Services that you cannot access despite being entitled

[Sheepshanks]

vikingaero said:

"Hi, I'd like to make an appointment to see a Doctor"
"Are you under 18, on our priority list or retired?"
"No, none of them."
"Well then the first appointment is in 3 weeks for you..

I haven't heard of that before, and ours isn't like that - it's just a straight "no appts left, call back tomorrow."

However twice in the last few weeks my wife has been able to get me a same day f2f appt by standing her ground with them. That's great for me, but it worries me that others would just let it go.


I was called for aortic aneurysm screening and went yesterday. Was at a different health centre to our usual one, but not a problem. Was waiting and an old guy came out of seeing a nurse and said he'd been told to make two appts next week to have his dressing re-done. The receptionists just laughed. He asked what he was supposed to do and as I left they waiting area they were talking about looking at other possible providers.

[Flooble]

loafer123 said:

Quite a long time ago, in Kennington, south London, I called the surgery for an appointment and they asked whether I worked. When I confirmed I did, they said “use the right hand queue, so you are seen first” on the logical assumption that those that didn’t work had more flexible schedules.

When the doctor saw me, and realised I am one of those stupid men who let things go too far before making an appointment, he said “if you feel you need to come for anything again, tell the receptionist I said it was fine to get a booking immediately”.

That's interesting and does seem eminently logical, whereas the tendency I have seen seems to be the inverse. "You are working? Well go away then." There does seem to be an assumption amongst some that anyone in work will have private healthcare or the ability to pay, and that they should go private to leave the NHS available to treat the retired/unemployed/whatever.

Which does then raise the rather obvious question of how many times one should pay for the same service. It's one thing to pay into a central fund that covers those less fortunate - almost the very definition of national insurance. But it is quite another to pay twice over. Not least because it seems hugely inefficient.

[loafer123]

Flooble said:

That's interesting and does seem eminently logical, whereas the tendency I have seen seems to be the inverse. "You are working? Well go away then." There does seem to be an assumption amongst some that anyone in work will have private healthcare or the ability to pay, and that they should go private to leave the NHS available to treat the retired/unemployed/whatever.

Which does then raise the rather obvious question of how many times one should pay for the same service. It's one thing to pay into a central fund that covers those less fortunate - almost the very definition of national insurance. But it is quite another to pay twice over. Not least because it seems hugely inefficient.

My family have had three interactions with the NHS in the last few weeks, and in two of those tests were done on the NHS at private facilities within a week of the GP visit. Quick and efficient.

The third interaction was an emergency (mum had a nasty fall) where the care was great despite the chaotic organisation.

[sutoka]

loafer123 said:

Flooble said:

That's interesting and does seem eminently logical, whereas the tendency I have seen seems to be the inverse. "You are working? Well go away then." There does seem to be an assumption amongst some that anyone in work will have private healthcare or the ability to pay, and that they should go private to leave the NHS available to treat the retired/unemployed/whatever.

Which does then raise the rather obvious question of how many times one should pay for the same service. It's one thing to pay into a central fund that covers those less fortunate - almost the very definition of national insurance. But it is quite another to pay twice over. Not least because it seems hugely inefficient.

My family have had three interactions with the NHS in the last few weeks, and in two of those tests were done on the NHS at private facilities within a week of the GP visit. Quick and efficient.

The third interaction was an emergency (mum had a nasty fall) where the care was great despite the chaotic organisation.

I'm having yet another MRI scan privately at the expense of the NHS next week. However it's very rare that anything other than a scan is referred privately.

Over here in Northern Ireland they've been talking about surgical hubs since 2016, basically taking 10 hospitals in NI. Each concentrating on a different surgery say orthopaedics, another for neurosurgery, another for transplants etc but the problem is there are just too many hospitals and not enough capacity so it's like rearranging the deckchairs on the Titanic.

The problem is that the whole system runs on red alert from one crisis to another and needs serious restructuring, if they threw 500 million at it after a few months it would be crying out for more.

I've been waiting 4 years and 5 months or 53 months for spinal fusion. If I lived in England, Scotland or Wales I'd at worst be waiting 12-18 months. If I lived in the Republic of Ireland I'd have been sent to a private hospital paid for by HSE years ago. My consultant talks about lack of capacity but he's only contracted to work 1 day a week on the NHS and does another 4 days at a local private hospital. It's £300 for a 5 minute consultation or else you will wait a year to see him on the NHS, he doesn't do letters, phone calls, legal or medical reports on the NHS.

I went private at the start of my treatment and paid several grand out of my own pocket for MRI and back injections, the report said 'he is happy to go private'. I made them change it to 'he had no other choice' but it's no surprise that people are paying for treatment out of their own pocket without any insurance cover. My local private hospital has seen footfall up 33% in the last year, so much so they are building an extension to increase capacity.

https://www.bbc.co.uk/news/uk-northern-ireland-649...

Edited by sutoka on Sunday 26th March 00:49

[off_again]

agent006 said:

'Services you cannot access despite being entitled' is a very different answer as a wheelchair user.

Or blind.

[voyds9]

Ian Geary said:

Option c: the government increase the NHS schedule of rates (carrot) but mandate a certain level of NHS work is carried out each year to get, I don't know, a practising licence?(stick)

The problem with option c is the carrot doesn't keep up with inflation and the stick grows exponentially

We've have this with optometry.
The NHS admit that what they pay is at best only half the cost of performing an examination
And the expectation for the examination grows year upon year

[Flooble]

loafer123 said:

Flooble said:

That's interesting and does seem eminently logical, whereas the tendency I have seen seems to be the inverse. "You are working? Well go away then." There does seem to be an assumption amongst some that anyone in work will have private healthcare or the ability to pay, and that they should go private to leave the NHS available to treat the retired/unemployed/whatever.

Which does then raise the rather obvious question of how many times one should pay for the same service. It's one thing to pay into a central fund that covers those less fortunate - almost the very definition of national insurance. But it is quite another to pay twice over. Not least because it seems hugely inefficient.

My family have had three interactions with the NHS in the last few weeks, and in two of those tests were done on the NHS at private facilities within a week of the GP visit. Quick and efficient.

The third interaction was an emergency (mum had a nasty fall) where the care was great despite the chaotic organisation.

Someone up thread said that middle-class people should use private dentistry to free up the NHS capacity for the others, hence my comment about paying twice.

I've fortunately avoided the NHS for years. Or perhaps, have been unable to use it. My last interaction was when I was ill and getting worse, so used a private GP who determined that the issue was serious enough to refer me to an emergency GP (didn't even know they existed) as A&E was "closed". That GP tried to refer me to the NHS hospital but ended up essentially having an argument with the department receptionist - I heard her phone call which basically went "Well where are they? Well bleep them then? Okay fine". The GP couldn't get the hospital to reply so I see no chance for a patient. I can't imagine things have improved since then.

My perception is that the "regulars" know their way around the system and can get attention (e.g. the local surgery has a facebook group so I am aware they have been through about three different systems - "TPP", "doctrin", something else), while someone who has a day job is left floundering; by definition if you need to see a GP you are sick so the last thing you want is to be trying to work out how to register and sign up for some new booking system that wasn't there ten years ago the last time you tried to get an appointment.

Increasingly, from what I see, employers are paying for not just private medical insurance but also private GPs. I can see at some point complex and emergency treatment being added to the "private" roster.

[loafer123]

Most private health insurance already provides access to digital GP appointments.

We have used it as an alternative to 111 triage when unsure about something, or for referral into private tests.

[Flooble]

loafer123 said:

Most private health insurance already provides access to digital GP appointments.

We have used it as an alternative to 111 triage when unsure about something, or for referral into private tests.

Yes - I am old, so I remember private insurance back in the 90s when you had to get a referral from your NHS GP in order to access the "private" part. Hence my comment that increasingly we are seeing private GPs - I first saw it being added as an option to the general packages (*) about ten years ago and it's really taken off in the last five.


(*) There was the "CityGP" thing before that IIRC

[Sheepshanks]

Flooble said:

Yes - I am old, so I remember private insurance back in the 90s when you had to get a referral from your NHS GP in order to access the "private" part.

I’ve seen people on here say they’ve just gone straight to a consultant and wife did it a few weeks ago, just booked an appt using the online booking system at the local private hospital. It did say it needed a referral but it wasn’t mentioned at the appt.

[Miserablegit]

We couldn’t get NHS dentistry provision so we’re paying privately for that.
There’s no grammar school provision in this area so we’re paying for that as well.
A&E has been good for accidents but we’ve ended up having to use our private healthcare insurance for anything else.
Like many on here we’ve been paying twice - once into the big pot for services for everyone and once into private provision in order that we can access services.
It’s not fair but we are fortunate we have that option.

[272BHP]

Anyone middle aged and who holds down a reasonable job should go private with dentistry anyway.

NHS provision is shockingly bad.

[Sheepshanks]

272BHP said:

Anyone middle aged and who holds down a reasonable job should go private with dentistry anyway.

That - without the middle aged bit - was what our dentist told us when she dropped all her adult NHS work a few years ago.

Her attitude was we were being ridiculous even thinking that we should remain covered by NHS.

[Randy Winkman]

I'm not sure what private dentistry would give me that NHS doesn't. I get an appointment when I want, I trust my dentist and he does the treatment that's needed and it always does the job. It isn't super-cheap but if I went private wouldn't I get the same for even more money?

I live on the edge of SE London by the way and appreciate I might just be lucky with both my location and the type of treatment I've needed.

[julian64]

Previous said:

julian64 said:

Previous said:

Dermatology (NHS)

My little one is 7, and in early February we noticed a raised / red / inflamed mole, that didn't seem to get better after a week.

Eventually managed to get GP to check him out, who issued an urgent referral to Dermatology at the children's hospital. The letter we received said we'd be seen in 2 weeks.

Various phone calls to the unit, visits to ask the GP to do something, turning up at the unit in person unannounced etc.

Weve finally got the service to agree to look at him.....on the 28th April

That is a very odd story. What did the mole turn out to be?

We don't know yet. We don't get to see the unit weve been referred to until 28th April.

It seems to have gone down a bit, and not getting any worse.

Wish I still had family private health, but moved jobs a while since then and new employer doesn't offer it.

I suspect, but its only a guess that your GP referred on a two week wait, but its been downgraded when it reached the hospital
Normally this happens if your GP sent a photo and the photo has been triaged by the hospital dermatologist.

[Red9zero]

I have had a raging toothache all weekend, face is swollen, can't sleep, can't eat. Called dentist this morning, no appointments available for the foreseeable future, either NHS or private. They suggest 111, but I have been on hold with them for over 30 mins now. fking joke.

Edit. 111 referred me to an emergency dentist - who has no appointments available.

Edited by Red9zero on Monday 27th March 09:48

[Sheepshanks]

Randy Winkman said:

I'm not sure what private dentistry would give me that NHS doesn't. I get an appointment when I want, I trust my dentist and he does the treatment that's needed and it always does the job. It isn't super-cheap but if I went private wouldn't I get the same for even more money?

I live on the edge of SE London by the way and appreciate I might just be lucky with both my location and the type of treatment I've needed.

In our case it gets you the dentist herself coming to get get you from the waiting room!

To be fair, I did have my one and only crown fall off on a Saturday afternoon a few years ago - the Saturday before Christmas Day was on the Monday. Called the private patients emergency number, she came into the surgery on Sunday morning and replaced it. It would have messed up my Christmas without that.

I don't get your comment about it not being super-cheap - if it's NHS then you should be paying the NHS fee..

I guess you normally only hear of problems, but it does sound like you're lucky to some extent in having on-demand access to NHS dentistry,

[Red9zero]

What area are you in to get appointments ? I am in North Somerset and there is absolutely nothing available, NHS or private. The emergency dentists listed on 111 have nothing and you can't even get referred to the dental hospital which is 10 minutes from where I live. In the meantime I sit here with a very painful tooth, a swollen face, unable to eat or sleep properly. It's an absolute fking mess.

[Gecko1978]

loafer123 said:

Most private health insurance already provides access to digital GP appointments.

We have used it as an alternative to 111 triage when unsure about something, or for referral into private tests.

The point here is you have paid tax so contributed to a system we all appear to think is a must have (hence its near 200bn budget) yet if you who pays for it can't use it then what's its point.

In saying that I use local private hospital for urgent appointments its £90 but works a treat

[loafer123]

I suppose the point is that, if you want an appointment convenient to you, with plenty of time and relaxed and efficient tests, you can choose to go private.

FWIW, I would give additional tax benefits on going private as the quickest and easiest way of getting efficient money into the healthcare provision in the UK, whilst taking pressure off the NHS.