Private vs. The NHS

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Here in the UK, the NHS turned 70 years old in July 2018.  That’s 70 years of providing free healthcare (yes, I know it comes from our taxes) for everyone – from major operations, GP appointments or ambulance care.  It’s something that has developed in leaps and bounds throughout those 70 years, and provides some of the best and top-rated treatments.

Unfortunately, as with most things in life, the NHS has had its ups and downs.  The most talked about are it under-funded, having over-stretched facilities and minimal staffing.  The time before that was last winter, when the sharp rise in hospital admissions from flu and other winter illnesses, meant that all non-emergency surgery was cancelled for months – and this was extended when the bed crisis didn’t let up.

I’ve heard and read some horror stories from people like me who have turned to our healthcare system for help, only to be turned away, let down or not treated fairly.  To some degree you can understand that the pressure put on NHS staff may get to them from time to time, leading to situations like these, but its not an excuse.  But then I’ve first-hand experienced how the NHS can save lives, and that restores my faith every time.

This doesn’t just apply to NHS hospitals – GP practices are harder to get into and even hard to make appointments with, particularly as most in the UK now operate under the guidance of the receptionists who dictate whether you can see a GP, a nurse or if you even need an appointment.

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On the other hand, private healthcare is becoming more and more accessible.  Private hospitals or healthcare is that in which you have to pay for the appointment, treatment or surgery you receive.  Its often either done through paying yourself or health insurance, but quite a few places I have been now offer their own payment plan, which is useful for those who’s health conditions or concerns aren’t covered by insurance.

Some private hospitals even take on NHS work.  I guess this is part of an “initiative” to reduce NHS waiting lists, as I know the hospital I work at take on NHS lists often – we even have consultants that come and use our outpatient clinic to reduce the NHS waiting times for first or follow up appointments.

I’ve been seen, treated and had surgery at both NHS and private hospitals, and there are definite differences between the two, but I’ve encountered problems at both…

Private Healthcare

My first experience of private healthcare was when I was first seeking a diagnosis.  I remember there being a separate waiting area for private patients and NHS patients.  Now, I’ve only ever paid for a consultant first appointment or follow up.  I’ve then been lucky to then been transferred to receive their care on their NHS lists, or I’ve chosen private hospitals on the NHS Choose and Book system.

I’ve found that there has always been a easier and quicker access to appointments – once or twice I’ve rang to bring an appointment forward or because somethings wrong, and I’ve been able to have something booked the next day.  The reception teams and secretaries I’ve spoken to are so much more willing to help you than some of the NHS ones I’ve dealt with.  The healthcare professionals, such as nurses and anaesthetists, have been so kind and warming and gone out of their way to make me feel better.

However, most private hospitals don’t have the facilities for overnight stays (unless they are large complex centres that offer major surgery), so I’ve often felt that there is a push to get you out.  After my first laparoscopy, I was really poorly afterwards but was sent home regardless as there wasn’t any overnight ward available.  This happened a second time after a bladder operation.

I’ve also found that if you have chosen a private hospital via NHS Choose and Book, you are only allowed a certain number of follow up appointments and treatments.  After these have “ran out” you are referred back to the NHS service regardless, and this may not be with the same consultant you’ve seen.  Private hospitals also have different facilities available to patients who are paying out of their own pocket, such as free TV, free newspapers etc, whereas NHS patients who are using private hospital facilities don’t have access to these.

Another drawback is that as most private hospitals are small and don’t offer all investigatory services (e.g. MRI scanners), you may be sent to an NHS hospital to have that done.  Now, this isn’t a bad thing at all, but you may be surprised to know that there are people out there who will turn their noses up at this, and will often demand appointments ahead of NHS patients simply because “they are paying”.  This is a culture I can’t stand.

You will also find that private hospitals are not specialist centers, so it is a rare occurrence to find a particular specialist, and if you do, then it’s likely you’ll be sent back to the NHS services because there is a more available there.

The NHS

Ah, the NHS.  My experience of this has been completely hit and miss.  I’ve never complained so much about a service in all my life!  However, I’ve always given praise and compliments when it’s been due.

My early experience of the NHS were all negative – I was unable to get GP appointments and when I did it was with a different doctor every time who didn’t have clue; I was sent to A&E by GPs and then being subject to rude and brush-off hospital staff members who simply “didn’t understand why I’d been sent there” (clue – I had a major kidney infection!).  It was then long waits to be seen by any consultant, and when I was seen, most of the appointments were about 2 minutes long with no outcome at all.

And in terms of surgery?  Well, I have been lucky in that my surgery dates were pushed forward through the persistence of my specialists and myself.  Seriously, you have to almost harass the theatre date staff to get anywhere, I’ve learned that.  But the aftercare I have received has been awful.  I have often been shoved onto wards full of dementia patients (and that’s not a dig at them, it’s a dig at the staff not bothering to find an appropriate place for me), I was once moved wards at 1am in the morning and refused pain relief because the member of staff didn’t believe me.  I’ve had surgery dates cancelled.  I’ve developed wound infections because the discharge information I was given was incorrect, the wrong number of medication and been told that as I was “another consultants problem” I wasn’t going to be treated.  Brilliant.

But on a serious note, the NHS did save my life when I developed sepsis last year.  Unfortunately, it took me begging a paramedic to take me into hospital (I had a temperature of 39 degrees, blood pressure in my boots and heart rate of nearly 200 – being a physio is helpful because I know what this means, but the paramedic told me “I didn’t have a temperature or any abnormal signs” *roll your eyes now*) to be taken seriously, but when I was the staff were amazing.  I pretty much had a nurse by my bedside the entire time I was there, and their quick thinking and quick acting meant I received antibiotics quickly.

I’ve found that the treatment and care I receive from the NHS is very much down to luck.  I am lucky to have a wonderful specialist team looking after me, who’s secretaries are approachable and wiling, their communication with my GP is detailed and accurate, and I am always able to get advice from them when needed.  Although this shouldn’t really be the case – it should be that you receive amazing care from whoever you see, but I think the face some departments are completely underfunded and understaffed, they have so much pressure to see a set amount of patients in a day, and the shifts are so long, that it must get to them, and this is then taken out maybe on patients.

The Bottom Line

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Hopefully reading this, you will see that actually, there are minimal differences between the private sector and the NHS in terms of care.  I’ve had problems at both and could honestly not choose one above the other.  The reasons why someone might choose to have private healthcare over NHS healthcare or vice versa will differ from person to person – it may be the shorter waiting times, the locality or the simple fact the NHS won’t fund what they need.

For me, I personally believe that it doesn’t matter if you have to pay for care or not, you are treated the same regardless – and that should be tip top treatment.  Where I work now, we introduced self-paying patients last year and my biggest concern was that we would be made to give so much more to these patients than our NHS patients, and this was something I wasn’t going to do as our care is five star regardless of whether you’ve paid.

If you are lucky enough to be able to afford or be covered by your health insurance to have your care completed by a private facility, then go for it – you’ll most likely have your own en-suite room, own nurse and be privileged to free TV, tasty food and short waiting lists.  If you decide or are having your care through the NHS, then I wouldn’t worry.  Yes, the waiting lists are longer, the facilities are probably run down and the wards are crowded and noisy, but the care is still there.

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