Private or NHS, the decision was mine...

February 2, 2018

In the UK, we are fortunate to have an amazing National Health Service, which is admired all over the world. Granted, it is stretched to the limits at the moment and it's not perfect, but it still knocks spots off public health services in other countries. 


So, if we have this world-class provision, why did I choose to go down the private route for my surgery and subsequent treatment for ovarian cancer?


My 'private' life

I have grown up accustomed to access to private health.  Following my father's untimely death, his previous employer continued to provide my family with private health cover.  At 21, I transitioned seemlessly to my employer's private health scheme.  Once I got married, I qualified for my husband's company scheme, as his wife and in turn, my sons were also covered. 


After my divorce, the private health cover was withdrawn, so replacement insurance was at the top of the essential outgoings list, a must-have rather than nice-to-have.  I carried out careful research to find the best value policy to cover me for every eventuality, including cancer - if I was paying for it, I might as well have extensive cover and I am so grateful I had this foresight 6 years ago.


It was an expensive necessity at £280 per month.  Since my cancer diagnosis and treatment, this has risen steadily and from March, I will be paying an eye-watering £415 a month, but I still regard it as a worthwhile expense and one I wouldn't do without.


Hospital experiences

I didn't become aware of the benefits of private health until my mother had a minor operation when I was about 10 years old.  I recall being taken to visit her for the first time. I walked into the clean, bright, modern building (check) and was led to her private room (check), complete with ensuite bathroom (check) and large colour TV (check).  However, that wasn't what impressed me the most.  As a food-obssessed child, it was the visitors' restaurant and the range of food on offer which swung it for me.  I couldn't wait to visit her in hospital, knowing that I would have dinner in the canteen!


When I was 19, I went to hospital to have my wisdom teeth removed and this first experience as a hospital inpatient was a private one.  However, I was disappointed to discover that not all private hospitals are the modern environment which I had witnessed during my mother's medical sojourn.  This was the Lindo Wing at St Mary's Hospital which, despite being the chosen place a few years earlier for the birth of Prince William and subsequently, Prince Harry, was somewhat rundown and not the lap of luxury I would have wished for.


My only NHS hospital experiences have been when my two sons were born.  The first time, I spent 4 nights in hospital, but managed to secure a side room.  A friend had also given birth the day before and was recuperating in the nearby private wing.  I would wheel my newborn in his cot to the private haven, where she and I would sit in relative luxury, drinking ice cold Coca Cola from the fridge in her room.  So despite having a perfectly good side room to myself, I still sought out that private experience.


With my second son, I was on a ward of four beds after giving birth.  However, there were only two of us on the ward, and I was only there for about 3 hours after giving birth before I was discharged.


I have on occasion taken myself to A&E for unexplained rashes or pains; I have always been very impressed with the attention paid to me and have never had to endure the lengthy waits often reported in the news. 


When my youngest son was 2 and rushed to A&E with a broken leg, he was mostly well looked after, except the full leg cast stopped short of the break. The top of the cast was pressing on the fracture, causing him unnecessary pain and distress, which he couldn't even communicate at his young age - I was secretly pleased that he peed all over the doctor who changed his cast to correct the error.  Weekly visits to the fracture clinic were arduous and I dispaired at the lack of organisation, always wondering whether I should have moved over to the private sector, to have avoided the crowded waiting room and apparent blatent disregard of appointment times.  


So, why is private health insurance so important to me? 

I have always paid my National Insurance contributions so have every right to use the National Health Service at my discretion.  So apart from A&E and maternity, why have I opted for private over NHS?


It's not because I am under the impression I will receive any better care or treatment in the private sector.  I honestly don't believe that money buys you superior healthcare, education or even handbags and shoes!  


However, private health does afford me the following benefits:


1. Peace of Mind 

This the main reason for my decision - the security of knowing that if ever feel unwell or am concerned about a health issue, I am able to seek advice and consult the relevant specialist almost immediately, without having to wait for an appointment via the NHS.  I know that if there is a lengthy gap between seeing a GP and being referred to a specialist, my mind would wander and my imagination would run wild.  By the time I saw the consultant, I would have convinced myself I was dying from the bubonic plague.  


Indeed, when I first visited my GP back in March 2016, with unexplained stomach pains which had been constant for 3-4 weeks, I saw a consultant gynaecologist less than a week later.  Despite being unable to see any cause for concern, she nevertheless carried out a series of blood tests, where a raised CA125 (marker for ovarian cancer) piqued interest.  CT and MRI scans followed and despite having gone down the private route, my case was scrutinised by the local NHS hospital's Multi-Disciplinary Team (MDT). 


It was that MDT which spotted the cyst on my tucked away on my right ovary, attached to my womb, which they originally diagnosed as a borderline ovarian cyst with just 10% chance of malignancy.  Although at that stage it wasn't classed as cancer, the MDT recommended cancer surgery. 


I was referred from the gynaecologist to a gynaecological surgeon, with the assumption that I would continue on the private route - I guess once you're in the system, that's where you stay until you request otherwise - and that probably works both ways.  Not that I questionned it either as it had been just 3 months from my initial GP appointment to the point of major surgery - I may not even have seen a consultant in that timeframe on the NHS.


2. Luxury

I am a snob, let's not beat around the bush.  I have always liked a nice environment and this was evident as early as the age of 3, when I was taken to Harrods, I looked around and declared "I like this shop!"   


As my oncologist said when I questionned whether I should receive my first round of chemo privately or via the NHS - and I quote - "why would you choose the hospital when you can have the hotel?"


Why indeed?  I was paying £280 per month, I had bought the right to be treated in a clean, modern hospital, in a private room with ensuite facilities, a TV, even room service with food and drinks available from the 'pantry' at the touch of a button. 


Like an five star hotel - or top department store - a private hospital has that air of luxury and exclusivity about it.  There are generally fewer people and it is often quieter too.


A big plus for me is having my own room with private facilities. Post-surgery, if I had been on a ward with other people, I would certainly have been deprived of much-needed sleep, as I am a very light sleeper and the smallest amount of snoring, talking or simply breathing can disturb me to the extent that I wake and find it impossible to return to sleep.


During chemotherapy sessions, I normally take my laptop and do some work or write a blog.  I may watch television, listen to music, read a book or have a nap, all without the distractions of other patients.  I know some people would hate the thought of being shut away in a solitary confinement and would miss the interaction with other patients which happens on an NHS chemo suite.  I think if I was in the chemo suite, I would close the curtains during treament to afford myself some privacy and avoid any interaction.  


3. Personal service

Each day, and night, following my operation, I had a dedicated nurse looking after me, whereas on the NHS, it tends to be whichever nurse on duty is able to attend.  This meant I built up a rapport with the nurses and they gained an understanding of my specific needs and requirements, which was very reassuring. During my last few days in hospital, I had the same nurse looking after me every day, who by then had a complete knowledge of my case history.


The same is true when I go for chemotherapy.  At each session, I am allocated a nurse who looks after me that day and sees my treatment through from beginning to end.  As I understand it, in the NHS chemo suite, you could be seen by numerous different nurses in one session.


I am not saying the private way is better than the NHS, but it is different and it works for me.


4. Additional benefits

Some drugs are available to private patients earlier than they would be on the NHS.  For example, Avastin (Bevicuzamab) was made available to me for second line chemotherapy, but there are much stricter guidelines for prescribing it on the NHS.  The Cancer Drugs Fund (CDF) stipulate specific criteria to qualify for the drug and then, only 18 cycles (whereas I have known some people to have been on it for up to 2 years).  


At some point in the future, I will be treated with drugs called PARP inhibitors.  Whilst NHS patients must have at least three rounds of chemotherapy to qualify for these drugs, my private insurance means I do not necessarily have to satisfy the same criteria.


Recurrent ovarian cancer and ongoing treatment means if I want travel insurance to cover the cancer, I would have to pay exorbitant amounts - I was recently quoted £1000 for a 2-week trip to Spain.  However, my private health cover includes travel insurance with no medical exclusions.


5. Cost

My private health insurance provides me with total transparency regarding the cost of my treatment.  I am able to check my statements online and see how much has been paid out for treatment.  


In 2016, the year of my operation and subsequent diagnosis, my healthcare provider paid out over £40,000 of which I paid only 8% of that amount in premiums.  In 2017, the amount paid out on my behalf had more than doubled, at over £84,000, of which I paid only 5% of this amount in premiums. 


The question is, have I saved the NHS this amount of money?  I found an NHS tariff online but it is difficult to navigate, so I haven't been able to find the comparable cost of my treatments on the NHS.  Similarly, the CDF gives no information on cost of drugs which are on it.  


The way I see it, the NHS is under-resourced and over-subscribed, so I feel like I am doing a public service by going privately.  I am one less person zapping the NHS's limited resources, at the same time, making space for someone who doesn't have the benefit of private health insurance. 

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