Private healthcare and Gastroenterology
Private health is parallel and completely independent of the NHS. The consultants see patients in their own time, outside their obligations to the NHS (which are policed through annual appraisal and job-planning- doctors no longer skip off to a private hospital when they should be doing an NHS clinic). Some consultants do purely private work, but they are the exception.
The main attractions of private healthcare is that it is very quick and care is delivered by the consultant (not by someone else in their name and there are no trainees). The down-sides are that it is extremely expensive (you need insurance or a big bank balance); insurance companies in reality limit the choice of whom you can see (which is not usually a problem) and there is a lack of depth as you are not being looked after by a department. On this last point, NHS departments offer a more joined-up multi-disciplinary delivery of care for chronic diseases such as Crohn's disease, diabetes etc. Private insurance companies in recent years have also become quicker to say no.
Insurance companies
There are many companies offering health cover; the two biggest are BUPA and then AXA-PPP, but others may offer better policies, so look around. Policies through work or organizations e.g. trade unions, employers are cheapest. If you are doing it by yourself, have a look at price-comparison sites (and also cash-back sites). Deciding to just save some money into a special savings account doesn't fly for most of us as private healthcare can burn through a large pile of cash in no time.
Policies divide care into two "pots": (a) Outpatient care (seeing the doctor, physiotherapist or dietitian etc; having blood tests or scans) and (b) Day-case (where you are in hospital for a couple of hours having an endoscopy or arthroscopy etc.), or, In-patient (where you stay several days in hospital). Many policies put a limit of about £1000-£1500 on Outpatient care, but there are usually no limits for Day-case/In-patient care.
An important point for those who are paying themselves is that all "procedures" (endoscopy etc.) carry two charges: (a) the "Theatre" fee levied by the hospital for use of the staff/equipment/drugs (a large amount!) and (b) the "Physician's" fee levied by the doctor for doing the test. None of this matters if you have private cover as the company sorts it all out.
All companies offer a variety of policies and the devil is very much in the detail. When deciding on a policy, the things to look out for are:
Getting a private appointment
All insurance companies insist on a referral letter from a GP to get things rolling. That can be a work, walk-in centre or NHS GP.
Once you have your letter, contact the insurance company and ask them for an authorization number. They will then give the go ahead to make an appointment. Ask them what limitations there are on your policy, especially how much "Outpatient" funds you might be allowed.
Many insurance companies insist that you choose a consultant from a list of three that they provide- so you may not be able to go to someone recommended by a friend. This is not a problem! Have a look at the suggested doctors' websites/entries on the hospital website and see: (a) whose areas of interest best match your needs; (b) whose "style" might fit yours. Ring or e-mail the doctor's secretary to make the appointment. This can usually be very quick. (Here is a shameless plug! If you don't know who is best to see and live in or commute to London, you can check out the site www.medicalfederation.com, or e-mail taz.shirley@medicalfederation.com for help).
The consultation
Arrive about 15 minutes early, as before being seen, you will have to register at the Consulting Rooms. A "New Patient" consultation lasts for about 20-30 minutes depending on the speciality, but some can be longer e.g. neurologist, psychiatrist. Any bloods or simple X-Rays will get done there and then, but other scans will need to be booked unless it's a "one-stop" set-up for things like breast lumps.
The focus of the meeting should be what your symptoms are: what's the key symptom, how long have you had it and what's been done so far? Whatever you do, don't drop a whole new symptom, or the fact that you've been investigated/treated before into the mix at the end of the conversation!
If you are concerned about "Outpatient" limitations on your policy, ask the consultant if they can request your NHS GP to do any blood tests or scans. Usually there are no problems with this, but your GP may not feel well placed to order more specialized scans. It will be up to you to get the results back to the consultant.
The consultant, after you have been seen, will write a report to the referring GP, copied to you. Be careful here, letters do not automatically go to your NHS GP, unless they were the one to make the referral to start with.
Follow-up
The style of follow-up is very much down to what works best. Sometimes it is just through e-mail, a letter sending on results or it can be another face-to-face meeting (about 10-15 minutes). Fees are only levied, generally, for face-to-face meetings.
Fees
Fees charged are decided by the insurance companies and so vary widely.
If you are insured, all doctor and hospital bills go directly to the insurance company; you would then only pay any deductible. Many doctors use fee collecting companies who will chase up any deductibles. This is because most people do pay and so it would be unfair on them not to chase "non-payers". Also employing secretaries, professional insurance, room hire and running a practice is expensive: it can cost the doctor about £60 just to see someone!
The main attractions of private healthcare is that it is very quick and care is delivered by the consultant (not by someone else in their name and there are no trainees). The down-sides are that it is extremely expensive (you need insurance or a big bank balance); insurance companies in reality limit the choice of whom you can see (which is not usually a problem) and there is a lack of depth as you are not being looked after by a department. On this last point, NHS departments offer a more joined-up multi-disciplinary delivery of care for chronic diseases such as Crohn's disease, diabetes etc. Private insurance companies in recent years have also become quicker to say no.
Insurance companies
There are many companies offering health cover; the two biggest are BUPA and then AXA-PPP, but others may offer better policies, so look around. Policies through work or organizations e.g. trade unions, employers are cheapest. If you are doing it by yourself, have a look at price-comparison sites (and also cash-back sites). Deciding to just save some money into a special savings account doesn't fly for most of us as private healthcare can burn through a large pile of cash in no time.
Policies divide care into two "pots": (a) Outpatient care (seeing the doctor, physiotherapist or dietitian etc; having blood tests or scans) and (b) Day-case (where you are in hospital for a couple of hours having an endoscopy or arthroscopy etc.), or, In-patient (where you stay several days in hospital). Many policies put a limit of about £1000-£1500 on Outpatient care, but there are usually no limits for Day-case/In-patient care.
An important point for those who are paying themselves is that all "procedures" (endoscopy etc.) carry two charges: (a) the "Theatre" fee levied by the hospital for use of the staff/equipment/drugs (a large amount!) and (b) the "Physician's" fee levied by the doctor for doing the test. None of this matters if you have private cover as the company sorts it all out.
All companies offer a variety of policies and the devil is very much in the detail. When deciding on a policy, the things to look out for are:
- Most policies will not cover any condition that you have had in the past ("pre-existing conditions"), that have been recorded by your GP. Some will though, at more expense.
- Insurance companies are not stupid, they may well reject a referral made immediately after a policy has been taken out.
- What hospitals are covered? No point in having a policy that does not cover the one you are likely to use.
- Policies that are limited to "cancer care" only are probably a waste of time. The difficult part of cancer care is diagnosing it and this may well not be covered as the doctor is just investigating a "symptom". Just use the NHS "Two Week Wait" system.
- Policies that only kick-in should the NHS not be able to provide a test within 6 weeks are probably not worth it as the vast majority of tests could well be done within this time frame.
- Most private hospitals work more efficiently that NHS ones doing private work, so easier to book scans etc.
Getting a private appointment
All insurance companies insist on a referral letter from a GP to get things rolling. That can be a work, walk-in centre or NHS GP.
Once you have your letter, contact the insurance company and ask them for an authorization number. They will then give the go ahead to make an appointment. Ask them what limitations there are on your policy, especially how much "Outpatient" funds you might be allowed.
Many insurance companies insist that you choose a consultant from a list of three that they provide- so you may not be able to go to someone recommended by a friend. This is not a problem! Have a look at the suggested doctors' websites/entries on the hospital website and see: (a) whose areas of interest best match your needs; (b) whose "style" might fit yours. Ring or e-mail the doctor's secretary to make the appointment. This can usually be very quick. (Here is a shameless plug! If you don't know who is best to see and live in or commute to London, you can check out the site www.medicalfederation.com, or e-mail taz.shirley@medicalfederation.com for help).
The consultation
Arrive about 15 minutes early, as before being seen, you will have to register at the Consulting Rooms. A "New Patient" consultation lasts for about 20-30 minutes depending on the speciality, but some can be longer e.g. neurologist, psychiatrist. Any bloods or simple X-Rays will get done there and then, but other scans will need to be booked unless it's a "one-stop" set-up for things like breast lumps.
The focus of the meeting should be what your symptoms are: what's the key symptom, how long have you had it and what's been done so far? Whatever you do, don't drop a whole new symptom, or the fact that you've been investigated/treated before into the mix at the end of the conversation!
If you are concerned about "Outpatient" limitations on your policy, ask the consultant if they can request your NHS GP to do any blood tests or scans. Usually there are no problems with this, but your GP may not feel well placed to order more specialized scans. It will be up to you to get the results back to the consultant.
The consultant, after you have been seen, will write a report to the referring GP, copied to you. Be careful here, letters do not automatically go to your NHS GP, unless they were the one to make the referral to start with.
Follow-up
The style of follow-up is very much down to what works best. Sometimes it is just through e-mail, a letter sending on results or it can be another face-to-face meeting (about 10-15 minutes). Fees are only levied, generally, for face-to-face meetings.
Fees
Fees charged are decided by the insurance companies and so vary widely.
If you are insured, all doctor and hospital bills go directly to the insurance company; you would then only pay any deductible. Many doctors use fee collecting companies who will chase up any deductibles. This is because most people do pay and so it would be unfair on them not to chase "non-payers". Also employing secretaries, professional insurance, room hire and running a practice is expensive: it can cost the doctor about £60 just to see someone!
