Consultant appointment in NHS 3 months, 1 month private

growstuff

greenlady102

growstuff

greenlady102

Doodledog

I don't think I am making myself clear.

I'm not saying anyone is moved up the queue, but that they get to join the queue faster than if they waited to see the same consultant on the NHS, as it can be done three times faster (as per the OP) if the patient can pay.

and the answer to that is to stop making consultants the gatekeeper to services.

But you've just written that consultants don't have control over NHS queues!

and if you accept that, how can you say that they join the queue faster. If the queue is operated on a basis of clinical need, how can it matter when you join it?

I don't accept it, but it's difficult to follow your arguments when you contradict yourself.

It is impossible to follow, and feels as though the 'arguments' are simply being grasped to support the 2-tier semi-private system that is currently in operation.

Mrs A and Mrs B both have equally painful arthritic hips.

Mrs A goes to her GP who puts her on the list to see Dr C to discuss a replacement op on the NHS.

Mrs B pays £200 to see Dr C direct and they discuss a replacement op on the NHS.

Mrs A's private appointment is on 3 December, and Mrs B is seen on 6th September on the NHS.

Dr C agrees that the both need replacements and puts both of them on the list.

Mrs A joins the list on 6th September, and Mrs B three months later, in both cases immediately after their respective appointments. Both get replacement hips in the same NHS hospital. Who gets her hip first? And why?

I was in extreme pain and put on morphine. I needed facet joint injections into my upper back, a 16 month wait on the NHS, so I go privately to see the pain Dr and he does his work in the evenings. It’s an excellent service and for me well worth the money. I don’t agree with it at all but at my age needs must. Finally recently it was found that I need an iron infusion as I was severely down on iron. I was dreading the wait but from seeing the Dr to having the infusion in hospital it was 10 days

Until recently, I worked in the private department of an NHS Hospital and believe that Greenlady's comments are correct. I don't understand how a consultant can directly place a patient on an NHS waiting list (e.g. for surgery) because in the Trust that I worked for private patients had to ask their GP for an NHS referral to that particular NHS consultant before they would be accepted on that consultant's list. The GP referrals are sent electronically to the Trust, paper referrals not acceptable to the system, and are evaluated as to medical status at that stage. Greenlady has already explained the system for allocating which patients will be operated on over the next few weeks, chosen by clinical need. In the Trust that I worked for it was simply not possible for a consultant to place a patient on a surgical waiting list, let alone higher up on a surgical waiting list, and no consultant would do that as there are strict rules about this which could impede his/or her career if they were found to have prioritised a private patient without good medical reasons. SuziHi's advice is worth considering.

greenlady102

growstuff

greenlady102

Doodledog

I don't think I am making myself clear.

I'm not saying anyone is moved up the queue, but that they get to join the queue faster than if they waited to see the same consultant on the NHS, as it can be done three times faster (as per the OP) if the patient can pay.

and the answer to that is to stop making consultants the gatekeeper to services.

But you've just written that consultants don't have control over NHS queues!

and if you accept that, how can you say that they join the queue faster. If the queue is operated on a basis of clinical need, how can it matter when you join it?

I don't accept it, but it's difficult to follow your arguments when you contradict yourself.

For goodness sake!

How are GPs responsible for long waiting lists to see consultants?

And how is it relevant that GPs aren't employed by the NHS directly?

growstuff

greenlady102

i can tell you how its done in the service I was involved in setting up and its done by clinical need. The referral from whoever goes into the joint replacement system. the information sent by the referrer is looked at and whatever else is needed for the triage is arranged. So if a private consultant appointment has said that eg the hip is crumbling but the patient has got a blood pressure issue that needs fixing before surgery then the bloodpressure issue will be addressed and that will determine their place in the queue. If the same consultant says that a patient is mobile but in pain which is managed by painkillers then they will go to that klevel of the queue. Nobody gets placed further up the queue because they have been referred by a private practitioner of any discipline. Similarly a fit and healthy paptient with a badly deteriorated hip will go up the queue regardless of how they enter the system.

Meanwhile, some patients haven't even made it to the referral stage.

blame the GP system for that. oh and GP's are not part of or employed by the NHS, they are contractors.

eazybee

If you are able to I would wait the three months, have your consultation, then ask your doctor why you would be able to see him two months earlier by paying £200 . You won't get an honest answer, but you can make your point, It is wrong, and this is why I have no sympathy for the striking doctors.

why is it wrong? If a plumber works his employed hours and then works privately eg at weekends, its ok.

growstuff

greenlady102

Doodledog

I don't think I am making myself clear.

I'm not saying anyone is moved up the queue, but that they get to join the queue faster than if they waited to see the same consultant on the NHS, as it can be done three times faster (as per the OP) if the patient can pay.

and the answer to that is to stop making consultants the gatekeeper to services.

But you've just written that consultants don't have control over NHS queues!

and if you accept that, how can you say that they join the queue faster. If the queue is operated on a basis of clinical need, how can it matter when you join it?

If you are able to I would wait the three months, have your consultation, then ask your doctor why you would be able to see him two months earlier by paying £200 . You won't get an honest answer, but you can make your point, It is wrong, and this is why I have no sympathy for the striking doctors.

greenlady102

i can tell you how its done in the service I was involved in setting up and its done by clinical need. The referral from whoever goes into the joint replacement system. the information sent by the referrer is looked at and whatever else is needed for the triage is arranged. So if a private consultant appointment has said that eg the hip is crumbling but the patient has got a blood pressure issue that needs fixing before surgery then the bloodpressure issue will be addressed and that will determine their place in the queue. If the same consultant says that a patient is mobile but in pain which is managed by painkillers then they will go to that klevel of the queue. Nobody gets placed further up the queue because they have been referred by a private practitioner of any discipline. Similarly a fit and healthy paptient with a badly deteriorated hip will go up the queue regardless of how they enter the system.

Meanwhile, some patients haven't even made it to the referral stage.

greenlady102

Doodledog

I don't think I am making myself clear.

I'm not saying anyone is moved up the queue, but that they get to join the queue faster than if they waited to see the same consultant on the NHS, as it can be done three times faster (as per the OP) if the patient can pay.

and the answer to that is to stop making consultants the gatekeeper to services.

But you've just written that consultants don't have control over NHS queues!

Doodledog

I don't think I am making myself clear.

I'm not saying anyone is moved up the queue, but that they get to join the queue faster than if they waited to see the same consultant on the NHS, as it can be done three times faster (as per the OP) if the patient can pay.

and the answer to that is to stop making consultants the gatekeeper to services.

I don't think I am making myself clear.

I'm not saying anyone is moved up the queue, but that they get to join the queue faster than if they waited to see the same consultant on the NHS, as it can be done three times faster (as per the OP) if the patient can pay.

To be clear, In this system, the private consultant has no control over the NHS queue for surgery. The advantage to the patient is that they can do things like prescribe different pain relief or start the patient on whatever other medication the patient might need eg blood pressure management if that is an issue.

i can tell you how its done in the service I was involved in setting up and its done by clinical need. The referral from whoever goes into the joint replacement system. the information sent by the referrer is looked at and whatever else is needed for the triage is arranged. So if a private consultant appointment has said that eg the hip is crumbling but the patient has got a blood pressure issue that needs fixing before surgery then the bloodpressure issue will be addressed and that will determine their place in the queue. If the same consultant says that a patient is mobile but in pain which is managed by painkillers then they will go to that klevel of the queue. Nobody gets placed further up the queue because they have been referred by a private practitioner of any discipline. Similarly a fit and healthy paptient with a badly deteriorated hip will go up the queue regardless of how they enter the system.

Right, so what are you saying happens? Does the consultant check the NHS queue like people scanning the bus queue to see who would have been next, and slot the paying patient in after them?

Doodledog

The OP has said that she could see a consultant in a month if she paid privately, but in three months if she didn't.

I have known numerous people who have paid, been seen ahead of the NHS queue and then had NHS treatment - it's very commonplace. They may not have jumped ahead of people already waiting for an op, but they most certainly have jumped ahead of those still waiting to see the consultant, who would have been ahead of them in the queue if there had been only one.

Yes, a lot of doctors work part-time for the NHS so they can work the rest of the week seeing private patients. If they weren't able to do this the shortage of doctors would be reduced, as would the NHS queues. If patients seeing consultants privately had to pay for private treatment afterwards they would impact less on the NHS than by being referred back to the NHS after the consultation - the only impact would be on the waiting times to see the consultant in the first place. But as it is, they not only see the consultant ahead of NHS patients, but are referred faster.

More and more people are finding that they have no choice but to pay to queue jump - the queues are very long, and being in pain, or watching conditions deteriorate doesn't give them a lot of choice, and I completely understand that. But that does not mean that they are freeing up an NHS place. If consultants have two separate lists and are only seeing private patients 'in their own time' then how can that possibly be true? It is the fact that the 'private' patients then join the NHS queues that are (a) the problem, and (b) the reason that they pay to see the consultant in the first place.

sorry, added my comment to the wrong quote, i meant to add it to this one.

ginny

I will be paying for all my treatment. Consultation , op and aftercare. I have been in constant pain for the last 18 months and would probably still have another 12 -18 months to wait on NHS.
Nobody knows my / our financial
position but what money we do have has been hard earned. I realise there are those who could unfortunately never afford private care but still reserve my right to spend my money where I see fit.

As I have already said, unless the consultant appointment turns up an uregent life threatening condition, they don't jump the NHS queue....or lets say should not. If they do, its the fault of the NHS. I was involved in setting up an elective surgery joint replacement system who took referrals from private consultants as well as GP's. The person was triaged by the team and slotted into the surgery/treatment queue according to their clinical need. It did save NHS consultant time because the part of the assessment done by the NHS consultant didn't need to be done again.

I will be paying for all my treatment. Consultation , op and aftercare. I have been in constant pain for the last 18 months and would probably still have another 12 -18 months to wait on NHS.
Nobody knows my / our financial
position but what money we do have has been hard earned. I realise there are those who could unfortunately never afford private care but still reserve my right to spend my money where I see fit.

The OP has said that she could see a consultant in a month if she paid privately, but in three months if she didn't.

I have known numerous people who have paid, been seen ahead of the NHS queue and then had NHS treatment - it's very commonplace. They may not have jumped ahead of people already waiting for an op, but they most certainly have jumped ahead of those still waiting to see the consultant, who would have been ahead of them in the queue if there had been only one.

Yes, a lot of doctors work part-time for the NHS so they can work the rest of the week seeing private patients. If they weren't able to do this the shortage of doctors would be reduced, as would the NHS queues. If patients seeing consultants privately had to pay for private treatment afterwards they would impact less on the NHS than by being referred back to the NHS after the consultation - the only impact would be on the waiting times to see the consultant in the first place. But as it is, they not only see the consultant ahead of NHS patients, but are referred faster.

More and more people are finding that they have no choice but to pay to queue jump - the queues are very long, and being in pain, or watching conditions deteriorate doesn't give them a lot of choice, and I completely understand that. But that does not mean that they are freeing up an NHS place. If consultants have two separate lists and are only seeing private patients 'in their own time' then how can that possibly be true? It is the fact that the 'private' patients then join the NHS queues that are (a) the problem, and (b) the reason that they pay to see the consultant in the first place.

Doodledog

Jackiest

If you think the price of private health care is expensive now you wait till there is no NHS and we have no option but to go private.

Private healthcare is expensive, but few people use it. Most of what people say is private care is just paying an NHS-trained consultant working privately in an NHS hospital for a one-off consultation and then jumping back to NHS care, so is not 'going private' at all. That costs a couple of hundred pounds (plus tests in some case), so is affordable for many but lengthens the NHS queues for those who don't have that money spare. It is the operations that these patients then get on the NHS that are expensive. If there were no NHS this would not be an option.

I can't imagine a fully private health system, as people would soon find that they would have to sell their houses or declare bankruptcy because of accident or illness. It isn't just the operations that would contribute to that, but the hospital care (which would no longer be available on the NHS) and the medication that a lot of older take routinely already, plus painkillers and other post-operative drugs.

If NHS treatment moved to insurance-based scheme, the chances are that most of us on here would struggle to pay the premiums, as existing conditions and advancing age will make them prohibitive. Younger people will be justified in saying that they should be able to opt out of paying towards what is now the NHS, so there will be even less to fund those who are not insured.

Sometimes people suggest that the ill-defined 'those who can afford it' should pay for what others get free, but they never pin that down to explain what 'can afford it' means. If that happened, unless 'those who can afford it' included so few people as to make it all pointless, there would be no point in anyone saving for old age or talking out private pensions, as doing so could tip people into the category whose life savings would be wiped out if they needed an operation or life-saving but expensive drugs.

If fewer people had savings or private pensions, it would mean more people claiming pension credit, which would take money out of the general welfare budget, and potentially would also mean that people would have to sell their houses as they do for care. There would also be less money circulating in local economies if fewer older people were spending 'the grey pound' on coffee with friends or other retirement pursuits.

Assuming that people sold their homes to pay for operations, would they be expected to cover the whole cost of healthcare, or a proportion? If the former, would there be a way to ensure that those living in areas with low house price inflation wouldn't get lower levels of care? Would the system suggested for care homes (ie that there is a cap that represents a tiny amount of the average price of a house in the SE, but most of the cost of a house in some areas of the North) be brought in, even though this would further increase geographical unfairness and kill the idea of so-called 'levelling up'?

There is already resentment at the two-tier care system, but it it would be political suicide to extend it to healthcare too.

(Sorry, Mawmac for derailing your thread further, but I often think that people who make these simplistic suggestions haven't thought them through.)

Private consultants are not allowed to work privately in NHS premises unless they pay for use of the premises and the premises are not in use for NHS work. I used to work in the NHS and know this for a fact. They are absolutely not allowed to see private patients in their NHS paid hours. Patients who buy such a service can only "queue jump" if the private consultation turns up an urgent life threatening condition. I also know from personal experience that private insurance will fund treatments eg for cancer that the NHS will not because they are too expensive for the outcome and/or the benefit is not clear. This service provision can help to get NICE to approve such tratments for wider use.

Doodledog

ginny

Doodledog

ginny
I agree. With Sodapop
Also you would be putting everyone else on the NHS list , one place up.
Can you explain how that works, please?

If I am removed from the waiting list , then the next person on the list moves up one place/has one less person in front of them.

No, if there were only one queue, instead of an NHS one and a private one, with the private patients always getting seen first, patients would be seen on the basis of clinical need and not ability to pay.

I don't blame people who are scared and in pain for paying to jump the queue, but I really object to seeing it presented as doing a kindness to the poor souls on the NHS. It really isn't anything of the kind.

The NHS buys the consultant hours that it wishes to. Like anyone else (eg most nurses) they are free to work outside the NHS outside of their employed hours.

Jackiest

If you think the price of private health care is expensive now you wait till there is no NHS and we have no option but to go private.

Private healthcare is expensive, but few people use it. Most of what people say is private care is just paying an NHS-trained consultant working privately in an NHS hospital for a one-off consultation and then jumping back to NHS care, so is not 'going private' at all. That costs a couple of hundred pounds (plus tests in some case), so is affordable for many but lengthens the NHS queues for those who don't have that money spare. It is the operations that these patients then get on the NHS that are expensive. If there were no NHS this would not be an option.

I can't imagine a fully private health system, as people would soon find that they would have to sell their houses or declare bankruptcy because of accident or illness. It isn't just the operations that would contribute to that, but the hospital care (which would no longer be available on the NHS) and the medication that a lot of older take routinely already, plus painkillers and other post-operative drugs.

If NHS treatment moved to insurance-based scheme, the chances are that most of us on here would struggle to pay the premiums, as existing conditions and advancing age will make them prohibitive. Younger people will be justified in saying that they should be able to opt out of paying towards what is now the NHS, so there will be even less to fund those who are not insured.

Sometimes people suggest that the ill-defined 'those who can afford it' should pay for what others get free, but they never pin that down to explain what 'can afford it' means. If that happened, unless 'those who can afford it' included so few people as to make it all pointless, there would be no point in anyone saving for old age or talking out private pensions, as doing so could tip people into the category whose life savings would be wiped out if they needed an operation or life-saving but expensive drugs.

If fewer people had savings or private pensions, it would mean more people claiming pension credit, which would take money out of the general welfare budget, and potentially would also mean that people would have to sell their houses as they do for care. There would also be less money circulating in local economies if fewer older people were spending 'the grey pound' on coffee with friends or other retirement pursuits.

Assuming that people sold their homes to pay for operations, would they be expected to cover the whole cost of healthcare, or a proportion? If the former, would there be a way to ensure that those living in areas with low house price inflation wouldn't get lower levels of care? Would the system suggested for care homes (ie that there is a cap that represents a tiny amount of the average price of a house in the SE, but most of the cost of a house in some areas of the North) be brought in, even though this would further increase geographical unfairness and kill the idea of so-called 'levelling up'?

There is already resentment at the two-tier care system, but it it would be political suicide to extend it to healthcare too.

(Sorry, Mawmac for derailing your thread further, but I often think that people who make these simplistic suggestions haven't thought them through.)

I hate the two-tier system in the health service (and in education come to that).
Having lived in the Netherlands for 18 years where there is one system for all I am appalled at how inefficient and sometimes corrupt our system is!

If you think the price of private health care is expensive now you wait till there is no NHS and we have no option but to go private.