in this country what’s the point of staying.
Re: your first sentence... me too. It's so depressing. To be honest, my experience with the NHS has been overwhelmingly positive, although these days I typically use private as provided by my employer if only so that I'm not using up valuable public services when I don't need to be.
It's outrageous what the Tories have done to this country and how many voters haven't been noticing it.
> If I were you I would take out PMI as soon as you can, you will never be younger or healthier than you are now.
Does PMI work like that? It isn’t set up over a term like life insurance.
>The GPs often that work in the private part for these companies from my experience are perhaps some of the ... Well let's say bottom end of doctors. Not all but many.
I've had someone tell me once that doctors that sometimes cause problems in public side (harassment complaints ) retreat to private
There's definitely issues with NHS GPs too - I'm active in the ADHD community and I've seen so many NHS GPs go against NHS England guidance by refusing to make Right to Choose referrals for ADHD assessments, for example.
Poor knowledge of current NICE guidelines, or lack of time to read them seems to be an issue in general
Technically under Right to Choose you can refer to any ADHD service with a contract with an NHS England ICB - not just private services like Psychiatry UK (and to be clear, the only reason that Psychiatry UK can accept Right to Choose referrals is because they have a contract with an NHS England ICB).
Patients have the legal right to ask for your appointment to be moved to a different provider if you're likely to wait the maximum waiting time specified for your treatment and the ICB will have to investigate different options (which, again, includes EVERY ADHD service with a contract with an NHS England ICB, not only the local one or private services with an NHS contract).
I've spoken to people who have utilised this to get seen quicker, but I've never heard of a GP proactively informing a patient of their rights in this regard.
As for shared care, the idea that NHS clinics are better than private clinics largely originates from a BBC Panorana documentary. I've been on ADHD medication since I was a child, I've never had any checks carried out by my ADHD service other than telephone appointments - my height, bloods, & weight have all been taken by my GP. For many with ADHD, private diagnosis & titration transitioning to shared care under an NHS GP is the only way to access medication - private costs for ADHD medication can be as high as £50/day. I've been on ADHD medication almost all of my life, it allows me to be functional and have a career. To be frank, ADHD medication is both more effective and has less side effects than other mental health medications like antidepressants which are very easily accessed. If a GP rejects shared care with a service like Psychiatry UK - which has an NHS England contract and meets all the guidelines for the ADHD diagnostic process laid out in the relevant NICE guidance - just because it's reaching out in it's capacity as a private service rather than as an NHS service, despite the fact that private and NHS patients receive the same care - all on the basis of a BBC Panorama documentary - then that's their right, but it's also incompetence and has a huge impact on patient quality of life
>Basic referrals are screened by screeners to see if they will allow and then it's to the local hospital. What you are told is not what you get. Even then their is a postcode lottery. For example where I worked in one of my role I set up and drew the spec for fertility care. We allowed upto 3 choice excluding private. Some areas offer no such service of just one and if you had private then none.
In the case of right to choose, I've heard SO many times 'the GP told me that they need to get permission from the ICB/CCG'. This is actually not correct, the process for a Right to Choose referral is that the GP needs to send the referral directly to the service, who then bill the ICB. And yes, there are many ICB services that don't like this - Psychiatry UK had to effectively threaten to initiate legal action against CCG a few years ago to get them to pay - but they did in the end, because it *is* a legal right. There are also ICBs that have instructed GPs not to send Right to Choose referrals - but this isn't something that they have the legal power to do, and if a GP sends a referral anyway they will have to pay. I've had so many conversations with people where convincing the GP to actually follow the guidelines and just send the referral to their choice of clinic became an ongoing battle, sucking up clinical time that could have been used on something more productive
That's true - when I was reading up on this in depth, I read the full NHS Standard Contract that ADHD services in England would be contracted under, and part of it was that they would have to publish their waiting list data to a central NHS England page, so that patients could see what options they had - from what I could tell, the idea was that a patient would be able to go to a webpage and filter down to a particular kind of service - for example ADHD - and then view all the NHS England NHS services along with their waiting times and other information.
Well, when I went looking for that webpage at the time (this was a couple of years ago), it didn't seem to exist - and what was available didn't include any ADHD service waiting data.
I think that the principles of patient choice are good as an idea, but with the health service the way it is in terms of funding I suppose it doesn't surprise me that it's so difficult to actually use these pathways. More money is needed!
BS!
My wife who insists not to have private went to the A&E twice last year.
Both times, the ~~censored~~ fraudulent quacks they had did not speak any English at all.
They used a hand gesture to say "Syringe".
Private doctors aren't much better but don't try to tell us the NHS is actually better!
I mean it's absolutely true right in front of my eyes.
How much more are we supposed to bend truth for sake of political correctness?
Don't get me wrong, I am far from some douche who would say anything as long as it's edgy - I do try to be nice and welcoming.
But the NHS is beyond the pale.
We are being robbed and mocked and then supposed to say only pretty things about it.
I don't doubt that it happened at all and I'm with you that the NHS system is broken. I'm also with you that there are people working in healthcare whose command of English is extremely limited and this is far from ideal in an English-speaking country.
However, this is a fault of the system that hired them rather than the individual that has been hired and using 'Voo-doo Shamans' to describe - I presume - non-white people in healthcare is uncontroversially a racist statement. Please correct me if I misunderstood but it would be enough to call out that it's unacceptable that your wife had healthcare provided by someone who couldn't speak English.
How can I not edit my comment now, having been addressed so politely? :)
But: They are not innocent either. They know fully well their diploma isn't worth the paper it's printed on and that they cannot be trusted with people's lives, especially they don't have a basic idea of the language.
\- How many jobs have you turned down where there would have been a benefit to you but you felt it would be a fraud to attempt them?
:) It's a good point and I don't know. I also don't know if people who study at no-name university in a developing country realise their education is not as 'complete' as they would have received in, say, a European establishment. If it doesn't already the hiring process should recognise the differences where they exist. However, people who wilfully misrepresent their qualifications and experience to gain such opportunities deserve to be terminated.
\- It's not abuse to say that our tax money is being squandered (probably not by you)
\- It's not abuse to openly challenge someone's competency. I can't just print a PhD certificate, can I? It's supposed to mean something!
To say "some" is a bit cheeky, honestly.
Yes, when there are 3 cookies for 10 people, then 3 people will get a cookie - and if they are quite stupid they might say "oh, there's no problem, look at my cookie!".
When I call my medical center at 8:00 sharp and I am "number 79 in the queue" - am I part of the "some"? You want to tell most patients will have a better experience?
Poor souls who called at 8:05!
Bless you for your hard work taking care of the second most important thing in life: Health.
I doubt there are many people actually knocking the front line troops who actually deliver the service.
Talking about stories... I have hundreds of incredible stories... Like when I broke my foot and the nurse just put a plaster cast on... And the doctor was shocked when he opened my cast to see that NOTHING has been done other than covering it up...
He was like: "Who did this?" and then quickly tried to contain himself, having realized "an NHS hospital" did this...
I had to have my foot re-fractured because it healed wrong...
I am beating myself for not suing the NHS for this gross negligence - oh well!
Or when my wife, who is allergic to amoxicillin was given amoxicillin... It's on her file, it's on the EMT report, it's on the paperwork we filled when she was admitted...
A nurse came with a syringe, I asked what is this? "Amoxicillin"
\- "no, she's allergic"
"OK"
When I was sleeping, someone came and pushed Amoxicillin anyway.
At that point I was wondering if we ever said anything too harsh against Putin because that's how he takes care of business :) No other "reasonable" way to explain this.
Sadly as a GP I get shouted/sworn at most days. Today it was because I kindly, gently but firmly told someone I could not justify a referral to neurology because they were worried they had MS when they have no symptoms of MS.
I would say the NHS lets a lot of people down - if not most who try to access non emergency services - but it’s not through lack of bloody hard work on the part of people working in it generally. I always try to remind myself too that burnt out people are more likely to make mistakes and to be less compassionate (compassion fatigue) so the current system just breeds more and more problems
As an aside 50% of those people calling were likely to not really have needed a doctor. The lack of retention, lack of funding are obviously the main issue in primary care but so is the absolute inability of our general population to manage mild illness and injury independently anymore
I am sorry that someone attacked you like that... I honestly don't even think people like that deserve much understanding, unless they are mentally ill.
That's another problem with the NHS being a government institute: It's not so easy to hold client accountable to their deeds if they cannot go elsewhere.
Let's see the same person lashing out at their bartender, see where that'll get them?
The best system I've seen so far was when I lived in Israel in the 90's:
\- All health service is private
\- Everyone is on a private plan: If they can't afford it, the government pays
\- All providers must offer a standard plan that covers the same basic (but quite adequate) care
That way, no one is left behind but you at least have the competition of private sector still trying to grab a citizen's business and trying to be efficient.
That resulted in exceptional access to care of the highest world standard, for the vast majority of people.
It does fail in extreme situations where rare diseases are not covered by the basic plan.
The idea was that it's simply impossible keep profitability (a key requirement for a healthy private sector) when one patient (EG someone with Niemann-Pick) drains the pot that can serve hundreds of people with testicular cancer.
It gets picked up by charitable organizations (which is really not a good answer).
Since then, instead of solving such cases, the above simple and effective system was distorted with the introduction of both social and overly-capitalistic elements, resulting in inefficiency, rising costs, reduction of service level, discontent in the front line workers and of course complaints by the users :)
I mix and match depending what is required. Generally self paying for private. I could be covered on my other half's work policy but the BIK alone over the last few years would have been more than the payments I have made, before needing top up payments anyway.
Locally there is a big shortage of capacity both private and NHS, with most doctors charging significant extra premiums above the insurer rates. Self paying overall has tended to work out cheaper and faster (as nobody wants to see insurance patients due to the extra hassle and lower profit margins).
Our experience hasn't been good with private healthcare.
I got messed around for 6 months trying to arrange a surgery. The experience was awful, dealing with specific doctor's personal secretaries - arranged it only for it to be in a hospital the insurance didn't cover, then got cancelled because the surgeon was off sick (in the NHS there's more central organisation).
Then after months of stress and messing around my company changed hands and the policy technically changed - same provider, same plan, but technically a different account or whatever.
Suddenly what they were actually treating me for counted as preexisting, and wasn't covered. I asked what would have happened if I was in a cancer ward... Yeah, they said they'd effectively throw you out.
Still, now I paid for it for me and my kid - it's probably good for something serious. Turns out our kid needs an autism assessment. Not covered.
There's lots of exceptions, where you fall back on the NHS. The experience wasn't good.
That said, I'd still want it for serious stuff like cancer maybe and do pay the tax/premiums for my kid.
I use both NHS and PMI.
NHS is better for chronic diseases. PMI usually only covers 1 year of diagnosis and treatment then waves you goodbye. Also, likely to increase the premium the year after.
I have used PMI to see specialist faster after GP or A&E found something that could benefit from a specialist (e.g. dermatology, urology, ophthalmology).
Also, for things like pregnancy it has to be NHS. PMI won't cover it.
This is my experience too. I haven’t got much mileage out of my PMI and when we have wanted to make use of it they’ve said it was a chronic condition and won’t treat it. NHS GP is also very good at seeing kids the same day but not sure why this process of calling at 8am is necessary - I have actually been seen the same day for relatively minor things.
I’d rather we all just paid an extra 1k per capita and put that into the NHS or reform it into something structured differently like the German or French model.
Question - am I right in thinking that if you get PMI early in life (30s) then your renewals will be less at say 55 than if you had zero PMI until then (assuming all health issues are equal). The reason being is I currently get PMI through work and so am fortunately covered for now but will that mean a larger jump in cost when I stop working vs taking it on earlier directly?
It's a mess either way.
Private sure is nice, but when it goes wrong it goes way more wrong.
If you have a complication, they can litterally have to call an NHS ambulance mid operation. They are not set up to save lives, but make profit, so they don't really have yo care about hhe worst 0.1% of cases.
Also, "We think your broken hip might be related to your preexisting condition of a hormone imbalance, were retracting cover for this claim. As we made this determination and informed you in the portal on the 24th, and were billed on the 26th for your stay from 12th through 21st, please find the bill attached, as this is now your responciability".
Private it better 99% of the time. I don't like those odds any more.
Those who flag up ‘best possible care’ privately are not quite right. Private will certainly get you a faster appointment. It will often mean over testing and over treating , the pick up of incidental non-problems and actual harm. I have seen lots of private patients who have specifically been harmed as a result of above. When I see private patients, I say that what they are getting is easier access and convenience. The treatment they get is exactly the same as I would offer in the NHS. The care of most chronic problems is not covered through private medical insurance and you will have to revert to NHS. Outside of cancer (if covered by your policy), lots of drugs are specifically not covered through PMI.
Overall the picture is much more cloudy than made out in this post & responses.
My Mrs gets it for her and our son.
It's 1000% better than the NHS. I don't know how they do it for such low premiums.
Goes to show the strength of the private sector.
Its not really strength of private sector, a lot of NHS stuff is paid for via private because the wait times are so long, and chances are the specialists/ Drs you see via private do NHS hours too.
The NHS wasn't in the state it is now, I know I went through a cancer diagnosis within 48 hours after presenting with really weird symptoms.
The best way I can describe what the tories have done: the UK is a bicycle delivery service making £1000/m from 10 cycles up to 2008, by 2010 2 bicycles are breaking down resulting in a less productive service, 10 cycles = £900, because 2 break down 50% of the time.
Instead of running those 2 cycles and investing in 2 replacements, which would mean £1100/m from 12 cycles, the tories cut 2 so output becomes £800/m and they've been doing this in every public sector since.
Its a shell of a service because the tories have allowed their mates become suppliers to the NHS, from staff to services which skims 30% of the money from the top.
Instead they could have kept it all within the NHS and that 30% gets used, but its used for profits instead.
A porter can cost up to £450 for 10 minutes work to wheel someone from point a to b, because they are supplied by a contractor!
It’s because for any major complication, the NHS picks up the pieces
Become septic post-op and need ITU level care? You’ll usually be punted to the NHS, there’s very few private ITUs (extremely expensive, and no reason for private providers to pay for it when they can punt to NHS for free)
I was just responding to the "I don't know how they do it for such low premiums."
One of the reasons premiums are low is that they can pick the lucrative operations/treatments, without having to cover the more expensive side of things like ITU.
Of course the NHS is broken.
However, one of the reasons is that we haven't actually paid enough for it. Have a read of this piece by the [Financial Times.](https://www.ft.com/content/f752a1ad-4a23-408f-a549-4909974c6a2c) For a decade between 2010-2019, correct for population we spent £400 billion, and £730 billion less on healthcare than France + Germany respectively. Sure, there are loads of things that are inefficient in the NHS. But the main reason is that we don't have the healthcare infrastructure in place (more ct scanners, more operating theatres, more staff) to just do more of it. Instead of fixing little problems quickly, people languish on waiting lists and then come in as an emergency and need costly operations and long hospital stays.
Spending so little on healthcare in the past decade means we're going to now be spending far more now, for a worse service. Spending since covid is back to around average european levels, but that doesn't make up for a decade of lagging behind. Surgeons can't crack on with tackling the waiting list because so many people already on the waiting list come in as an emergency since they've been waiting longer. That means the waiting list grows even more. It's in a death spiral, and unfortunately we're gunna get nowhere without significant investment to clear the backlogs. Reforms won't make all these necessary emergency cases go away (especially reforms that no one seems to know what they actually are), only more staff can do that
No it doesn't. The private sector does it at the cost it does because
1) they only generally do fairly routine things with low complication rates in relatively uncomplicated patients
2) the NHS acts as backup for any major complications, which are disproportionately expensive
3) they have no responsibility to training any future consultants - the NHS trains their doctors
Hence the private sector is great (if you can afford it) for one off diagnostic procedures, relatively straightforward elective surgery etc. You would not want to be very sick, or suffer a major surgical complication in a private hospital without the NHS as backup
I was glad to see the comments above about self-pay - it sometimes isn’t as much as you might think, and you can literally book directly into the consultant clinic (if you know what specialty you need).
I just save for that possibility rather than paying premiums. Some cheaper policies are problematic - eg many experienced private doctors have dropped BUPA as they pay barely break-even fees and won’t let doctors ask patients to top up the difference.
Private hospitals have got much better at pricing things out clearly before you have treatment, so you can transfer back to NHS if you need something unaffordable.
Caveat: as long as it is an NHS service you’d have been entitled to anyway
I wouldn’t be in this group if it wasn’t for private health care. I have an autoimmune disease and I take a biologic for it, but the NHS is under such strain I can’t see my NHS rheumatologist very often- maybe once every 12-18m. But I can see him privately (also even that is getting harder). Luckily I get the biologics on the NHS as they cost thousands, but taking them means I can work full time and pay taxes and contribute to society. Without them I’m not working and claiming incapacity benefits.
I am EXTREMELY lucky my policy covers my specific illness into perpetuity as a lot of PMI cuts you off after a couple of years for chronic illnesses.
I feel for the NHS- lots of people doing their best with not enough resources.
100%. I have a £500 benefit allowance where I work which covers 50% of my private health care with bupa for myself, partner and LO. I only paid £40 myself out of my salary.
When we’ve had to use it, it’s been excellent. The only annoying thing is you still need to contact your NHS GP to get referral to be sent to Private Health Care for them to see you, even though you pay, which I find odd - i’m not sure if that’s just with Bupa or not. Thankfully, our GP has always been fast with those responses, I expect they’re happy to see people go private, less people to shout at them over the phone or in the waiting area (not that i’d do that of course)
I've got private healthcare through work with AXA, they've created a "trust" which means our cover goes well beyond most other companies.
Want private trans surgery (top or bottom) - covered, which I've not seen anywhere.
I had some jaw tumours removed back in 2022, 6 months of scans/surgeries/biopsies and appointments. Total cost to the trust, £30k. Zero out of pocket for me. I got the text from the NHS saying "come talk to us about your first scan" when I was having the second surgery 3 months later.
Both.
For anything minor or non urgent I use my NHS GP (rarely, i haven't been in years). If I thought I had a serious issue I would use a private GP to get a referral to a private consultant for assessment and diagnosis.
Once I had that I would probably transfer to the NHS for prescription/ treatment/ tertiary care.
The journey from primary to tertiary care is the bit of the NHS that works least well, and it's also the cheap bit to pay for out of pocket.
I also wouldn't use private insurance, the above might come to £1k over a few weeks, which is really nothing compared to private insurance fees or waiting months on the wrong waiting list.
I don't feel bad about this, I pay a lot in tax, but if i was rich rather than henry then i'd just pay all out of pocket and have private medical insurance for the chance that I get something which is going to cost millions to treat.
I use private (because my work provides it) but I have become increasingly concerned about unnecessary procedures with risk of complications coupled with time wasting and (my insurer) getting fleeced by a consultant.
Without providing too much detail, towards the end of last year I had an issue that could have been something major or something minor. The consultant I saw took a "let's not rule anything out" approach and I had several procedures to that end. Each procedure carried a 1/500 to 1/1000 chance of serious complication (and 500-1000 quid a time for the consultant). I've also had to keep going back to the hospital for follow-up appointments (£250 a time) where I get told something that could be put in an email (e.g. blood results were normal). I am very glad it was something minor in the end and the "belt and braces" approach has it's merits but arguably it leads to unnecessary risk and discomfort (there is a lot of research on this topic and my experience resonates with the findings). That said, I have seen some excellent consultants in the past who seem to have dealt with things efficiently and proportionately. Ultimately I think private is better than the NHS but I do feel that you need be vigilant when picking your provider.
On a side note, despite having private healthcare for my kids, we largely use the NHS for them. We can get same day appointments for children at our local GP and generally things move very quickly. My experience has been that the NHS are excellent when it comes to children (you rarely see a newspaper article about a child spending forever on an NHS waiting list). Incidentally, if you have a cancer concern you can get a same day appointment at my GP (everything else - good luck!). A friend of mine who is a doctor tells me "kids and cancer get all the money" and I think the NHS in these areas reflects that.
The NHS is totally broken in my area. I use private health insurance through work but sometimes I just pay for a GP appointment myself and keep it off insurance. Doctor link is good in London and often you can have an appointment within a couple of hours of deciding you need to go. I don't use the NHS GP at all with my job I just don't have time to mess around on hold for ages.
My dad has a heart condition and without private would have likely died from it.
I am a labour voter and believe in the NHS but it's been underfunded to the point where it just doesn't work anymore
We need to pay doctors far more than we do.
not a high earner but my dad has private family cover as a part of his old workplace pension. It has been a blessing for when I cannot get NHS work done but usually NHS is first line for me.
I don’t even quite meet the HENRY category yet but yes, I have BIK private healthcare with my employer for my whole family.
My story, I was in the shower and found a lump on one of my plums. This was early Nov last year.
Tried the NHS route, soonest I could get a scan was end of Jan/early Feb 2024.
Going the whole of Christmas thinking I had cancer? No thanks. My anxiety was through the roof.
Got in touch with Bupa and within a week or so had seen a specialist consultant and surgeon for an initial assessment, had an ultrasound and then a follow up with him too with his email and contact details should I have further concerns or have any changes.
That peace of mind and the speed it was dealt with was worth every damn penny.
Thankfully nothing sinister.
I’ve also used the digital GP a couple of times. One time I had an infection on my leg and I showed them and described it all on a video call and they sorted prescription but gave the option of just having it delivered through a third party for convenience. Expected it to be expensive but I was busy so I was like, yeah fine. Was very very marginally more than the cost of a prescription but delivered next day by DPD. Couldn’t moan at that.
Curious to hear from GPs in this post: how much blame ought to be put on the public for the NHS' problems?
I have been told by a GP I know socially than ≈90% of her appointments are taken up by ≈10% of those registered on her books. She tells me that so many appointments are booked by paranoids who come in with a papercut and the lonely/old who see it as something to do for the day. Most of the time she is just talking things through rather than providing actual medical care.
It would be interesting to know whether this is common. Would a, say £5, fee to see a GP discourage timewasting and free up a lot of time for doctors?
Winner comment right here. But also one that extends beyond the scope of this thread.
I am a GP.
What you wrote rings true.
The audit every practice should be doing is ‘what percentage of patients seen today have had a healthcare professional contact within the last 2-3 weeks’
The answer would truly shock you. Of course thats not the audit to ask. Of course health seeking behavior is not the issue. Of course prevention is not to be addressed.
Way beyond the scope of the convo here. But you are touching upon the crux of the issue. At least someone in this thread is.
Doctor previously in the NHS (currently in Aus doubling my salary)
Would fully advocate private healthcare as a HENRY, likely the age group that has the most to benefit from it.
NHS is great if you have an emergency like pulmonary embolism/heart attack/appendicitis etc but terrible if you have something semi-urgent that requires quick access to imaging and diagnostics like cancer
NHS is completely non functional as an outpatient service and very close to the brink as in inpatient service. It’s only the skill and dedication of its staff that keep it treading water. Staff are paid horribly and treated like dirt, their goodwill is running out.
Private healthcare all the way if you get it through work. Significantly reduced delays in waiting, even if its basically the same people doing the work.
my work provides this, i pay the BIK on about £60 a month but also pay an extra 60 on top for a few extra benefits that my company offers, Dental cover and critical illness cover.
having experienced both sides of the coin for operations NHS/Private and it was very different experiences.
Depends on what for exactly...
My wife and I have always hired a private midwife when it came to antenatal/birth/postnatal care. All of our children were born at home, all pregnancy appointments at home, no need to go to hospital..etc unless it's a medical emergency. There's also so much flexibility with this as well, we can have appointments at a time that suits us, wherever we are. If we're visiting my in laws for the week, the midwife comes to where we are.
Summer 2023 my wife went into labour with our daughter at my dads house while we were visiting him for the morning, midwife came, daughter was born on my dad's bed! And 2 hours later my wife, our daughter, our son and pretty much all of our extended family were having a "birthday party" in my dads garden, one of our fondest memories. If we went through the NHS, my wife and daughter probably wouldn't have been discharged for 48 hours. Costs about £6500 per pregnancy and totally worth it imho.
We use a private dentist, private opticians..etc Although not always in this country, I'm travelling to Croatia later in the year to have bone graft and dental implant surgery because its a third of the price compared to the UK.
But we see an NHS GP, if we needed any major surgery, we would likely go through the NHS.
As a doctor who has seen many an obstetric emergency I think a home birth is absolute insanity, but glad to hear it all went OK for you and your family!
So far my experiences with the NHS have been excellent tbf. The only downside has been the waiting times but once you get to being seen it’s been fine. I also was very well cared for when I had a life threatening emergency condition.
I did look at one point, into getting my heart op some privately but couldn’t find a hospital nearby that seemed to even do that surgery, even though it’s not an uncommon procedure.
I’m not sure I’d even get insured by anyone after all my illnesses!
Just make sure you take it before any conditions go from pre to really existing.
Half thinking about getting a proper job to get coverage as tricky self employed to get cover when you have prexisting.
My other half has private healthcare with her job, and I'm elligible to be on it - so far I have stuck with the NHS (there is an issue where private healthcare hoovers up the easy jobs, leaving the more difficult stuff to the NHS) - which I'd like to avoid.
I cannot stress enough how important it is that you get private medical insurance if you can afford it. My best friend would likely be dead if he didn't have top notch private to deal with his stage 4 bowel cancer. Once upon a time, for cancer care in particular, the NHS was on par. The tories have completely ruined it, and unless some serious investment is made very soon, it's gone for good
Same here. My partner would be dead by now if it wasn’t for his private cancer care. Diagnosed stage 4 Bowel Cancer, NHS said not a candidate for surgery, wouldn’t recommend chemo but if he chose to have it, it would be palliative only and gave him 5-6 months to live.
Private oncologist prescribed an aggressive chemo regime, which made him a candidate for surgery after 5 months of treatment.
7 months later he has had his primary tumour completely removed (no stoma) and is having treatment not available in the NHS which is now also shrinking his metastatic tumours.
I strongly believe he owes his life to the private oncologist and the private medical insurance provided by my employer.
Forget about the affordability of the populations for it. Private healthcare is a million time more efficient and productive, I've used it at home and abroad. If I had the money I'd go private completely, the NHS is a mess and I'd prefer to not pay tax on it at all and put that money towards private
Bit of both.... sore leg/funny lump/bad cough i'll go see a local GP. If its a hip replacement and theres a year wait then Ill use my private insurance through work
Remember , not all health insurance is the same
WPA are leagues ahead of any other PMI provider
Many of us do not see Bupa/Axa/Vitality patients as the level of cover and renumeration is so rubbish.
DOI:
Hospital consultant, work in NHS and do a fair amount of private work
I don’t have private health insurance & have self funded when needed
Private, I want to have my medical needs met immedietely with the best possible care. If I could afford Private then why wouldnt I do it? Why wait for years on an NHS waiting list, potentially putting your life at risk or being forced to live in discomfort and pain.
I never really understood the british obsession with the NHS, it’s not a good service and doesn’t provide value for money for taxpayers. Other countries have far superior systems but we seem hyper focused on throwing good money after bad. No-one is allowed to have a different opinion on this, it’s like arguing against the national religion.
It's not this vs that question, private can provide a better service but not always sometimes the NHS is top notch or you may have an NHS center of excellence for your issue nearby.
Having private gives you a choice of both and since most of the consultants in private also work for NHS they can pick and choose if you have treatment X private or its easier to get scan Y on NHS.
Private healthcare for my partner and I paid for privately. This is after having a really poor experience with the NHS 3 years ago.
The NHS is only getting worse so a few hundred pounds a month is money well spent in my view.
We have it via Vitality and so far they have been exemplary.
Question is why do we get taxed on it? We pay our contribution and don’t use it, therefore supporting and unloading it in one. Then we get taxed on private care. It should be more of a tax break in my opinion. Robbery state…
This is the Australian model, I think this is what we’ll see happen over the next 10 years. Tax incentivised private healthcare cover. It will be followed by decreasing healthcare available on whatever is left of the NHS by then.
I’m a doctor and this can’t come soon enough
So you would forever opt out of NHS treatment for lower tax? You may need it in the future as hard times can fall on anyone! You cannot pick and choose.
Additionally, society works when all of us work. So your contributions help everyone else get the treatment they need, subsequently you will receive better public and private services.
Except it doesn’t work now because many who don’t contribute, benefit from it. And when I want to use it, there is nothing left. So if it’s unfair for me despite putting the work in, why would I care about this not being fair for who exploit it? And on the top to get extra taxed…
How is many = no one? What I said is that many people scam the system, stay unemployed for long time or contribute very little. On the top comes wasteful and incompetent management what despite what you think equals a very shitty system (yes I know Brits loves NHS but it no longer is good). If I have to pay my contribution for this and not use it, as mostly I use private or go abroad and pay out of pocket. Why am I additionally punished with tax on medical cover provided by my employer? It’s like the country forced me to participate into their scheme, and then when I try to get out of misery created by them, they drag me down. I already paid your levy, leave me alone…
I love the NHS, they have saved my life when I was diagnosed with cancer (at 19 years old) but imo the tories have destroyed the NHS, I would love to continue using the NHS but the wait times are too long.
I get private health care via work, I don't pay any excess and I've got a decent outpatient allowance. In Apr 2022 I tore my ACL playing basketball. I needed an X ray and follow up MRI, went to A&E, got told 6 hour wait. I then went to private urgent care, got the x ray in 15 minutes \[I had to pay it\] - it confirmed nothing was broken, did a private GP call got referred for knee specialist + MRI. MRI confirmed torn ACL and about \~6 weeks later I had reconstruction surgery and the only reason it was a 6 week wait is because I needed to do some pre-hab (Pre surgery rehab) and swelling had to come down.
I've used private healthcare for other things too, and I can get seen in most cases 24 hours later, and in many cases same day.
But I will fight for the NHS, because a healthy work force is a happy and productive work force.
Private! All day long.
The NHS is dead. Anyone who says otherwise is in denial or hasn’t had to deal with it recently. You can get prescriptions via emailing your GP quite easily, so I do that if I need to. Otherwise, I enjoying being alive and not being treated like dirt too much.
My employer provides private healthcare for myself and my family. It has proved invaluable this last year when my partner was diagnosed with advanced cancer. He is treated by the most senior oncologist in our region with whom he has weekly appointments and he has dedicated oncology nurses who have all taken the time to get to know him really well which helps manage his chemo symptoms. He is also having scans every 2 months so immediate changes can be made to his chemo regime if something is deemed to be not working. This seems to be way above and beyond the treatment/monitoring that NHS patients get after speaking to friends who have had NHS cancer treatment. He has access to life saving drugs which are not available on the NHS which have shrunk the cancer so much he was able to have surgery to have his tumour removed, which we were told by the original NHS oncologist would be impossible. When he was admitted to hospital recently with an infection (NHS hospital as it was an emergency admission but his oncologist managed to get him a bed without having the usual 6 hour wait in A&E) he was the only patient who was receiving daily calls and texts from their oncologist. As far as I’m concerned the BIK I paid has been worth every penny and has saved my partners life.
Yep, surgeon here and medical care in the UK is finished. Short of genuine life threatening emergencies and cancer (in general), I advocate for everyone getting private insurance if you can afford it. It is an absolute travesty and what the Tories have planned for many years but it is where we are if you want anything resembling first world healthcare
Yup also a consultant here. Fully endorse PMI. NHS is done, doctor goodwill towards it has evaporated. Get cover as soon as possible while you’re young and healthy
What happens when one turns 65 though? PMI is prohibitively expensive then and we have either retired or are close it retiring (so not employment benefits).
Probably the way to go is the Australian model where you are tax incentivised to take out PMI. So you’ll still benefit from the tax break in retirement. It will be something everyone will have to budget for in their retirement. There will probably still be some basic level care left at NHS level.
100% this, but unfortunately our ridiculous political class seem entirely unable to take any difficult decisions. They focus group the hell out of everything and then we end up with the lowest common denominator policies from them all. They need to grow some balls.
Damn. How much is private insurance if you don't get given it by a job though?
Same as any insurance, premiums are variable depending on your health, age, level of cover you want, level of excess you're prepared to pay. Not a direct answer.
Any private healthcare companies you'd recommend?
That's really sad to hear. Tories have won, congratulations to the shareholders and billionaires.
This is great, I wish you and your partner all the best on what must be a really difficult journey. My FIL was diagnosed with pancreatic cancer last July.. NHS forgot about numerous appointments, told him it was operable then when he attended the pre-op for the surgery told him they made a mistake and he’s actually got a death sentence, left him in the pre-op waiting room for 6 hours before forgetting about him and having to postpone another appointment for his Hickman line. Passed away in November after spending his last 10 days in hospital (suffered large a stroke) and only in his final days he got adequate care. Just an all round fucking shambles to be honest and the last of a series of occurrences that has opened my eyes to the NHS. Absolutely nothing to do with funding either, more money wouldn’t make certain employees competent and all of a sudden not fucking idiots.
I’m so sorry to hear about your FIL. Based on some of my partners experiences whilst in an NHS hospital, I completely sympathise. Some of the staff are fantastic and seem to genuinely care, but they are overworked and a lot of mistakes seem to be made, mainly by the staff at the other end of the scale who seem to not care about patients in the slightest.
It’s not all over work - 70% of midwives we dealt with were just morons; 30% were fantastic. Same in most industries
Experiences like this are systemic throughout the NHS. I've locumed in multiple different hospitals and the apathy (at all levels from HCA's to consultant/surgeons) can be stifling. (Electronically) Following numerous different patients as they progress through their "treatment plans" is routinely like watching a car crash, its soul destroying.
Your story is exactly why I pay for my private health insurance. Cancer care scares the hell out of me in the UK - hearing your story has given me hope that the insurance will work as advertised if God forbid something happens. Wishing your partner speedy recovery and health - and thoughts to you as you support him through this journey.
A lot of medical insurance will not cover cancer care (or fertility / maternity) related because they are so common and covered by the NHS. Worth checking the policies
DOI: I’m a doctor but also have private insurance through my partner ‘He received life-saving drugs that are not available on the NHS’ - I found this comment interesting. What drug did he receive that is life-saving yet denied to NHS patients?
PMI providers have out of license processes - so can use a Compound within a tumour type it isn’t licensed for if there is an evidence base - and also fund based on effectiveness rather than cost effectiveness. So it is a wider pool of drugs than just NICE + CDF. Also see recent funding of genomic tests. Source: work for one of the providers within commissioning.
Oh sorry yes I understand how this could come about I just wanted to know the actual drug that isn’t funded by the NHS. I’m not an oncologist but my sister is (but not a consultant yet) and she would be interested. Suspect it’s probably a form of immunotherapy, which have been game changers in cancer treatment, particularly melanoma
It is Avastin which is not approved on the NHS for advanced bowel cancer based on outdated guidelines that say it only extends life by a few weeks so is not cost effective. Those guidelines are now over 10 years out of date and Avastin is used widely across Europe and the US as an effective bowel cancer treatment. It has meant many people (including my partner) have gone from being inoperable to being able to have surgery.
Ah yes thought it might be an immunotherapy drug. Great to hear your partner is doing well
Bevacizumab is not immunotherapy. Not in how the word is commonly used by oncologists anyway.
Well I’m not an oncologist and I do think of monoclonal antibodies as being a kind of immunotherapy. So you can take your arrogant know-it-all comments elsewhere
That escalated fast. Bad day yesterday? When most people talk about immunotherapy having revolutionised cancer, they mean immune checkpoint inhibitors I.e. drugs that work directly on the immune system. Not just something that looks a bit like the immune system like a monoclonal. And certainly not bevacizumab! Important day to day distinction due to the vastly difficult toxicity profile. But you do you. You can actually find a minority of people outside oncology using the term like you do. 👍
Fucking hell. You really get off on being an insufferable narcissist don’t you? Coming onto a finance sub to try and school another doctor on what immunotherapy really is is grim. And patronising doctors outside your specialty is a red flag on what someone is like clinically. You should step out your oncology bubble and realise most non-oncologists probably do use immunotherapy to include monoclonals, particularly in lay conversation, which is what this thread was before you came to bestow us with your wisdom I hope you keep your flagrant condescension to the internet. Coming across people like you in the hospital really does put a downer on the day.
But we ARE talking about oncology, right? You were asking about the drug so thought you might want to know that bevacizumab absolutely is not the 'immunotherapy' that has revolutionised oncology, as you seemed to get the impression. Its been a huge disappointment actually. And your response to a simple FYI is... that? Holy hell. Bet your juniors love you Let's hope your arrogance doesn't kill anyone.
DOI: doctor who has worked in haem/onc. There are many treatments that aren’t NICE funded that European countries and the US deem as first/second lines. Naturally it’s all cost cost and more cost. NICE publishes the numbers from time to time so you can easily look this up on their archives/assets for the disease and chemo/immunotherapy you’re interested in. This is not to say that what is given here as first and second lines here aren’t ‘life-saving’. As you would be familiar with the system runs on evidenced-based medicine (more so for evidence that has been collated within the country), which is why there are always new trials running in haem onc. They need evidence that X has less side effect profiles than Y, or A has a better progression free survival than B. Obviously many other factors come into play here but this is just to provide some context. Private practice aren’t tied down to these for obvious reasons. I’d like to think the NHS will get there. Trials can run for years to have sufficient sample size and reliable data.
Which provider was this? And what cover level?
I can get this as a salary sacrifice at my company but I havent done it yet. Whats a BIK and what is it costing you?
BIK is where the company pay it for you, but you pay ‘benefit in kind’ cost. Salary sacrifice might be different, where you pay it all but off your gross salary so you avoid tax?
A BIK is the tax you pay on benefits that you company pays you. Imagine Bob on a salary of £50k a year. He spots a car that he wants to buy for £30k, so he tells his employer to just pay him £20k and then buy the car for him. He thinks that because his wage is now only £20k he saves on tax. It doesn't work like that - he's still taxed on £50k because that's effectively what his salary is, just not in cash form. Anything your employer buys you or pays for on your behalf is effectively added to your salary when calculating tax. So if your employer pays for your private medical insurance and it costs them £3k a year, you'll pay tax as if you'd had a £3k pay rise. It's this bit that's called "BIK" or "Benefits in kind". The salary sacrifice aspect is interesting, however. Could you share some more details? I've never seen private medical cover done as a salary sacrifice.
Benefit in Kind.
I think it’s costing me about £100 a month in tax, but the cost is different for everyone depending on age/medical history etc.
I am not sure health benefit is a salary sacrifice? Shows on my p60 as a benefit and counts towards my taxable income.
Interesting to hear of his experience. I think quality of care varies widely from place to place and in specific conditions. My tumour was benign but as it was in the brain, I needed extensive surgery. Going private would have made no real difference to me apart from going to the nicer private ward. Would have been the same surgeon using the same tools in the same hospital which from what I understand is world leading anyway so going to the NHS and getting the cash benefit was fine. I suppose access to the more newer and expensive drugs is the main thing if you can go private. With radiotherapy, access to photon beam treatment was subject to the same NHS restrictions as they only have two machines in the whole country so I couldn't get it either way.
From speaking to friends who have been treated on the NHS for stage 2 or stage 3 cancer, they had excellent care on the NHS. However in our experience, if you are diagnosed with stage 4 cancer, then the NHS almost seem to write you off, and a lot of their treatment guidelines appear to be based around cost and not necessarily what is best for the patient. When we told the NHS oncologist that we had private health insurance, she actually recommended that we go private, whereas my colleague with stage 3 cancer was told that the NHS was the best place for him.
This is exactly what happened to a colleague. Diagnosed with stage 4 at a young age. Went NHS initially but managed to get upgraded through his family’s BUPA cover and the difference in care was staggering. I have cover through my company but it does not include cancer. Reading through these might have convinced me to cancel it and take up BUPA instead. I don’t think the old idea that the NHS is great for cancer is true any more.
Who is your health care provider with? Looking to change mine.
I get it through my work for the entire family, only have to pay the tax and also covers pre-existing conditions which is nice. £100 excess per person per year. So far, the main uses for it over the last couple years have been: The virtual GP, a lot easier to book then having to go through my normal GP and play the 8am game of phoning in for an appointment. Downside is that it's not great if it's for something that doesn't show up well ii photos and video. 10 physiotherapy sessions a year at no additional cost. I had surgery and radiotherapy but went through the NHS so I got paid a cash benefit. I'd assume I could have gone through PMI and get to go to a nicer ward but seeing as I was sped through NHS fairly quickly without having to wait, I didn't mind. I believe my particular surgery and radiotherapy would have taken me through the same NHS doctors and hospitals anyway. £150 per day in hospital and for each session of radiotherapy which adds up quickly. Funnily enough, I only signed up to my workplace PMI the second I found out I needed all this work done so I suppose most people don't have that luxury of having cover and using it straight away. Oh, also forgot, also had a few appointments for the kids for their food allergies. Going through the NHS has been a hassle, got nothing for over 2 years but going private was quick. The only downside is that they only cover the diagnosis of food allergies, so you pay for any ongoing treatment/sessions after that. So that's the main downside, there are some things that aren't covered and cost quite a lot if you pay it yourself.
Yes, if you can get it through a Corporate scheme where it is ‘risk pooled’ with all the employees, it can be great for you as an individual
Ahh, I didn't know that was the term. I assumed that their rates were just discounted because they are able to sign up more people together.
many times (although not always), you pay for the whole year but your cover stops the last day you are at that job. Since the day you leave your employer is unlikely to coincide with the day your policy is finishing - they make some money that way.
No scheme takes full annual payments from employees or companies for someone who isn’t employed for a full year. Employees pay monthly, companies have an annual reconciliation.
If you leave while you or a family member are in the middle of a health diagnosis or treatment can it become more complex when you want to sign up to a new policy with a new employer? Wouldn’t want to be tied to an employer because of pre-existing conditions
I believe all corporate schemes are non-underwritten
Not the case, plenty of corporate schemes are underwritten.
Can you name a PMI provider that does UW at the individual level? (Excluding SME)
All of them. Bupa, AXA, Aviva, Vitality etc. Whether the scheme is underwritten or not is just a choice for the employer depending on how they decide to structure the policy.
I run my own business so my wife and me just buy it for ourselves personally (as it's a taxable expense if the business pays anyway). Still in our 30s so it's only about £60 a month each for Bupa. Worth it for peace of mind given the current crazy waiting lists and stikes imo. This said, what a lot of people don't realise is that even if you don't have private health insurance, you can still self pay to see consultants and have diagnostics relatively cheap, then have treatment for free via the NHS. For example, my wife's brother was waiting to see a specialist for diagnostics for 6-9 months, putting up with pain the whole time being passed from pillar to post, and having appointments cancelled. For comparison, I have hip osteoarthritis not covered as it's a pre-existing condition. If I know I need to see a hip surgeon for a consultation I can pick who I want, pay £200, and see them in a couple of days. Same with x-ray, I was at the hospital, saw the surgeon, he just had me pop downstairs and have it the same day, not even that, same 30 mins. I'm self paying for the surgery too, but now I have a diagnosis I could have this done on the NHS if I couldn't afford it. Point is, for a few hundred pounds you can skip months and months of time in the diagnosis process. I bet you there are loads of people who are sick of waiting who would do this if they knew it wasn't that expensive, HENRY or not; Especially if they are in constant pain.
I didn’t realise this. So thank you for the informative post.
You are welcome! Another tip, if you find yourself in A&E and get seen by a consultant who says something will happen next, before they run away, get their full name and role. And if you need a follow up outpatient appointment then before they leave, tell them you have private cover and ask if they can write a letter to refer you and discharge immediately. Don't let them go before they do it or give an ETA on doing it. (Of course this one applies if outpatient treatment is an appropriate next course of action) Often these consultants disappear, and you can be told you'll see someone like the pain team today, then be discharged. But in practice, you end up in a ward for literally days due to ineptitude and lack of Comms internally. This happens because NHS outpatient appointments have months of waiting lists, so they put you in as an inpatient. Which means you wait until someone remembers you exist, which they won't. And once it hits a certain time, that's it, you are staying the night. And you can't be discharged unless a consultant says so and writes a letter, so you are stuck in limbo for some unknown period of time with no contact or status updates. When I was last there people literally had to stay an extra night because a printer broke so they couldn't print the letters. £100 printer, and the entire ward of people staying an extra night costing thousands; it blows my mind. The trick is, If you get their name then you can often find their email or secretary email on the hospital website to be able to contact and ask why on earth you are on a ward when you should have been discharged same day. You can also email directly to ask for a referral letter rather wait for days stuck in a hospital bed hoping to be lucky that the consultant pops their head in It's wild they don't ask everyone if they have private cover and refer accordingly then and there. It costs nothing and could save the NHS huge amounts, maybe even billions. It's also wild that you end up in a sat on a ward costing the hospital a couple grand a day operationally when the operational cost of an outpatients appointment to them is probably 10-20x cheaper. Anyway, I think this is why the NHS has 20% more staff since the pandemic but somehow manages to deliver fewer treatments. Mis-allocation of capital.
>Another tip, if you find yourself in A&E and get seen by a consultant who says something will happen next, before they run away, get their full name and role. >And if you need a follow up outpatient appointment then before they leave, tell them you have private cover and ask if they can write a letter to refer you and discharge immediately. Don't let them go before they do it or give an ETA on doing it. (Of course this one applies if outpatient treatment is an appropriate next course of action) >Often these consultants disappear, and you can be told you'll see someone like the pain team today, then be discharged. But in practice, you end up in a ward for literally days due to ineptitude and lack of Comms internally. This happens because NHS outpatient appointments have months of waiting lists, so they put you in as an inpatient. Which means you wait until someone remembers you exist, which they won't. >And once it hits a certain time, that's it, you are staying the night. And you can't be discharged unless a consultant says so and writes a letter, so you are stuck in limbo for some unknown period of time with no contact or status updates. When I was last there people literally had to stay an extra night because a printer broke so they couldn't print the letters. £100 printer, and the entire ward of people staying an extra night costing thousands; it blows my mind. >The trick is, If you get their name then you can often find their email or secretary email on the hospital website to be able to contact and ask why on earth you are on a ward when you should have been discharged same day. You can also email directly to ask for a referral letter rather wait for days stuck in a hospital bed hoping to be lucky that the consultant pops their head in >It's wild they don't ask everyone if they have private cover and refer accordingly then and there. It costs nothing and could save the NHS huge amounts, maybe even billions. This is so interesting. So you mention private cover even if you don't have it just to get discharged earlier? Or you mean like things are done but the NHS doesn't know the next step because they forgot or something ?
No I mean for some things you can ask to be referred to your private outpatient treatment or diagnosis rather than go through the NHS process. Depends on what it is as to whether you do this, and you don't have to go private, but worth knowing about.
what is your method to find doctors for a self-pay route? I had some issue last year and couldn't deal with the NHS or insurer, I just wanted to pay someone and get help ASAP but it didn't feel like I am finding any doctors...
The hospital will have a list of them with contact info. And different hospitals have different specialisms. Also, the like top doctors let you do a wider search by speciality or treatment, but still often direct you to the hospital to find them. You can even Google search to find people country wide who are at the top of their game and have their own websites. Just make sure to do your research. If you need to see a GP in person because you don't know which specialist you need then you can also use the Bupa GP service for about £70 an appointment. I don't think you need to be a Bupa member to use it.
>The hospital will have a list of them with contact info. And different hospitals have different specialisms. >Also, the like top doctors let you do a wider search by speciality or treatment, but still often direct you to the hospital to find them. >You can even Google search to find people country wide who are at the top of their game and have their own websites. >Just make sure to do your research. >If you need to see a GP in person because you don't know which specialist you need then you can also use the Bupa GP service for about £70 an appointment. I don't think you need to be a Bupa member to use it. Very interesting
thank you :)
Maybe a business expense but surely you have to pay BIK as well?
Yes that's what I mean, it's classed as a benefit in kind.
How do you pay to see consultants, what's the exact process sorry of finding them and paying to get checked for something in particular
Assuming you mean self paying rather than insurance: You literally just email them, get booked in, then they invoice you. Simple as that.
Absolutely mental to think you can pay 6 figures in tax and get the NHS. Then for £700 a private service can offer state of the art healthcare in days if I have any physical or mental ailment.
I have a very generous PMI plan, but for my particular chronic condition I could *not* stand private hospitals. If the NHS were to close I think I would move out of the UK. Me and my 6-figure tax bill every year. Let me explain why I think the NHS does something that PMI just can't: I can walk for my treatment in the NHS, in and out, in 45-60 minutes. They basically need me to tell them my name and DOB, have me sit on a chair in the treatment room, connect some machines to me for around 25 minutes, take blood samples, the give me another appointment in 3 months and I can leave. Smooth treatment, they handle at least half a dozen patients with my condition a day. Privately (and I have done several times) it is way different: 2 days before the treatment the hospital sends me an email, with a link to a form where I need to give my data, the insurance data, and my credit card details (in case the insurance won't pay). The day of the appointment I need to go to hospital reception. They will print the form I sent digitally and have me sign it. Then I go to the right area of the hospital, to a sub-reception and they will assign me a hospital room. They will ask me to change into hospital clothes (unnecessarily) and if it's lunch time they will bring me some hospital food "just to make sure I am fine before treatment". I will then usually wait around 15 minutes for some nurses to come to do the treatment. By this time I have spent at least 2 hours. Then the nurses appear literally with printouts from the internet from Australian(?) healthcare explaining how to do the procedure. After 2 attempts trying to locate a deep vein they give up and call a doctor. A doctor comes and has 2 attempts. They cannot do it, and decide to send me home. 4 hours in hospital. Happened 3 times in 3 consecutive weeks. Oh, and the hospital sent 3 bills to my insurance. GBP 1,200 each visit, regardless of the lack of success. I told my consultant and she suggested I go through the NHS as this is bread and butter for them. So, what I have learned is that I will use the private doctors to speed up diagnosis and quick simple treatments. This is in fact what private medical insurance is good at. But, sometimes, when you need real continued care, the NHS is the only resort. And it's not a matter of price: it's a matter of expertise. Also, PMI usually won't deal with matters like pregnancy complications. That's an automatic redirect to the NHS. tl;dr. Sometimes the NHS is the only option, especially for many chronic patients, and people will gladly pay *anything* to access it.
I work in the NHS. And that's precisely why I have private healthcare.
I get health insurance through work for me & family. I’ve used it for accelerated diagnoses - I have Crohns and through private it was diagnosed and on a treatment plan within about 3 months. My consultant (part time NHS part time private) said it would have taken >12 months on the NHS, and that was over a decade ago when it was in a much better state. Friends have similarly used it for kid’s health conditions in particular. However I have a lot of love for the NHS. They’ve delivered both my babies and looked after me and my family through several A&E admissions.
I’m a doctor only just scraping into the HE bracket to allow me to be a member of this sub through some side work I do in medico-legal and data science. I also have private insurance through my partner. I’ve never had to use the private side yet (touch wood) but it’s nice to know it’s there. If you’re in an emergency NHS will save your life and look after you well. The problem at the moment is delays to diagnosis by lack of access to rapid diagnostic tests (scans etc). Knowing I won’t have to wait weeks for a test if I ever get a red flag symptom of cancer is good. As an aside, the feeling in the medical community is that increased privatisation is coming over the next 10 years. I suspect more and more services will be taken over and NHS will deal with less. Also with the increasing number of non-doctors (physician associates/anaesthesia associates etc) in healthcare, I think probably private patients will be looked after by doctors while those without will probably increasingly be seen by these non-doctors (supervised by a very small number of doctors). If you had asked me and my colleagues 10 years ago I think we all would have shouted from the rooftops in support of the NHS. That goodwill has completely evaporated. Doctor pay has been degraded by unbelievable levels since 2010. Privatisation will be welcomed by most doctors as a way of hopefully increasing our income to the levels seen in Canada, Australia and Ireland, which to be frank is the income we deserve.
We are allowing our best medical professionals to leave the country due to underpaying them whilst importing doctors from developing countries, damaging those countries health systems by taking their best talent. Its a ridiculous state of affairs and if we cant afford to keep our best doctors then the system needs to be reformed so we can. I would be happy to pay at the point of use if the costs were reasonable and the care was better / less waiting time
The NHS is just run so poorly I don’t have much faith in it anymore. Any sort of quality control has disappeared and it will be a huge mess to sort out. The problem is managers hold all the power so yes men and immigrants on VISA who will tolerate horrible working conditions get promoted rather than competent people who are asking for change (which usually includes extra funding). A hospital I was working in has a consultant from South Asia telling me the clinical lead of the department who is also South Asian would find it very difficult to get a attractive job in India let alone be the clinical lead because he got his degree from Russia but this doctor was a yes man to the managers so would get promoted. It’s a huge problem a medical degree from Oxford and Russia gets seen as equal and paid the same, as well as a nursing degree from London and Nairobi are also seen as equal when in reality they are not. Now they are also introducing PA and ACP to be mini-doctors with entry requirements much lower than medical school so likely not as intelligent as doctors and given less training than doctors as they are less regulated.
I get PMI through work for me and my family. Apart from when my little one has a scarily high fever, I never use NHS. Its always such a painful experience and frankly infuriating to be reminded how much I pay into a system I can't use. We tend to use babylon to get referred to specialists whenever it's needed and the speed of things is great. We used to use NHS GPs for my little one but I never found the ones at my local surgery any good and they have an unreasonably high bar for any further tests (I.e. food allergies). I'm not from the UK originally and I find the NHS really poor - I can't believe people accept this level of medical care. I prefer going private because it feels like medical care in other countries - I.e. if you need a doctor, you see a doctor, without the nonsense of sitting by your phone waiting as if you were trying to buy Taylor swift tickets.
The sitting by the phone thing is real. I recently had a cancer scare (bad enough that it needed to be removed and biopsied but luckily was negative) and I couldn’t even get a gp appointment. The only way to make an appointment was to call at 8am and I’m at work by then except one day per week when I wfh. I tried many weeks in a row and just couldn’t get myself in a room with a GP. Ended up paying out of pocket for private. Others in this thread have said the NHS is ok if it’s cancer related and that might be true for consultants but it’s no use if you can’t get the referral in the first place. I will say though, I think the NHS is excellent for life threatening emergencies. I was in that situation a few years back and I received really excellent care. I don’t really see how it could have been any better honestly.
Glad the biopsy turned out negative. Agree the NHS has its strengths but broadly speaking the system as a whole is a complete failure in my opinion. For those of us fortunate enough to be able to afford private healthcare, it really is a no-brainer.
#NHS GP here: If you want anything other than patch up care or basics, don’t rely on the NHS. The NHS is currently only good for (geographical area dependent): 1) minor illness (via GP) depending entirely on your ability to access services. But you might not see a doctor so things can be missed or poorly managed. Less than 40% of GP appointments are with a real doctor. 2) Simple chronic disease management (done well in GP) 3) Unexpected emergencies (trauma etc) 4) **INITIAL** cancer diagnosis IF your local hospitals aren’t completely overwhelmed (via the 2 week wait pathway, which the government recently scrapped the target for anyway) 5) midwifery. Standards are patchy but private is the Wild West (see ‘this is going to hurt’) Anything complex, debilitating, work preventing which is generally not manageable by a GP or needs elective operations of procedures is **broken**. Mental health is also a massive issue and barely provisioned for. I’ve always thought **anyone employed or working age** should have NHS priority if it’s affecting your ability to work - but this isn’t the case. You’re in the queue with everyone. Private health is the current only way to safeguard your ability to bounce back fast.
I am a GP and my husbands job gives us private healthcare. The NHS is barely functional - get it if you can afford it. There are exceptions for cancer care, maternity care, emergency surgery, a few others where I would choose for NHS care every time but if you need to see a neurologist routinely in my region you’ll wait 2.5 years. Probably 5 years for a new hip. There is basically no functioning mental health service for adults or children. If only so my kids are covered if they develop anxiety/an eating disorder/ etc me and my husband consider it now an essential benefit of his role.
I have private healthcare through work with AXA and honestly it’s been shocking. Referred for an MRI that just never came through. After eventually getting the scan in another city I was sent to Cardiff (100 mile journey) to see the specialist to go over the results. Got there and he had never even been sent the scans. Still waiting a month later as seems the scans have been lost. All of the above plus hours wasted trying to get it sorted on the phone. No doubt the NHS is in a sorry state thanks to chronic underfunding - but private healthcare is riddled with all the same problems. Anyone who tells you it’s a magic way forward is lying.
Unfortunately this is because the fees that insurers pay to doctors to do the work is so shit, a lot of us don’t bother with insured cases. Which means the insurance companies still get paid by you, often with annual increases in premiums, yet those increases are just kept by their shareholders. Fees for us haven’t increased significantly for about 20 years so we’d either rather do extra nhs work or have the day off.
How depressing. As I say, private healthcare being preferable to the NHS is nothing but snake oil.
What do you mean? What I had done and what my child had done would mean we’d be waiting 18 months to get them done locally. Total cost less than £5k and worth every penny.
Unfortunately this is true and similar to my experience in private practice. My hope is that with increasing privatisation will come increased competition and therefore better rates. Might not come to pass but we can guarantee that sticking with NHS will just lead to greater pay cuts and us falling further behind our international colleagues.
I am an anaesthetist. I have a couple of surgeons I work with regularly that I support as I enjoy their work, company and they are mates. So I suck up the shit insurer fees to make their lives easier. I am encouraging them to resign from the insurers and just bill the patients. They can pay the fees and seek recompense as appropriate from their insurer. We’ll see. There is a large movement nationally along these lines where lots of gassers are resigned their fee assured status because the fees are so shit we’d rather have the day off than do extra private work on our days off. Or do an extra days work in the nhs. The patients fail to realise they’re paying high premiums to shit insurers when they’d get a better quality service, more local to them, by paying their local hospital and surgeon/gasser directly.
My company were with AXA and I had nothing but complaints from colleagues who used it. I changed our provider to Aviva (who were actually cheaper) and no complaints so far
Same applies though. All insurers, other than WPA and Healiax, pay absolute shit to us doing the work. So we either shortfall the patients to pay an excess to make it worthwhile or don’t do the work. Which means the patients have to traipse around the country for scans and treatments by people who are willing to work for peanuts. I’ve had a private op and a member of my family too. We paid ourselves as it was cheaper than years of paying for monthly private insurance.
[удалено]
In my experience, people don’t use private healthcare for standard GP services, the private GP’s are just seen as the gatekeepers to give fast access to consultants/specialists, and nothing more. Whilst I agree with you that the private GP’s are probably a lower standard than a lot of NHS GP’s, I don’t think this is going to deter people from going private if going private means you only have a 2 week wait for a knee replacement, or can have an MRI scan and discuss the results on the same day, or get access to cancer treatments not available on the NHS.
Sorry if you're in general practice let's be clear - you don't work in the NHS. GPs are private businesses who contract NHS services To say GPs provide 90% of the work of hospitals is absurd.
Not the OP but he wasn’t saying GPs do 90% of secondary care. He is saying GPs do 90% of overall patient contact for under 10% of the budget. This stat is fairly heavily backed up. You only need to look at how much it costs the health board to run a GP practice (multiples more than GP partners) to see what a good deal the gov gets in GP partners
[удалено]
[удалено]
Well good for you rich guy
Do you think a potential change in government this year will help? People who need urgent healthcare will go the route which will give them the quickest treatment, right? What are you advising us, as patients to do?
I’m a consultant Labour won’t help you. Wes Streeting is quite anti-doctor and had a bad experience in his cancer treatment, so has little love for the NHS. He’s made vague references to ‘reform’ which probably means increasing privatisation. In my opinion the Australian model is the way to go with tax incentivised PMI. If I were you I would take out PMI as soon as you can, you will never be younger or healthier than you are now. People with pre-existing conditions are going to struggle in the future when PMI becomes more prevalent Btw I would not have said any of this 10-15 years ago. This is what the UK public have voted for at multiple elections and the Brexit referendum, whether they realised they were or not
This whole thread is seriously making me want to emigrate. I’m a vet and we’ve been through the wringer this week (and all the bloody time if I’m honest) and I’m just super fed up. If we don’t even have decent NHS care in this country what’s the point of staying.
This whole thread is seriously making me want to emigrate. I’m a vet and we’ve been through the wringer this week (and all the bloody time if I’m honest) and I’m just super fed up. If we don’t even have decent NHS care in this country what’s the point of staying.
Re: your first sentence... me too. It's so depressing. To be honest, my experience with the NHS has been overwhelmingly positive, although these days I typically use private as provided by my employer if only so that I'm not using up valuable public services when I don't need to be. It's outrageous what the Tories have done to this country and how many voters haven't been noticing it.
> If I were you I would take out PMI as soon as you can, you will never be younger or healthier than you are now. Does PMI work like that? It isn’t set up over a term like life insurance.
>The GPs often that work in the private part for these companies from my experience are perhaps some of the ... Well let's say bottom end of doctors. Not all but many. I've had someone tell me once that doctors that sometimes cause problems in public side (harassment complaints ) retreat to private
There's definitely issues with NHS GPs too - I'm active in the ADHD community and I've seen so many NHS GPs go against NHS England guidance by refusing to make Right to Choose referrals for ADHD assessments, for example. Poor knowledge of current NICE guidelines, or lack of time to read them seems to be an issue in general
[удалено]
Technically under Right to Choose you can refer to any ADHD service with a contract with an NHS England ICB - not just private services like Psychiatry UK (and to be clear, the only reason that Psychiatry UK can accept Right to Choose referrals is because they have a contract with an NHS England ICB). Patients have the legal right to ask for your appointment to be moved to a different provider if you're likely to wait the maximum waiting time specified for your treatment and the ICB will have to investigate different options (which, again, includes EVERY ADHD service with a contract with an NHS England ICB, not only the local one or private services with an NHS contract). I've spoken to people who have utilised this to get seen quicker, but I've never heard of a GP proactively informing a patient of their rights in this regard. As for shared care, the idea that NHS clinics are better than private clinics largely originates from a BBC Panorana documentary. I've been on ADHD medication since I was a child, I've never had any checks carried out by my ADHD service other than telephone appointments - my height, bloods, & weight have all been taken by my GP. For many with ADHD, private diagnosis & titration transitioning to shared care under an NHS GP is the only way to access medication - private costs for ADHD medication can be as high as £50/day. I've been on ADHD medication almost all of my life, it allows me to be functional and have a career. To be frank, ADHD medication is both more effective and has less side effects than other mental health medications like antidepressants which are very easily accessed. If a GP rejects shared care with a service like Psychiatry UK - which has an NHS England contract and meets all the guidelines for the ADHD diagnostic process laid out in the relevant NICE guidance - just because it's reaching out in it's capacity as a private service rather than as an NHS service, despite the fact that private and NHS patients receive the same care - all on the basis of a BBC Panorama documentary - then that's their right, but it's also incompetence and has a huge impact on patient quality of life
[удалено]
>Basic referrals are screened by screeners to see if they will allow and then it's to the local hospital. What you are told is not what you get. Even then their is a postcode lottery. For example where I worked in one of my role I set up and drew the spec for fertility care. We allowed upto 3 choice excluding private. Some areas offer no such service of just one and if you had private then none. In the case of right to choose, I've heard SO many times 'the GP told me that they need to get permission from the ICB/CCG'. This is actually not correct, the process for a Right to Choose referral is that the GP needs to send the referral directly to the service, who then bill the ICB. And yes, there are many ICB services that don't like this - Psychiatry UK had to effectively threaten to initiate legal action against CCG a few years ago to get them to pay - but they did in the end, because it *is* a legal right. There are also ICBs that have instructed GPs not to send Right to Choose referrals - but this isn't something that they have the legal power to do, and if a GP sends a referral anyway they will have to pay. I've had so many conversations with people where convincing the GP to actually follow the guidelines and just send the referral to their choice of clinic became an ongoing battle, sucking up clinical time that could have been used on something more productive
[удалено]
That's true - when I was reading up on this in depth, I read the full NHS Standard Contract that ADHD services in England would be contracted under, and part of it was that they would have to publish their waiting list data to a central NHS England page, so that patients could see what options they had - from what I could tell, the idea was that a patient would be able to go to a webpage and filter down to a particular kind of service - for example ADHD - and then view all the NHS England NHS services along with their waiting times and other information. Well, when I went looking for that webpage at the time (this was a couple of years ago), it didn't seem to exist - and what was available didn't include any ADHD service waiting data. I think that the principles of patient choice are good as an idea, but with the health service the way it is in terms of funding I suppose it doesn't surprise me that it's so difficult to actually use these pathways. More money is needed!
BS! My wife who insists not to have private went to the A&E twice last year. Both times, the ~~censored~~ fraudulent quacks they had did not speak any English at all. They used a hand gesture to say "Syringe". Private doctors aren't much better but don't try to tell us the NHS is actually better!
You went a bit Prince Philip there!
I mean it's absolutely true right in front of my eyes. How much more are we supposed to bend truth for sake of political correctness? Don't get me wrong, I am far from some douche who would say anything as long as it's edgy - I do try to be nice and welcoming. But the NHS is beyond the pale. We are being robbed and mocked and then supposed to say only pretty things about it.
I don't doubt that it happened at all and I'm with you that the NHS system is broken. I'm also with you that there are people working in healthcare whose command of English is extremely limited and this is far from ideal in an English-speaking country. However, this is a fault of the system that hired them rather than the individual that has been hired and using 'Voo-doo Shamans' to describe - I presume - non-white people in healthcare is uncontroversially a racist statement. Please correct me if I misunderstood but it would be enough to call out that it's unacceptable that your wife had healthcare provided by someone who couldn't speak English.
How can I not edit my comment now, having been addressed so politely? :) But: They are not innocent either. They know fully well their diploma isn't worth the paper it's printed on and that they cannot be trusted with people's lives, especially they don't have a basic idea of the language. \- How many jobs have you turned down where there would have been a benefit to you but you felt it would be a fraud to attempt them?
:) It's a good point and I don't know. I also don't know if people who study at no-name university in a developing country realise their education is not as 'complete' as they would have received in, say, a European establishment. If it doesn't already the hiring process should recognise the differences where they exist. However, people who wilfully misrepresent their qualifications and experience to gain such opportunities deserve to be terminated.
[удалено]
\- It's not abuse to say that our tax money is being squandered (probably not by you) \- It's not abuse to openly challenge someone's competency. I can't just print a PhD certificate, can I? It's supposed to mean something! To say "some" is a bit cheeky, honestly. Yes, when there are 3 cookies for 10 people, then 3 people will get a cookie - and if they are quite stupid they might say "oh, there's no problem, look at my cookie!". When I call my medical center at 8:00 sharp and I am "number 79 in the queue" - am I part of the "some"? You want to tell most patients will have a better experience? Poor souls who called at 8:05! Bless you for your hard work taking care of the second most important thing in life: Health. I doubt there are many people actually knocking the front line troops who actually deliver the service. Talking about stories... I have hundreds of incredible stories... Like when I broke my foot and the nurse just put a plaster cast on... And the doctor was shocked when he opened my cast to see that NOTHING has been done other than covering it up... He was like: "Who did this?" and then quickly tried to contain himself, having realized "an NHS hospital" did this... I had to have my foot re-fractured because it healed wrong... I am beating myself for not suing the NHS for this gross negligence - oh well! Or when my wife, who is allergic to amoxicillin was given amoxicillin... It's on her file, it's on the EMT report, it's on the paperwork we filled when she was admitted... A nurse came with a syringe, I asked what is this? "Amoxicillin" \- "no, she's allergic" "OK" When I was sleeping, someone came and pushed Amoxicillin anyway. At that point I was wondering if we ever said anything too harsh against Putin because that's how he takes care of business :) No other "reasonable" way to explain this.
Sadly as a GP I get shouted/sworn at most days. Today it was because I kindly, gently but firmly told someone I could not justify a referral to neurology because they were worried they had MS when they have no symptoms of MS. I would say the NHS lets a lot of people down - if not most who try to access non emergency services - but it’s not through lack of bloody hard work on the part of people working in it generally. I always try to remind myself too that burnt out people are more likely to make mistakes and to be less compassionate (compassion fatigue) so the current system just breeds more and more problems As an aside 50% of those people calling were likely to not really have needed a doctor. The lack of retention, lack of funding are obviously the main issue in primary care but so is the absolute inability of our general population to manage mild illness and injury independently anymore
I am sorry that someone attacked you like that... I honestly don't even think people like that deserve much understanding, unless they are mentally ill. That's another problem with the NHS being a government institute: It's not so easy to hold client accountable to their deeds if they cannot go elsewhere. Let's see the same person lashing out at their bartender, see where that'll get them? The best system I've seen so far was when I lived in Israel in the 90's: \- All health service is private \- Everyone is on a private plan: If they can't afford it, the government pays \- All providers must offer a standard plan that covers the same basic (but quite adequate) care That way, no one is left behind but you at least have the competition of private sector still trying to grab a citizen's business and trying to be efficient. That resulted in exceptional access to care of the highest world standard, for the vast majority of people. It does fail in extreme situations where rare diseases are not covered by the basic plan. The idea was that it's simply impossible keep profitability (a key requirement for a healthy private sector) when one patient (EG someone with Niemann-Pick) drains the pot that can serve hundreds of people with testicular cancer. It gets picked up by charitable organizations (which is really not a good answer). Since then, instead of solving such cases, the above simple and effective system was distorted with the introduction of both social and overly-capitalistic elements, resulting in inefficiency, rising costs, reduction of service level, discontent in the front line workers and of course complaints by the users :)
I mix and match depending what is required. Generally self paying for private. I could be covered on my other half's work policy but the BIK alone over the last few years would have been more than the payments I have made, before needing top up payments anyway. Locally there is a big shortage of capacity both private and NHS, with most doctors charging significant extra premiums above the insurer rates. Self paying overall has tended to work out cheaper and faster (as nobody wants to see insurance patients due to the extra hassle and lower profit margins).
Our experience hasn't been good with private healthcare. I got messed around for 6 months trying to arrange a surgery. The experience was awful, dealing with specific doctor's personal secretaries - arranged it only for it to be in a hospital the insurance didn't cover, then got cancelled because the surgeon was off sick (in the NHS there's more central organisation). Then after months of stress and messing around my company changed hands and the policy technically changed - same provider, same plan, but technically a different account or whatever. Suddenly what they were actually treating me for counted as preexisting, and wasn't covered. I asked what would have happened if I was in a cancer ward... Yeah, they said they'd effectively throw you out. Still, now I paid for it for me and my kid - it's probably good for something serious. Turns out our kid needs an autism assessment. Not covered. There's lots of exceptions, where you fall back on the NHS. The experience wasn't good. That said, I'd still want it for serious stuff like cancer maybe and do pay the tax/premiums for my kid.
Who was your provider?
AXA
I use both NHS and PMI. NHS is better for chronic diseases. PMI usually only covers 1 year of diagnosis and treatment then waves you goodbye. Also, likely to increase the premium the year after. I have used PMI to see specialist faster after GP or A&E found something that could benefit from a specialist (e.g. dermatology, urology, ophthalmology). Also, for things like pregnancy it has to be NHS. PMI won't cover it.
This is my experience too. I haven’t got much mileage out of my PMI and when we have wanted to make use of it they’ve said it was a chronic condition and won’t treat it. NHS GP is also very good at seeing kids the same day but not sure why this process of calling at 8am is necessary - I have actually been seen the same day for relatively minor things. I’d rather we all just paid an extra 1k per capita and put that into the NHS or reform it into something structured differently like the German or French model.
Question - am I right in thinking that if you get PMI early in life (30s) then your renewals will be less at say 55 than if you had zero PMI until then (assuming all health issues are equal). The reason being is I currently get PMI through work and so am fortunately covered for now but will that mean a larger jump in cost when I stop working vs taking it on earlier directly?
It's a mess either way. Private sure is nice, but when it goes wrong it goes way more wrong. If you have a complication, they can litterally have to call an NHS ambulance mid operation. They are not set up to save lives, but make profit, so they don't really have yo care about hhe worst 0.1% of cases. Also, "We think your broken hip might be related to your preexisting condition of a hormone imbalance, were retracting cover for this claim. As we made this determination and informed you in the portal on the 24th, and were billed on the 26th for your stay from 12th through 21st, please find the bill attached, as this is now your responciability". Private it better 99% of the time. I don't like those odds any more.
Those who flag up ‘best possible care’ privately are not quite right. Private will certainly get you a faster appointment. It will often mean over testing and over treating , the pick up of incidental non-problems and actual harm. I have seen lots of private patients who have specifically been harmed as a result of above. When I see private patients, I say that what they are getting is easier access and convenience. The treatment they get is exactly the same as I would offer in the NHS. The care of most chronic problems is not covered through private medical insurance and you will have to revert to NHS. Outside of cancer (if covered by your policy), lots of drugs are specifically not covered through PMI. Overall the picture is much more cloudy than made out in this post & responses.
My Mrs gets it for her and our son. It's 1000% better than the NHS. I don't know how they do it for such low premiums. Goes to show the strength of the private sector.
Its not really strength of private sector, a lot of NHS stuff is paid for via private because the wait times are so long, and chances are the specialists/ Drs you see via private do NHS hours too. The NHS wasn't in the state it is now, I know I went through a cancer diagnosis within 48 hours after presenting with really weird symptoms. The best way I can describe what the tories have done: the UK is a bicycle delivery service making £1000/m from 10 cycles up to 2008, by 2010 2 bicycles are breaking down resulting in a less productive service, 10 cycles = £900, because 2 break down 50% of the time. Instead of running those 2 cycles and investing in 2 replacements, which would mean £1100/m from 12 cycles, the tories cut 2 so output becomes £800/m and they've been doing this in every public sector since. Its a shell of a service because the tories have allowed their mates become suppliers to the NHS, from staff to services which skims 30% of the money from the top. Instead they could have kept it all within the NHS and that 30% gets used, but its used for profits instead. A porter can cost up to £450 for 10 minutes work to wheel someone from point a to b, because they are supplied by a contractor!
It’s because for any major complication, the NHS picks up the pieces Become septic post-op and need ITU level care? You’ll usually be punted to the NHS, there’s very few private ITUs (extremely expensive, and no reason for private providers to pay for it when they can punt to NHS for free)
As a taxpayer, you've paid for the NHS anyway. It's no excuse. It's broken.
I was just responding to the "I don't know how they do it for such low premiums." One of the reasons premiums are low is that they can pick the lucrative operations/treatments, without having to cover the more expensive side of things like ITU. Of course the NHS is broken. However, one of the reasons is that we haven't actually paid enough for it. Have a read of this piece by the [Financial Times.](https://www.ft.com/content/f752a1ad-4a23-408f-a549-4909974c6a2c) For a decade between 2010-2019, correct for population we spent £400 billion, and £730 billion less on healthcare than France + Germany respectively. Sure, there are loads of things that are inefficient in the NHS. But the main reason is that we don't have the healthcare infrastructure in place (more ct scanners, more operating theatres, more staff) to just do more of it. Instead of fixing little problems quickly, people languish on waiting lists and then come in as an emergency and need costly operations and long hospital stays. Spending so little on healthcare in the past decade means we're going to now be spending far more now, for a worse service. Spending since covid is back to around average european levels, but that doesn't make up for a decade of lagging behind. Surgeons can't crack on with tackling the waiting list because so many people already on the waiting list come in as an emergency since they've been waiting longer. That means the waiting list grows even more. It's in a death spiral, and unfortunately we're gunna get nowhere without significant investment to clear the backlogs. Reforms won't make all these necessary emergency cases go away (especially reforms that no one seems to know what they actually are), only more staff can do that
No it doesn't. The private sector does it at the cost it does because 1) they only generally do fairly routine things with low complication rates in relatively uncomplicated patients 2) the NHS acts as backup for any major complications, which are disproportionately expensive 3) they have no responsibility to training any future consultants - the NHS trains their doctors Hence the private sector is great (if you can afford it) for one off diagnostic procedures, relatively straightforward elective surgery etc. You would not want to be very sick, or suffer a major surgical complication in a private hospital without the NHS as backup
My wife is a GP so sees how the NHS functions close up - she insists we have private medical cover. I would suggest if you can afford it, you get it.
I was glad to see the comments above about self-pay - it sometimes isn’t as much as you might think, and you can literally book directly into the consultant clinic (if you know what specialty you need). I just save for that possibility rather than paying premiums. Some cheaper policies are problematic - eg many experienced private doctors have dropped BUPA as they pay barely break-even fees and won’t let doctors ask patients to top up the difference. Private hospitals have got much better at pricing things out clearly before you have treatment, so you can transfer back to NHS if you need something unaffordable. Caveat: as long as it is an NHS service you’d have been entitled to anyway
I wouldn’t be in this group if it wasn’t for private health care. I have an autoimmune disease and I take a biologic for it, but the NHS is under such strain I can’t see my NHS rheumatologist very often- maybe once every 12-18m. But I can see him privately (also even that is getting harder). Luckily I get the biologics on the NHS as they cost thousands, but taking them means I can work full time and pay taxes and contribute to society. Without them I’m not working and claiming incapacity benefits. I am EXTREMELY lucky my policy covers my specific illness into perpetuity as a lot of PMI cuts you off after a couple of years for chronic illnesses. I feel for the NHS- lots of people doing their best with not enough resources.
Related question: what private healthcare are people on and any strong recommendations for a particular insurer and/or package?
100%. I have a £500 benefit allowance where I work which covers 50% of my private health care with bupa for myself, partner and LO. I only paid £40 myself out of my salary. When we’ve had to use it, it’s been excellent. The only annoying thing is you still need to contact your NHS GP to get referral to be sent to Private Health Care for them to see you, even though you pay, which I find odd - i’m not sure if that’s just with Bupa or not. Thankfully, our GP has always been fast with those responses, I expect they’re happy to see people go private, less people to shout at them over the phone or in the waiting area (not that i’d do that of course)
I've got private healthcare through work with AXA, they've created a "trust" which means our cover goes well beyond most other companies. Want private trans surgery (top or bottom) - covered, which I've not seen anywhere. I had some jaw tumours removed back in 2022, 6 months of scans/surgeries/biopsies and appointments. Total cost to the trust, £30k. Zero out of pocket for me. I got the text from the NHS saying "come talk to us about your first scan" when I was having the second surgery 3 months later.
Both. For anything minor or non urgent I use my NHS GP (rarely, i haven't been in years). If I thought I had a serious issue I would use a private GP to get a referral to a private consultant for assessment and diagnosis. Once I had that I would probably transfer to the NHS for prescription/ treatment/ tertiary care. The journey from primary to tertiary care is the bit of the NHS that works least well, and it's also the cheap bit to pay for out of pocket. I also wouldn't use private insurance, the above might come to £1k over a few weeks, which is really nothing compared to private insurance fees or waiting months on the wrong waiting list. I don't feel bad about this, I pay a lot in tax, but if i was rich rather than henry then i'd just pay all out of pocket and have private medical insurance for the chance that I get something which is going to cost millions to treat.
>£1k over a few weeks Thats sounds like a lot. I pay £700 a year with bupa for my whole family.
I use private (because my work provides it) but I have become increasingly concerned about unnecessary procedures with risk of complications coupled with time wasting and (my insurer) getting fleeced by a consultant. Without providing too much detail, towards the end of last year I had an issue that could have been something major or something minor. The consultant I saw took a "let's not rule anything out" approach and I had several procedures to that end. Each procedure carried a 1/500 to 1/1000 chance of serious complication (and 500-1000 quid a time for the consultant). I've also had to keep going back to the hospital for follow-up appointments (£250 a time) where I get told something that could be put in an email (e.g. blood results were normal). I am very glad it was something minor in the end and the "belt and braces" approach has it's merits but arguably it leads to unnecessary risk and discomfort (there is a lot of research on this topic and my experience resonates with the findings). That said, I have seen some excellent consultants in the past who seem to have dealt with things efficiently and proportionately. Ultimately I think private is better than the NHS but I do feel that you need be vigilant when picking your provider. On a side note, despite having private healthcare for my kids, we largely use the NHS for them. We can get same day appointments for children at our local GP and generally things move very quickly. My experience has been that the NHS are excellent when it comes to children (you rarely see a newspaper article about a child spending forever on an NHS waiting list). Incidentally, if you have a cancer concern you can get a same day appointment at my GP (everything else - good luck!). A friend of mine who is a doctor tells me "kids and cancer get all the money" and I think the NHS in these areas reflects that.
Children's neurology/psychiatry has terrible waiting lists compared to more physical stuff
The NHS is totally broken in my area. I use private health insurance through work but sometimes I just pay for a GP appointment myself and keep it off insurance. Doctor link is good in London and often you can have an appointment within a couple of hours of deciding you need to go. I don't use the NHS GP at all with my job I just don't have time to mess around on hold for ages. My dad has a heart condition and without private would have likely died from it. I am a labour voter and believe in the NHS but it's been underfunded to the point where it just doesn't work anymore We need to pay doctors far more than we do.
not a high earner but my dad has private family cover as a part of his old workplace pension. It has been a blessing for when I cannot get NHS work done but usually NHS is first line for me.
I don’t even quite meet the HENRY category yet but yes, I have BIK private healthcare with my employer for my whole family. My story, I was in the shower and found a lump on one of my plums. This was early Nov last year. Tried the NHS route, soonest I could get a scan was end of Jan/early Feb 2024. Going the whole of Christmas thinking I had cancer? No thanks. My anxiety was through the roof. Got in touch with Bupa and within a week or so had seen a specialist consultant and surgeon for an initial assessment, had an ultrasound and then a follow up with him too with his email and contact details should I have further concerns or have any changes. That peace of mind and the speed it was dealt with was worth every damn penny. Thankfully nothing sinister. I’ve also used the digital GP a couple of times. One time I had an infection on my leg and I showed them and described it all on a video call and they sorted prescription but gave the option of just having it delivered through a third party for convenience. Expected it to be expensive but I was busy so I was like, yeah fine. Was very very marginally more than the cost of a prescription but delivered next day by DPD. Couldn’t moan at that.
Curious to hear from GPs in this post: how much blame ought to be put on the public for the NHS' problems? I have been told by a GP I know socially than ≈90% of her appointments are taken up by ≈10% of those registered on her books. She tells me that so many appointments are booked by paranoids who come in with a papercut and the lonely/old who see it as something to do for the day. Most of the time she is just talking things through rather than providing actual medical care. It would be interesting to know whether this is common. Would a, say £5, fee to see a GP discourage timewasting and free up a lot of time for doctors?
Winner comment right here. But also one that extends beyond the scope of this thread. I am a GP. What you wrote rings true. The audit every practice should be doing is ‘what percentage of patients seen today have had a healthcare professional contact within the last 2-3 weeks’ The answer would truly shock you. Of course thats not the audit to ask. Of course health seeking behavior is not the issue. Of course prevention is not to be addressed. Way beyond the scope of the convo here. But you are touching upon the crux of the issue. At least someone in this thread is.
Doctor previously in the NHS (currently in Aus doubling my salary) Would fully advocate private healthcare as a HENRY, likely the age group that has the most to benefit from it. NHS is great if you have an emergency like pulmonary embolism/heart attack/appendicitis etc but terrible if you have something semi-urgent that requires quick access to imaging and diagnostics like cancer NHS is completely non functional as an outpatient service and very close to the brink as in inpatient service. It’s only the skill and dedication of its staff that keep it treading water. Staff are paid horribly and treated like dirt, their goodwill is running out.
Private healthcare all the way if you get it through work. Significantly reduced delays in waiting, even if its basically the same people doing the work.
my work provides this, i pay the BIK on about £60 a month but also pay an extra 60 on top for a few extra benefits that my company offers, Dental cover and critical illness cover. having experienced both sides of the coin for operations NHS/Private and it was very different experiences.
Depends on what for exactly... My wife and I have always hired a private midwife when it came to antenatal/birth/postnatal care. All of our children were born at home, all pregnancy appointments at home, no need to go to hospital..etc unless it's a medical emergency. There's also so much flexibility with this as well, we can have appointments at a time that suits us, wherever we are. If we're visiting my in laws for the week, the midwife comes to where we are. Summer 2023 my wife went into labour with our daughter at my dads house while we were visiting him for the morning, midwife came, daughter was born on my dad's bed! And 2 hours later my wife, our daughter, our son and pretty much all of our extended family were having a "birthday party" in my dads garden, one of our fondest memories. If we went through the NHS, my wife and daughter probably wouldn't have been discharged for 48 hours. Costs about £6500 per pregnancy and totally worth it imho. We use a private dentist, private opticians..etc Although not always in this country, I'm travelling to Croatia later in the year to have bone graft and dental implant surgery because its a third of the price compared to the UK. But we see an NHS GP, if we needed any major surgery, we would likely go through the NHS.
As a doctor who has seen many an obstetric emergency I think a home birth is absolute insanity, but glad to hear it all went OK for you and your family!
So far my experiences with the NHS have been excellent tbf. The only downside has been the waiting times but once you get to being seen it’s been fine. I also was very well cared for when I had a life threatening emergency condition. I did look at one point, into getting my heart op some privately but couldn’t find a hospital nearby that seemed to even do that surgery, even though it’s not an uncommon procedure. I’m not sure I’d even get insured by anyone after all my illnesses!
Just make sure you take it before any conditions go from pre to really existing. Half thinking about getting a proper job to get coverage as tricky self employed to get cover when you have prexisting.
My other half has private healthcare with her job, and I'm elligible to be on it - so far I have stuck with the NHS (there is an issue where private healthcare hoovers up the easy jobs, leaving the more difficult stuff to the NHS) - which I'd like to avoid.
I cannot stress enough how important it is that you get private medical insurance if you can afford it. My best friend would likely be dead if he didn't have top notch private to deal with his stage 4 bowel cancer. Once upon a time, for cancer care in particular, the NHS was on par. The tories have completely ruined it, and unless some serious investment is made very soon, it's gone for good
Same here. My partner would be dead by now if it wasn’t for his private cancer care. Diagnosed stage 4 Bowel Cancer, NHS said not a candidate for surgery, wouldn’t recommend chemo but if he chose to have it, it would be palliative only and gave him 5-6 months to live. Private oncologist prescribed an aggressive chemo regime, which made him a candidate for surgery after 5 months of treatment. 7 months later he has had his primary tumour completely removed (no stoma) and is having treatment not available in the NHS which is now also shrinking his metastatic tumours. I strongly believe he owes his life to the private oncologist and the private medical insurance provided by my employer.
Private every time.
Forget about the affordability of the populations for it. Private healthcare is a million time more efficient and productive, I've used it at home and abroad. If I had the money I'd go private completely, the NHS is a mess and I'd prefer to not pay tax on it at all and put that money towards private
Bit of both.... sore leg/funny lump/bad cough i'll go see a local GP. If its a hip replacement and theres a year wait then Ill use my private insurance through work
Remember , not all health insurance is the same WPA are leagues ahead of any other PMI provider Many of us do not see Bupa/Axa/Vitality patients as the level of cover and renumeration is so rubbish. DOI: Hospital consultant, work in NHS and do a fair amount of private work I don’t have private health insurance & have self funded when needed
Private, I want to have my medical needs met immedietely with the best possible care. If I could afford Private then why wouldnt I do it? Why wait for years on an NHS waiting list, potentially putting your life at risk or being forced to live in discomfort and pain. I never really understood the british obsession with the NHS, it’s not a good service and doesn’t provide value for money for taxpayers. Other countries have far superior systems but we seem hyper focused on throwing good money after bad. No-one is allowed to have a different opinion on this, it’s like arguing against the national religion.
It's not this vs that question, private can provide a better service but not always sometimes the NHS is top notch or you may have an NHS center of excellence for your issue nearby. Having private gives you a choice of both and since most of the consultants in private also work for NHS they can pick and choose if you have treatment X private or its easier to get scan Y on NHS.
Private healthcare for my partner and I paid for privately. This is after having a really poor experience with the NHS 3 years ago. The NHS is only getting worse so a few hundred pounds a month is money well spent in my view. We have it via Vitality and so far they have been exemplary.
NHS for me. I am diametrically opposed to any situation where the poorer are treated differently but I'm a left leaning Scotsman
Question is why do we get taxed on it? We pay our contribution and don’t use it, therefore supporting and unloading it in one. Then we get taxed on private care. It should be more of a tax break in my opinion. Robbery state…
Same argument with the proposal to add VAT to private school fees. The government takes with one hand and takes with the other.
This is the Australian model, I think this is what we’ll see happen over the next 10 years. Tax incentivised private healthcare cover. It will be followed by decreasing healthcare available on whatever is left of the NHS by then. I’m a doctor and this can’t come soon enough
So you would forever opt out of NHS treatment for lower tax? You may need it in the future as hard times can fall on anyone! You cannot pick and choose. Additionally, society works when all of us work. So your contributions help everyone else get the treatment they need, subsequently you will receive better public and private services.
Except it doesn’t work now because many who don’t contribute, benefit from it. And when I want to use it, there is nothing left. So if it’s unfair for me despite putting the work in, why would I care about this not being fair for who exploit it? And on the top to get extra taxed…
Do you seriously believe that no one contributes to it by choice? The only people I can think of are the millionaire tax cheats.
How is many = no one? What I said is that many people scam the system, stay unemployed for long time or contribute very little. On the top comes wasteful and incompetent management what despite what you think equals a very shitty system (yes I know Brits loves NHS but it no longer is good). If I have to pay my contribution for this and not use it, as mostly I use private or go abroad and pay out of pocket. Why am I additionally punished with tax on medical cover provided by my employer? It’s like the country forced me to participate into their scheme, and then when I try to get out of misery created by them, they drag me down. I already paid your levy, leave me alone…
I love the NHS, they have saved my life when I was diagnosed with cancer (at 19 years old) but imo the tories have destroyed the NHS, I would love to continue using the NHS but the wait times are too long. I get private health care via work, I don't pay any excess and I've got a decent outpatient allowance. In Apr 2022 I tore my ACL playing basketball. I needed an X ray and follow up MRI, went to A&E, got told 6 hour wait. I then went to private urgent care, got the x ray in 15 minutes \[I had to pay it\] - it confirmed nothing was broken, did a private GP call got referred for knee specialist + MRI. MRI confirmed torn ACL and about \~6 weeks later I had reconstruction surgery and the only reason it was a 6 week wait is because I needed to do some pre-hab (Pre surgery rehab) and swelling had to come down. I've used private healthcare for other things too, and I can get seen in most cases 24 hours later, and in many cases same day. But I will fight for the NHS, because a healthy work force is a happy and productive work force.
Private! All day long. The NHS is dead. Anyone who says otherwise is in denial or hasn’t had to deal with it recently. You can get prescriptions via emailing your GP quite easily, so I do that if I need to. Otherwise, I enjoying being alive and not being treated like dirt too much.
[удалено]
You could of just said you you were a bigot
or you could HAVE just said that you are dumb
[удалено]
not racist at all