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[santaman2000]

......BTW stories come from foreign nationals who have never used it, foreign governments in hock to their private system HMOs, internal politicians with an axe to find against those in power. It's a political potato being kicked around for political arguments.

Still I went to the gp for a wheezing issue and was in and out of x-ray with an all clear in the time it took me to drive into town from the gp, park up and go into the x-ray department. I literally walked in gave my name and got xrayed. It's been a good as that before but it's been worse. So far nobody in our family have had a bad service. Truly bad that is.

That's the problem with describing private medicine as well. It gets slandered by foreign nationals who've never used it. If I come across as putting down the NHS that's not my intention. They do pretty good for what they are (a socialized system ---- run by government rather than driven by patient demand)

Realize however that when you give your opinions they're based on never having been to a proper private doctor or hospital. Do they ask about my insurance? I'm thankful to say that, yes, they do. Why am I thankful? Because it means the admin person asking that and filling out the forms has just become my secretary for the case and is doing all the paperwork and filing for me.

Do I get in and out as quickly as you described? My answer has the same qualifier you used; sometimes. This morning my regular podiatry appointment took less than 20 minutes from the time I walked in the door (5 minutes of that was me updating changes to my meds since my last visit) Normally I'm seen before my appointment time if I show up early; sometimes I've had to wait as long as a half hour past the scheduled time if the doctor had something unexpected come up.

I've been treated in the NHS system when I was there and was disspointed. Mostly by the doctor's attitude. He acted exactly like what he was (an official with authority to decide what was or was not allowed on the taxpayer's dime) rather than how a doctor in private practice would act (a valuable professional the patient can easily replace) I suppose another contention was that the NHS is indeed a "system." That means it has a bureaucracy in charge. Private medicine is mostly between the patient (customer) and the doctor (consultant) Even the interference from insurance agencies has to bow to competition from other agencies.

 

[santaman2000]

I do not think you can credit NHS with the improvement in Dental technology and treatment.....

Dentistry is a newish discipline, the blacksmiths all around the World did dental extractions in the good Old Days. .....

Actually it was barbers, not blacksmiths originally. That's why the traditional barbers' pole is red and white striped; from the bloody towels they hung on them.

 

[Tengu]

I am only alive because of the NHS.

But I expect you are the same.

 

[Paul_B]

I've only gone private once but it was through the nhs if that makes sense. Great service but ultimately it's the fluff around the edges that was different. Hotel reception style entrance, free coffee, American levels of customer service (which being British and not used to it I found it more than a little insincere), etc.

My partner has been fully private having worked overseas a long time. She said it was good and bad. Some things were good others bad. She said overall she still learnt to appreciate the uk's nhs more after experiencing private healthcare.

One of the things that interested me was that she got a telephone directory style list of doctors she could see about different medical specialities. She could pay for extras not covered by insurance which she did and for a lot less cost than UK private for the same treatment.

At the end of the day I only care about getting treatment. NHS has fulfilled that most important criteria the whole of my life. I don't really need much more than that tbh.

 

[santaman2000]

I am only alive because of the NHS.

But I expect you are the same.

My first incident of being saved by medical care from death was when I was 6 years old. Appendicitis cred by immediate surgery. All on traditional private medicine.

There will be many examples of people being treated for various potentially deadly ailments and recovering to live healthy lives in almost every medical system. There will also be many examples where the care failed and they dies or were permanently crippled in all systems. Dependency doesn't equal quality. In the case of medical systems it usually just means nothing else is reasonably available.

 

[santaman2000]

.....At the end of the day I only care about getting treatment. NHS has fulfilled that most important criteria the whole of my life. I don't really need much more than that tbh.

I'm not so easily satisfied. I want much more than just "getting treatment." I want (and demand) to be the one who decides just what treatment I get. ALL options of treatment, not just the ones allotted by a government body or approved by an assigned doctor. I want (and demand) to see all treatments available (a listing of different treatments, their success rates and benefits vs drawbacks, etc.) and a long discussion with the doctor (or multiple doctors) of my choice before making that decision.

 

[santaman2000]

I've only gone private once but it was through the nhs if that makes sense.....

It makes sense to me at least. I expect it's similar to my own situation: I'm retired military and eligible to use the military medical system directly (it's much like NHS in that it's a government system with it's own facilities and staff operating under government management) Rather than that though, I use it as my insurance policy (TriCare is indeed set up exactly like an insurance policy) to pay for private care and treatment. It works exactly the same as any other employer funded insurance at the end of the day.

 

[Janne]

NHS is a kind of mixed system, state/private.
GP's and dentists work from own surgeries, on a contract from NHS that gives them a certain funding for a certain number of patients/ treatments.
So, they are private contractors, funding the surgery, equipment, staff, materials, malpractice insurance, courses, everything associated with the job..


If they do less work than contracted ,their funding is reduced next year, if they do more than funded, they do not get paid for this extra work, but can (if is a 'good" NHS area) get the funding upped to cover more treatments next budget year.
For Dentists this is a very difficult task, to judge how much treatment can be done, as none wants to run out of 'points' too early in the year.
It works on points, called Units of Dental Activity, UDA's. Each dentist is given a certain number of UDA's, and each UDA has a monetary value the dentist is paid.

Some treatment that technically should be provided under the NHS contract is impossible to do, as it would mean the dentist would have to pay for the associated costs of the treatment from his/her own pocket.
The patients are usually offered a 'private treatment' option for these.

Not sure how GP's do.

NHS hospitals are pure NHS ventures that employ staff.

 

[Chainsaw]

NHS is a kind of mixed system, state/private.
GP's and dentists work from own surgeries, on a contract from NHS that gives them a certain funding for a certain number of patients/ treatments.
So, they are private contractors, funding the surgery, equipment, staff, materials, malpractice insurance, courses, everything associated with the job..


If they do less work than contracted ,their funding is reduced next year, if they do more than funded, they do not get paid for this extra work, but can (if is a 'good" NHS area) get the funding upped to cover more treatments next budget year.
For Dentists this is a very difficult task, to judge how much treatment can be done, as none wants to run out of 'points' too early in the year.
It works on points, called Units of Dental Activity, UDA's. Each dentist is given a certain number of UDA's, and each UDA has a monetary value the dentist is paid.

Some treatment that technically should be provided under the NHS contract is impossible to do, as it would mean the dentist would have to pay for the associated costs of the treatment from his/her own pocket.
The patients are usually offered a 'private treatment' option for these.

hmm must be different in Scotland well it certainly was 10 years ago! In Scotland, as you say they are private contractors with the same issues you mention above. They may however qualify for some 'grants' to help comply with any new regulations or procedures brought in by the NHS. Last big one I recall was separate decontamination rooms (and staff members!) Also grants for improving disabled access, creating ground floor surgeries etc. Dentists could treat NHS and private patients and indeed offer NHS patients private treatments if they wanted.

Dentists were paid capitation, a very small fee for every active patient on their books. A patient became inactive after 1 or maybe 2 years after last visit. Other than that, treatment was paid for as it was performed via the GP17 claim form or EDI equivalent. There was a list of allowed treatments (eg no white fillings/implants) and if a treatment plan exceeded a certain £ limit it had to go for prior approval. The amount an NHS patient would pay was also capped with the service picking up the balance. There were no UDA system as I recall although that may have changed.

Rgds
Alan

 

[santaman2000]

Sounding more and more like an HMO. Except HMOs don't give grants.

 

[Janne]

Grants were /are given to establish practices in areas which are not so attractive to do business in.
I think each NHS area are a little bit different there. East Sussex NHS Trust ( called today) did not want to give the clinic any funding when we wanted to get a NHS dentist that also would see people with mobility issues. We needed funds for a special dental unit and a lift.
No funds given so we placed him downstairs and rebuild a store room to a handicap surgery.
This is 12 years ago, I guess things change year to year.

 

[Tengu]

Santaman, you are not the first American to tell me how wonderful your system is.

My Family would never have been able to dream of affording the healthcare that my mother needed all her life. or my fathers heart surgery.

From what I have heard, 40% of Americans have no insurance. (Are they the ones who can pay up front?) Certainly people die from lack of money. it happened to my friend.

He had a heart attack, didnt even see a GP. He couldnt afford it.

I do not know what healthcare is like in many parts of the world but I suspect many people can at least see a doctor to be told what they are dying of.

We do have private healthcare here, for those of you who want it. (It is, I assure you, optional, even if you are wealthy or a visitor. No one is MADE to endure socialised medicine here) but from what I have heard it is swings and roundabouts.

(One good trick is to pay for a private diagnosis, then get treatment on the NHS. Getting diagnosises takes waiting, but treatment is generaly prompt if you have a diagnosis.)

My Psycologist does take private patients. I asked him what he charges.

£600 per hour.

But he is one of the top in his field.

 

[Janne]

Psychologist, not a psychiatrist? 600 per hour seems steep for a psychologist!

Using both systems like you describe has one more benefit: second opinion.

No hospital in US will turn away an emergency patient without money. Plus there are in fact hospitals that treat patients virtually for free. Plus there is a system with Nurse Practitioners ( think “half doctors’ ) that provide essential treatments free of charge.
It is a myth that people die in the US because if lack of insurance.

Here we have a state run hospital plus two private hospitals.
The newest one, a private hospital, does not charge the patients portion ( usually 20%) if the patient can not afford it.

Canada has a similar (copied from Sweden it seems) healthcare.
My son has certain problems in his abdomen, inherited from me. Needs a coloniscopy. Months and months of waiting time, just like in UK and Sweden.

The US system has it advantages. And disadvantages too of course!

 

[santaman2000]

Your numbers are wrong. As Toddy said earlier there are about 10% uninsured; and even they can be treated. Anybody dying from "lack of care" here is simply not going to a doctor. As Janne said, ALL emergency room MUST treat patients. If somebody is truly poor the government program, "Medicaid," covers them. If they're elderly or disabled the "Medicare" program covers them. The problem with both of those programs is that they are indeed government run socialized medicine.

The real advantage of our "system" is that it isn't a system at all. That said, it's not the "benefits" of our way of getting medical care I espouse; rather it's the unwanted government intrusion of a socialized "system" I abhor. My medical care is for me and my doctor to discuss and decide.

As Janne said, 600 pounds per hour (for a psychologist)seems too expensive by a factor of 10. In any case, a private psychologist or psychiatrist would be covered by insurance.

I know you're not forced to use the NHS and you can go to a private doctor. But you are forced to pay exorbitant taxes to pay for said NHS whether you use it or not. Your anecdote about the psychologist also indicates that rather than doctors in actual private practice, you have NHS doctors moonlighting on their own time?

 

[Janne]

Yes, a MD, be it a GP or specialist can work on a private basis outside his NHS hours/contract.

Our GP in Crowborough had Private slots during every day. Maybe one hour slot each day.

 

[santaman2000]

Yes, a MD, be it a GP or specialist can work on a private basis outside his NHS hours/contract.

Our GP in Crowborough had Private slots during every day. Maybe one hour slot each day.

But no truly private doctors? No truly private clinics with staff unbeholden to the NHS?

 

[Janne]

Oh yes, they exist. Plus purely private hospitals. I think the largest number are connected to an insurance called BUPA. Not 100% sure there though.

There are many clinics that perform highly specialised private care, like laser eye surgery.

I know that many people look down on private healtcare in UK and Scandinavia but it does free up funds, time and space within the State healthcare for the other people that can not afford to pay privately.

I personally had many a verbal confrontation with people why I did not accept a full NHS cintract but a very limited one. Even the local NHS trust wanted to force us accepting NHS patients.