Would a mixed NHS / Private model work?

lostinrates

michaels wrote: »

So this is the heart of my question, I can completely see how unfair it would be but at the same time if it brings in revenue to the NHS for something that they would otherwise be doing anyway for free then I can see that it would also be a 'win' in some ways.

I know basically nothing on how easy it is to get private treatment in the UK or how much it costs or how easy it is to integrate with NHS treatment.

Ok, I might be able to help here a bit as I have both.

You cannot use private to queue jump on NHs. I mean, some might, but, its not wife spread. E.g. I am seeing my consultants privately but i will be having a surgery NHs.

Why? Because its a lot of money not covered by insurance, its probably the first of a series and there might be other work that the NHs won't cover nor my insurers ( e.g. If my surgery is a partial success and the team want to try further push I've been told its unlikely the NHs will want to try experimental surgery on me twice)

So, I see my consultants and pay but am on NHs lists for waiting for surgery. ( sort of....GP keeps mucking up referral ....bring on decent access to private gps paid by performance please!)


In other circumstances I've gone privately to NHs resources at the same time as NHs patients, This IS faster. Otherwise no different. This is a paid for 'queue jump' if you like, though if the testing were available at private facility I'd happily have used that facility. Instead the money went into NHs.

Consultants appointments vary in cost. The average I see out side London is about £220-250 for a normal consult. A couple are more. You pay a whatsit ( word gone) each time you go.....the bit of insurance you pay before insurers kick in.....so even insured its not free. How much this is varies on premium. For my insured parent its £1000. For me I think we pay the first £100 or £150 of each appointment. So in those months where I am average ing an appointment every week its not cheap. The insurance doesn't mean you don't have an investment in your own health.

What else? Happy to say how it works for me.


Edit EXCESS, the word is excess. Crikey.


Edit. Private healthcare provided by employer is a taxable benefit iirc. Not sure. Some one here will know.

lostinrates

LydiaJ wrote: »

My GP practice has a triage system which means that if they judge you (when you speak to a doctor over the phone) to need a same day appointment, you can always have one. It works very well. I would like to see the NHS make all GP practices do likewise (or at least all GP practices with, say, 4 or more doctors in them). I think it would quickly and easily make a bit improvement in access.

Otoh, couldn't that doctor be seeing a patient then? Or dealing with telephone appointments?

Not all people want appointments on particular days because of health need but for economic reasons.

I phoned first week of year and the soonest appointment I could get was 28th January. I asked for telephone appointment to go to fir instead. 28 th january. . The reason fir wants particular time / day appointments is to be able to get to them.

LydiaJ

Generali wrote: »

By being operated on privately I took myself out of the public queue meaning that patients in the public system were also seen sooner. I paid for everything I was allowed to pay for which meant I was seen quicker but also meant that someone in the public system got my place in the queue.

The cancer wing of Westmead Hospital has a lot of posters up encouraging people with health insurance to use it and get out of the public queue. I reckon they know a lot better than me what is best for the system.

It seems a bit odd that it should be a better outcome for treatment to be worse but equal.

I see. That makes more sense then. I do agree that worse but equal is not better.

I also know what you mean about people who could easily afford to pay taking up free spaces that would otherwise go to people who couldn't afford it. I remember years ago having a babysitter for my kids who was a teenager at a very well regarded and highly sought after state school. Her parents appeared to be rolling in money (as judged by the uber-expensive house that they lived in) and I remember thinking it was a pity they hadn't paid for her to go to a private school to leave her place at the outstanding state school for some kid whose parents couldn't afford the private option.

Flugelhorn

LydiaJ wrote: »

I see. That makes more sense then. I do agree that worse but equal is not better.

I also know what you mean about people who could easily afford to pay taking up free spaces that would otherwise go to people who couldn't afford it. I remember years ago having a babysitter for my kids who was a teenager at a very well regarded and highly sought after state school. Her parents appeared to be rolling in money (as judged by the uber-expensive house that they lived in) and I remember thinking it was a pity they hadn't paid for her to go to a private school to leave her place at the outstanding state school for some kid whose parents couldn't afford the private option.

I could afford private education but feel that the state version locally is better and have saved the money to help the kids at uni.
Re private / NHS - causes havoc mixing the 2, some of the work in our GP practice is private (eg reports / medicals etc etc ) but costs a packet in admin. If we saw patients privately they would still all be seen same day.

Generali

LydiaJ wrote: »

I see. That makes more sense then. I do agree that worse but equal is not better.

I also know what you mean about people who could easily afford to pay taking up free spaces that would otherwise go to people who couldn't afford it. I remember years ago having a babysitter for my kids who was a teenager at a very well regarded and highly sought after state school. Her parents appeared to be rolling in money (as judged by the uber-expensive house that they lived in) and I remember thinking it was a pity they hadn't paid for her to go to a private school to leave her place at the outstanding state school for some kid whose parents couldn't afford the private option.

I had to pay an excess, known as a gap payment here, for surgery so there is a disincentive to going private. I go private whenever I can as a matter of principle. Yes it means I get seen a bit quicker but it helps those that can't afford insurance.

The people that annoy me are those that could quite easily afford to use their health insurance but are too tight to do so. If you hold up the queue for things like cancer ops then you may well kill someone for the sake of a few hundred bucks.

We aren't rich by any means but we scraped together the $500 required. Some can't and I'd hate to deny them treatment.

Generali

Flugelhorn wrote: »

I could afford private education but feel that the state version locally is better and have saved the money to help the kids at uni.
Re private / NHS - causes havoc mixing the 2, some of the work in our GP practice is private (eg reports / medicals etc etc ) but costs a packet in admin. If we saw patients privately they would still all be seen same day.

In Aus it is just normal to mix public and private so the system is set up to deal with it.

lostinrates

Flugelhorn wrote: »

I could afford private education but feel that the state version locally is better and have saved the money to help the kids at uni.
Re private / NHS - causes havoc mixing the 2, some of the work in our GP practice is private (eg reports / medicals etc etc ) but costs a packet in admin. If we saw patients privately they would still all be seen same day.

Nothing happens same day in my GP practice. My referral for surgery saga had been going on since last autumn.( they did refer once, to the wrong hospital). My endocrinologist has made a complaint to the surgery but the surgery seem to have lost it. The surgery are saying I can only be referred to one hospital ( not the one endocrinologist has recommended) because its in area, but just as hard for me to get to. And they refuse to put this in writing.

PasturesNew

I can see both sides of it.

If I were in the queue behind a millionaire and we both had the same thing, is it wrong that they can jump the queue and get it seen to, whereas I sit on an endless list until I die? For £20-30 I think it's immoral. If the "fix" is £100k then I can accept that.

Question is, where's the balance between cost and who can get it.

At £25 I'd probably never go to a Doctor. I'd end up Googling stuff and buying things from abroad over the Internet.

LydiaJ

lostinrates wrote: »

Otoh, couldn't that doctor be seeing a patient then? Or dealing with telephone appointments?

Not all people want appointments on particular days because of health need but for economic reasons.

I phoned first week of year and the soonest appointment I could get was 28th January. I asked for telephone appointment to go to fir instead. 28 th january. . The reason fir wants particular time / day appointments is to be able to get to them.

That's awful. I'm getting much better service than that from my practice. And yes, I do understand about work putting restrictions on when one is available. As you know, I'm a part-time teacher, so for anything other than emergencies I'm expected to fit things like doctor's appointments into the times when I'm not timetabled to be teaching.

The triage phone call is usually quite short - a few minutes - and it's done by the doctor you will be seeing if you come in for the same day appointment, so it cuts down on the time you spend in the room talking to the doc, because part of the conversation has already happened. Sometimes it turns into a phone appointment instead.

Real examples:
Me: My daughter has earache and is in quite a lot of pain. I don't know if she needs antibiotics or not. Can she have an appointment today please?
Receptionist: The triage doctor will phone you within half an hour.

---

Triage doc: Hello, I'm returning your call. What can I do for you?
Me: My daughter has earache and is in quite a lot of pain. I haven't got an auriscope so obviously I can't tell if it's infected or just congested so I don't know if she needs antibiotics or not.
Triage doc: You'll need to bring her in. Just turn up any time today.

[Similar conversation with receptionist]
Triage doc: Hello, I'm returning your call. What can I do for you?
Me: [Affliction I've had on several previous occasions has happened again. Details omitted because it's a public forum.]
Triage doc: Ah yes, I can see you've got a history of that and that medication x has worked well for you in the past. I'll leave a prescription for you at reception, and [details of arrangements for test to confirm that it is indeed the same thing I've had before].

Me: I want to make an appointment for my son to see Dr Y. It's not urgent, but I don't want him to miss school, so it needs to be after 4pm on a Tuesday or a Thursday.
Receptionist: I can offer you one in 4 weeks' time.

Me: I would like to make an appointment. It doesn't need to be today, and I don't mind which doctor I see, but I can only come on a Thursday, or else a Friday morning.
Receptionist: I haven't got anything for this Thursday or Friday but I can offer you an appointment on Thursday next week with Dr Z.

lostinrates

PasturesNew wrote: »

I can see both sides of it.

If I were in the queue behind a millionaire and we both had the same thing, is it wrong that they can jump the queue and get it seen to, whereas I sit on an endless list until I die? For £20-30 I think it's immoral. If the "fix" is £100k then I can accept that.

Question is, where's the balance between cost and who can get it.

At £25 I'd probably never go to a Doctor. I'd end up Googling stuff and buying things from abroad over the Internet.

Pn, you don't go to the doctor anyway . Have you registered yet:cool:?