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Private Health Insurance :is It Worth It???

 Poster: A snowHead
Poster: A snowHead
I have worked in the NHS for forty-one years (albeit recently as a self employed practitioner) and my wife has been a Director in BUPA and BMI Hosptals.

I have used her private insurance for back operations, gastro issues, and currently the knee specialist of my choice. A quick Econsult to my GP asking for referral left me sat infront of him the next week. If that Econsult had popped up on my work computer I would have directed him to our physio who has currently been working remotely from home for the last 11 months! This is an ongoing knee issue I thought I could sort out as I would not be skiing, and the wife is retiring soon thus loosing private cover. If the knee had popped twisting whilst walking the dog I would have gone to A&E and would have been referred to a Knee Clinic. I know how to play the system!

Unfortunately physiotherapy has become a bit of a cinderella service in the NHS in some places. Perceived to be a cheap cut by NHS accountants. It must be frustrating for the physios. However paying privately would not be excessive and a good investment in Rehab. Recently paid for several sessions after my mother had a femoral fracture repaired on the NHS with little post op physio. follow up.

If I had serious condition I know, as would my wife, where we would be going - University Hospital Southampton. Private healthcare is fantastic for elective conditions, and possibly for cancer care but I would want an all singing all dancing ITU on hand.

When my wife no longer has work paid private insurance we will look into the costs based on our reduced income.
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@brnttptr, I agree with the suggestion to look into increasing your excess. It can sometimes make a huge difference to the premium and IMO it is seldom worth claiming (due to loss of NCD) unless the claim is well over a thousand. It can also be worth self-paying for initial consultations and then decide whether to claim depending upon the outcome of the consultation/test etc.
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boarder2020 wrote:
Quote:

They have better machines than the NHS guys


Other than ultrasound I'm not really sure what machines a physio would need. That's the issue I have with the private physio I wouldn't recommend - he's all flash gizmos and buzz words over substance but people seem to buy into it (again if you are at a physio you probably don't know a lot about this stuff hence why you are there so perhaps unreasonable to expect any more). Physios do pretty much identical base training, any half decent musculoskeletal physio can treat sports injuries regardless if they promote themselves as a sports specific physio. If you are a decent athlete you will have a specialist physio attached to you in some way (I don't think the tour de France guys are scanning yellow pages for physio recommendations wink ). For the rest of us as much as you may not want to believe it your requirements are not much different to a regular person that doesn't exercise much. Injuries might be a little different (although sports injuries are mostly pretty easy to diagnose) but treatment is pretty identical.

The other interesting thing is that the people I know who rave about their physio the most are also the ones that spend the most time and money seeing them. If they were so good at their job you would hope their clients didnt end up so injured they were constantly there!

As for the actual question like with any insurance it's a kind of gamble. You are essentially betting that you will get injured. If you stay injury free you lose out, but perhaps not a bad thing overall! Know 2 people that had hernias 1 with private health insurance was given op pretty much straight away, the other has been waiting over 1.5 years (ok this is probably more than usual due to covid). Night and day difference. If I had the money to spare I'd definitely be considering private insurance, but as a youngish healthy person is rather spend my limited money elsewhere.


Physiotherapy, and for that matter surgery, are no different to any other service. All have sound practitioners and all have those devoid of communications skills, capability and trust. There are many who talk a good game or name drop associations to try and sell you. On the other hand physiotherapy is an extremely poorly paid specialty in private practice, there is an over supply of inexperienced practitioners, the hoped for NHS jobs didn't ever materialise driving them into the private sector whilst very green. In addition the physiotherapy body has been extremely poor at protecting their title so many offer physiotherapy with very mediocre qualifications that loosely resemble physiotherapy. I know many physiotherapists whose quality should allow them to invoice more than an medic. Many are less good.
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The press in the UK seems to think there is a double win for private healthcare (maybe not private medical insurance though), in that large NHS waiting lists means the NHS purchases private healthcare to reduce waiting lists and individuals pay for private healthcare to bypass NHS waiting lists.

Private medical insurance is probably more affected by employment levels, however it may also receive a boost from employers seeking to protect employees from long waiting lists.

Armies of nurses heading into workplaces to vaccinate the under 50s are possible, probably with mobile vaccination buses.

Certainly, there has been an increase of TV advertising of private healthcare providers (not insurance providers)
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boarder2020 wrote:
Other than ultrasound I'm not really sure what machines a physio would need. ...

The point was that the machine they used on me wasn't available to the CCG physio.
The type of machine isn't remotely relevant.
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Bigtipper wrote:
...Certainly, there has been an increase of TV advertising of private healthcare providers (not insurance providers)

Puzzled Isn't pretty much all private healthcare nowadays through an insurance provider / company?
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ecureuil wrote:
Bigtipper wrote:
...Certainly, there has been an increase of TV advertising of private healthcare providers (not insurance providers)

Puzzled Isn't pretty much all private healthcare nowadays through an insurance provider / company?


You can access it directly and just pay for it. I ended up doing this for my shoulder before Christmas 2019. I self funded the op and it was done as a package which included the post op physio required.
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@ecureuil, not in the UK. I read some statistics, probably on a particular healthcare providers reports and accounts, which gave a breakdown of where the income came from. Insurance only made about 30% of that particular provider, with NHS outsourcing making a similar contribution. The remainder coming from self funded operations.

Overall I do not know the breakdown, as one would need to collate all the individual providers together with consistent statistics, which is not always available. However, I expect the situation will have changed post covid 19 as I was looking at pre covid 19 breakdowns. Also this provider was operating in Scotland where there are very few private hospitals compared to England.

I suspect the insured proportion would be higher in private heathcare providers which operate mainly in England, and predominately in London. However, the NHS purchasing beds and operations currently may be much higher than previous years.
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ecureuil wrote:
... Puzzled Isn't pretty much all private healthcare nowadays through an insurance provider / company?
Not in my experience. I don't think I know anyone who pays for insurance, but I know many people who use money to get things done.

In the UK the NHS is the insurer of last resort, so unless you think you're less healthy than average pooling risk may not be the best approach.
To me, giving control to an insurer defeats the main purpose paying for my health, which is control.

I'm not sure how you could sensibly collate private costs because of the way they're billed.
NHS "consultants" for example run their own businesses, and although they "report" to the GP what's done clinically,
billing data isn't provided at all, and the tariff structure is not that used by the NHS. And then people like me buy medical
care wherever I happen to need it around the world...
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@philwig,

indeed. last time I had to wait to see a consultant privately (spire health), I had to wait as he was stuck in NHS surgery
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Problem these days is that policies have highly restrictive limits on outpatient and day patient, I,e about £1500.

My diagnosis was private and meant I got my tests and various scans done privately and very quickly.
My treatment to address the acute life threatening aspects can’t be done in one go and has taken circa 30 treatment visits over 3 years (would have been 2 if lockdown 1 and 2 hadn’t come along), which are quite simple but still require doctor attendance and participation. The insurers however just ad hoc decided after 6 months that I’d had enough treatment and stopped paying, even though my cover was for acute conditions.

So I think the private health companies are doing what they have to do because interest rates are so low that they cant get a return on our payments, and therefore have to restrict cover.
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So in particular "Spire Healthcare" says in 2020 their revenue came from:

The NHS - 47.6%, Private medical insurance - 37.4%, and self-pay - 15% (in 2019 it was NHS 29.9%, PMI 51.4%,Self pay 18.7%)

I am not sure if this is representative of all healthcare providers, but it may be more similar in 2020. So some significant increases in NHS funding.
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Those numbers sound about right to me.
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Interesting thread, lots of good info and opinions giving food for thought
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I think Spire Healthcare run the Murrayfield hospital in Edinburgh, which does a lot of the private healthcare for Scottish rugby union. In particular the scans and physio work from injuries from playing. One of the few private hospitals in Scotland.

Is there a potential conflict of interest with NHS consultants working for a private company being funded mainly by the NHS which competes over the same business?
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 Poster: A snowHead
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I suspect that private vs NHS is debatable both ways...

Sister is a doctor and has complained about some private operations, pointing out that they weren't that much slower on the NHS, but x% will have certain complications, regardless of who does it and the private providers have no/limited capability to actually deal with this (they just call an ambulance and ship the now seriously ill patient to the nearest NHS A&E who then have to pay for the costs of fixing it...) This is also leading to some push for privatisation that really needs care (private providers going "Look, we can do the operation cheaper than the NHS!" while failing to mention this is only by cherry picking patients (while NHS rates allow for the fact that a good chunk of what you are charging is actually for the complex cases and running A&E/intensive care/etc wards that deal with the cases where it went wrong). (if the insurer/private care were required to deal with everything rather than pushing off ther most expensive immediately life threatening bits off to the NHS, costs would go up drastically in the UK)

Equally she has used private physios because the NHS provision is basically non existant. It isn't urgent and usually won't kill the patient so isn't a priority and is an easy place to cut costs... Of course in the long run instead of recoving you now have a patient with long term issues (weight gain and associated problems, mobility issues and needed support, injuries from falls etc) which get worse over time, costing far more in the long run than providing proper physio would have cost in the first place rolling eyes
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@qwerty360,
Quote:

some private operations, pointing out that they weren't that much slower on the NHS, but x% will have certain complications, regardless of who does it and the private providers have no/limited capability to actually deal with this (they just call an ambulance and ship the now seriously ill patient to the nearest NHS A&E who then have to pay for the costs of fixing it...)

I'm extraordinarily glad that this was not my experience of major heart surgery, carried out privately by a team (both surgeon and anaesthetist anyway) shipped in lock, stock and barrel from a major London teaching hospital. The private hospital was, effectively, an outpost of the said teaching hospital, for the purposes of urgent, private cardiac surgery. I had to wait for the surgeon, even privately; I would have been dead before reaching the top of his NHS waiting list. I remember asking my (NHS) consultant cardiologist why he recommended this particular surgeon, and he said, 'because he's the right man for the job'. If I'd had to stay in the NHS, I wouldn't have had the best man for the job. Thank God for my health insurance. Incidentally, post-op, I just slotted back into NHS care at the teaching hospital for the foreseeable future.
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@Hurtle, and how very glad we all are!
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@holidayloverxx, aw, thanks.
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Hurtle, it is brilliant you got your cardio operation done before any health disaster. Well done to all concerned. Glad it all worked out. No one would begrudge you.

But your post does illustrate that all good Private Hospitals are essentially outposts of a nearby NHS hospital. Sometimes the nearby hospital is a Teaching Hospital. In London there are lots of Teaching Hospitals, so the likes of London Clinic, Princess Grace, Cromwell and Wellington are served by doctors from a number of Teaching Hospitals. The nurses may be employed by the Private Hospital, but mostly the doctors are not: they are ordinary NHS staff working in their spare time. Some may be special, most are not. Anyone on the GMC register can work in a Private Hospital.

If you had gone with the "major London teaching hospital" (I am intrigued to know of any minor London teaching hospitals) then presumably you would have got the same surgeon.

So the medical staff are same as NHS. What you get going private is a smart building, your own room, better food, and (usually) the ability to get your treatment quicker than on the NHS. Which for many - like you - is the main selling point.
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I think you can add being able to select your consultant is a big selling point for me. Or being referred to a specific consultant can make all the difference with certain treatments.
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@Jonpim,

Have you ever had a medical procedure/surgery?
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@Jonpim, the value of having surgery you need sooner when you are in debilitating pain is well worth the thousands of pounds I spent on getting the surgery I needed.
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skimottaret, you can actually select your hospital/consultant on NHS (NHS Choice Framework), but often your GP will resist if not part the practice's normal pathways. The process is easy if go Private.

Mr.Egg, yes.

NickyJ, quite agree. As i said: the main selling point. My partner did just that when damaged her shoulder.
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@Jonpim, in my case it was my shoulder- interestingly, the consultant was saying they had stopped doing that op on the NHS. Apparently due to inconsistent outcomes. Having had that surgery on my other shoulder, I was told I needed to start physio after a number of days or weeks (I can’t recall now), but it didn’t come through so I paid privately for the physio which gave me great outcome. Talking to others who had se surgery they also didn’t get physio.... no wonder it wasn’t getting good outcomes!!!
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I think that may be the difference between "being insured" and buying what you need when you need it.

If you're insured, you're no longer dependent upon taxpayer value for money, instead you have insurance company profits to deal with.
No doubt the food's better, but it's essentially the same thing compromise.
Paying for stuff is different, if and where you compromise is entirely up to you.
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Interesting thread. I would agree that the main benefit of private healthcare is speed. This is going to be even more important over the coming years as the NHS struggles to catch up from a 15 month hiatus. Interestingly some NHS trusts have put a block on private work in certain areas eg cardiology as they are prioritising NHS patients. Self pay is always a gamble but will work out for some but not all. I enquired about some talking therapy for one of the kids recently which was included on the family policy, but in order to get company to payout they had to be seen by a psychiatrist first! Needless to say we are paying twice as using a 'self pay' child psychologist to ensure nothing recorded on child's medical history which might come back to bite in the a$$...
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@Jonpim,
Quote:

If you had gone with the "major London teaching hospital" (I am intrigued to know of any minor London teaching hospitals) then presumably you would have got the same surgeon.

By 'major' I meant nothing more than a hospital which most people would have heard of. And, no, as I explained, the NHS wait for that particular surgeon would have been too long to be safe. I stress that for the period leading up to the operation (actually there were two operations, I had to have an aortic valve redo) and ever since, I was and remain with the NHS*. It was only the surgery itself that needed, in my estimation, to be dealt with privately. Incidentally, post-operative physio on the NHS was excellent.

*Actually, that's not quite true. I had to see my consultant cardiologist (of 8 years' standing) privately before he would pull his finger out and look at my backlog of annual echos, to identify for himself the problem which was immediately and blindingly obvious to both the valve specialist consultant and the surgeon when they eventually got to see them. I was not amused and am rather glad to be out of his care at this point and in the care of the valve clinic instead.
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Mr.Egg wrote:
@Jonpim,

Have you ever had a medical procedure/surgery?
He's a retired consultant, I believe.
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@philwig,
Quote:

the difference between "being insured" and buying what you need when you need it.

With the benefit of hindsight, I wish I had saved to 'self-insure' from the point at which I started having to pay for insurance myself. Too late now. Confused
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@Snowsartre,
Quote:

Interestingly some NHS trusts have put a block on private work in certain areas eg cardiology as they are prioritising NHS patients.

Exactly the case for the hospital I attend. Fair enough, in my view.
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I’ve got a Axa policy via my employer. Never used it but had cause 4 weeks ago to see a GP. Urgent referral for an ultrasound, 5 weeks wait on NHS or one phone call and I was seen at 1pm the next day so less than 24h later abs one less person clogging up the NHS waiting list. Went in, Spire Murrayfield actually, scan done, wanted to see something else so asked if I had time and gave me an MRI about 30 mins afterwards. Consultant got me a cup of tea and then we had a chat about the outcome which thankfully is all good. In and out in 3 hours. Seems like a similar debate to private schooling - is it additive or not to the overall system ?
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