With all the shock headlines that we’re seeing about the NHS today, from funding problems to long waiting times, you might be forgiven for thinking that the private healthcare system, awash with money from the UK’s £4.7bn medical insurance market, has the financial luxury of treating its patients better.
I have had my first ever brush with private healthcare recently, courtesy of an unexpectedly aborted medical procedure, and if this experience was anything to go by, I will never be tempted to use it again.
A bit of background – I have a tendency to get blepharitis, which can lead to hard lumps on my left eyelid. I have come to learn that these are called “chalazia” (plural for chalazion – which sounds like a boarding school from an Enid Blyton story, but I digress).
A chalazion is benign, although it can lead to more serious problems if it gets infected. It can also be treated at home with hot compresses and other products, but persistent chalazia that won’t go away or are particularly inflamed/growing in size can be treated with surgery.
The surgery isn’t like a triple heart bypass – it can be done by a specialist fairly quickly, under local anesthetic, with a small incision made in the lump to drain it. You have to wear an eye patch for a day, with bruising up to a week afterwards.
The standard advice is to visit your GP if a chalazion hasn’t gone away after several weeks. But trying to get a chalazion removed on the NHS is a time-consuming and slightly fraught process. You need to visit your GP, then get referred to an opthamologist, and there is no guarantee that the surgery will be approved (largely because it isn’t life-threatening). So you may spend hours in various waiting rooms, during working time, to no avail. My last attempt to get a chalazion removed saw me wait in an eye hospital for half a day.
“Fair enough!”, you might say. I pay my taxes and try to be a responsible citizen. I didn’t really want to use the NHS to treat a largely benign condition. So I decided against pursuing surgery on the NHS and fortunately my first chalazion (makes it sound my “first true love”) went away of its own accord after about six months.
I didn’t think it would come back. But it did – with a vengeance! This time, it was bigger, badder and redder than before. While it is still clearly a bog-standard chalazion and nothing more serious, it wasn’t going away and it was starting to make me feel self-conscious, particularly when doing TV or online appearances.
I decided that on this one occasion, I would dig into my pocket and pay for the one-off treatment. Don’t get me wrong reader, I’m not sitting in my golden office chair right now blowing my nose with £10 notes. I am hugely grateful for the NHS and believe wholeheartedly in the concept of heath-care based on need, not ability to pay. I don’t have private health insurance and have never spent money on medical treatment before (I am blessed with reasonably good health). But I wanted a speedy and effective treatment for a problem that was really bugging me, and I was prepared to pay for it.
I started shopping around online. I wanted to get the treatment done in Edinburgh after I took part in an ethical round-table event. I found a private clinic in Edinburgh that claimed to offer the treatment I needed. I phoned up, and enquired about the procedure and cost. I was told that I could have a consultation, treatment and advice on aftercare all in one session at a rate of £395.
While I have some decent savings, and my earnings have seen a nice little uptick recently, this is still a lot of money for a self-employed young professional to spend in one go. But this was actually cheaper than all the other quotes I had been offered, starting typically at £500, so I reasoned that I was getting a (comparatively) good deal within this market for quite a straightforward treatment. So I booked it and made plans to work from my parent’s home in Edinburgh for a few days while the eye recovered (no Vanity Fair Oscars after-party invite for me).
But I wanted to make sure that the consultation and treatment would go ahead at the agreed price. So I phoned the clinic the week before my scheduled appointment to double-check all the details. Yep, all confirmed: £395 for the consultation, treatment and aftercare advice.
Fast forward to the day itself and I arrive at the clinic in question with my mum (for moral support), feeling a tad nervous and looking forward to getting my chalazion removed. After checking in, I am asked to wait outside the treatment room. Half an hour passes…crikey, this is a bit of a long wait for an appointment booked weeks in advance privately, no? Still, I try to be a patient patient. Getting the procedure would be worth the wait.
I am eventually ushered into a room where I proceed to describe the problem and the treatment I’m seeking…a formality really, given the doctor already has my notes from the receptionist who booked my procedure, and is a specialist who does this probably every week and knows the routine procedure inside out.
Because that’s what I’d been told over the phone. That I would be seen by a specialist who will diagnose, treat and then advise on aftercare.
Only after I’ve given the low-down does the doctor tell me: “I don’t do chalazia”. Eh? What do you mean you don’t “do” chalazia? I thought I was seeing a specialist about this very problem? Far from it. She says: “trust me, you wouldn’t want me going anywhere near your eye”. Phew. I don’t feel in the slightest bit worried now about this clinic being let loose on my eyeball.
NOTE: not my actual eye. This one is lot prettier than mine
There was a mix-up. This doctor does everything EXCEPT chalazia. It was almost like the clinic had played a rather mean trick on me. “The receptionist you spoke to wasn’t aware that I don’t do chalazia. They haven’t updated their records.” So those two phone calls I made to check I would be receiving this treatment on this particular day with the right doctor were entirely pointless, because it turns out the clinic’s booking systems aren’t fit for purpose.
She says: “We would need to get you booked in with a chalazion specialist. I don’t know if anyone will be free this week.” Seriously?
I say: “I’m very disappointed. I have explained several times over the phone what the problem was and what treatment I was seeking. I have booked time off and made arrangements to have this procedure done, and now you’re telling me it can’t happen because of a mistake?”
No apology. No words of reassurance. She says: “Let me make some calls.” What benevolence! She rings once. No response. A few minutes pass, with her telling me the same thing three different ways. “I’ll give them another ring and we’ll try and sort something out.” She says this like it’s a Herculean task to source a healthy kidney in a war zone rather than find someone in the building to provide a service I’ve booked for.
After she hangs up, she tells me that the clinic *might* be able to squeeze me in this afternoon, as a consultant has an unexpectedly free window. She then asks me to accompany her on a mission to accost said consultant on the stairs of this clinic to confirm (I’m not joking). My mum and I hang around on the landing like naughty children while the specialist explains my medical needs to the consultant in full earshot of people passing by. Hardly the professional, confidential and efficient service you hope for.
But worse was to come. The doctor said we would have to wait another half an hour – fine – but then came the sting in the tail. Just as we neared reception, only this time with lots more people listening in the quiet waiting room, she told us that she wouldn’t charge us for her “consultation”. Just a quick recap – this doctor didn’t even look at or touch my eye, let alone diagnose or advise on it. To not pay hundreds of pounds to a doctor who just told me she couldn’t treat me…well, my heart swelled with gratitude, doves flew out of the alcoves and the heavens opened with all the trumpets and angels, proclaiming this a truly saintly act. Canonise this lady, forthwith!
“But the doctor who is treating you will be charging differently. And you may have to pay a separate consultation fee for him, but I’m not sure. He’ll let you know.” How much?
£650, without even taking a consultation fee into consideration. This was almost twice the original cost, and I had the bonus pleasure of having to wait around for half an hour to find out if the consultant would rinse me for a further £200 just for diagnosing a problem already familiar to all of us (with no option, by that point, except to pay up).
After the consultant left me to stew on the new hole that would appear in my bank statement, I tried to make my peace with this new turn of events. But my confidence in this clinic was shattered. I had received no apology, no offer to reflect the mistake in my new eye-watering treatment price, no cognisance of the inconvenience, embarrassment and financial shock that had occurred. No attempt at medical or financial confidentiality and no effort to even book me with the right consultant in the first place. If the clinic had behaved in such a shoddy way thus far, how could I trust this consultant, squeezing me in between patients and his lunchtime packet of crisps and BLT from Sainsburys, to perform the procedure safely and correctly on my eye?
However qualified, dedicated and careful their doctors might be, I couldn’t afford to risk my money and left eyeball in a clinic that had (so far) been incompetent, careless and high-handed. So with a heavy heart, I cancelled my treatment and left.
I felt misled, foolish, disappointed and disturbed. I didn’t know much about private healthcare prior to this experience, but I had assumed there was a level of quality, transparency, service and professionalism that would be concomitant with such a huge industry funded mainly from private medical insurance policies and not burdened by the same demands facing the NHS. I now understand, from the offhand way in which my treatment price was raised, that there is no discernible connection between value and service thanks to the insurance system. Most people seeking private treatment go through their health insurer, so my experience of a more straightforward transaction is probably not typical.
But I would be deeply worried if I was paying private medical insurance to fund such dysfunctional clinics, which have an obvious disregard for pricing clarity or consistency. Was my clinic really any more efficient and functional than an NHS hospital? Was it offering PMI holders any better “value for money” that they could get from paying their taxes and visiting their GP? I wonder.
Fundamentally, I suspect there is a cultural problem at play. The medical professionals I dealt with just didn’t seem to care that much. Didn’t seem to care that this had become important to me, that I had made plans around my treatment, that I was a young professional who was going out on a limb to have and pay for this service, that I would be nervous about people touching my eye and that I was seeking reassurance, clarity and fair play. The prices quoted might not be much to them, but they were a lot to me, and anyone with a ounce of empathy in this scenario would have responded far better to the initial mistake and handled me more sensitively and fairly.
Because errors do happen, as they do in the NHS. It is the way we deal with them that counts. Do we hold our hands up, admit we’ve got things wrong and try to put them right so the patient feels happy and secure in our care? Or do we refuse to acknowledge or even apologise for what we’ve done wrong, let alone try to atone for it?
Well, I’ve certainly learned from my mistakes here. I have realised that private healthcare is not the answer. I took another route, and re-registered with my GP in Edinburgh (as I’m spending more and more time there on account of work). As soon as I did this, I started getting comprehensive, thoughtful and sensible advice on how to treat my dry eyes, blepharitis and chalazia. Even the receptionist at my local practice gave me the helpful suggestion of booking an appointment with my optician (last appointment made: 2008!)
So I trekked through the snow in Edinburgh last week (which was strangely enjoyable) for a thoroughly productive consultation with someone who knows everything there is to know about eye gripes. He gave me a detailed treatment plan, and told me to come back only when I had exhausted all self-care options. The total cost was £25 for a test to check I didn’t have glaucoma (all clear) and eye drops to keep my peepers lubricated.
But the optician also wasn’t afraid to kick me up the butt. He made me realise that (sometimes) there are no easy answers you can pay for when it comes to your health. He would rather have taken the time to get to know my problem, my lifestyle and more practical ways to treat my condition than rush into surgery at my (considerable) expense. That’s REAL care and compassion, right there on the NHS – and you can’t put a price on it.