So....here we are... the future of the NHS

https://whh.nhs.uk/application/file...s2Z-MsCGXEw0u9X4H76JHL7Av__xJRA1fEt6SNc-CjCIU

This is coming to a hospital near you all too soon.

 

I dread to think how much I would have paid to have some nitrous oxide blasted on my back, like I did last week, up at Dermatology. I'm pretty sure the Consultant thought I was wasting his time and NHS money, but the GP referred me.

For a wart, it turned out.

 

Blimey I've notched up quite a few of those, free, gratis and for nothing!
Quick tot-up, £23K, and I may require a ganglion cyst removal if the injection doesnt work. Ker-ching!
What is this then, a queue-jumping service?

 

So what is it?
I can see it's a list of prices, but how does it work?

 

A cheaper alternative to going private for procedures which the NHS regards as low priority.

 

Is it this idea of the basic no-frills service run in tandem with the jump-the-queue gold-star option?

I understand that's an idea that has been mooted.

 

No its not free, gratis and for nothing. You have already paid and will continue to pay for these services regardless of if you use them or not.

Its called taxes, you should not be expected to pay a second time for most medical procedures.

 

As I understood it.... this is the shape of things to come. Judged probably as non-emergency procedures if you want/need them doing ...you pay.

 

Not really. It is a list of procedures that the NHS will seldom perform unless there is, say, particular psychological need. In the past, people who want, for instance, a vasectomy reversed have had to go private or, if their hospital trust offers it at all, have had to face a very long waiting list. This scheme (offered by many hospital trusts) offers a cheaper alternative to going private.

Cataract removal costs £2000 - £4000 per eye if going private, while My Choice offers it for £1624 per eye for those who want to avoid the typical 18-week waiting list.

 

So the NHS is becoming an emergency-only system?

Many of the things listed are life-changing operations, treating things which can prevent people working or having a quality of life: hip & knee replacements, cataract operations, steroid joint injections, treating heavy menstrual bleeding.

How is cost-effective to have to pay for operations etc which would enable people to work and contribute to the economy, rather than being a drain on it through disability and illness?

 

What is the psychological need for a knee or hip replacement? Cataracts? Steroid joint injections? Heavy menstrual bleeding? They are debilitating conditions preventing people from working.

 

Well my hubby had to have a cataract replaced and he didn't have to wait too long but we would have waited ages rather than pay £1.624! Some of the things listed are essential not done on a whim.
It's the slippery slope just like the dentist, now it's very difficult/impossible to find an NHS one.Private ones always want you to visit the hygienist or have more x-rays. I stopped having x-rays at my last NHS dentist as the film, even when using children sized ones always made me gag and choke.

 

If the condition is debilitating, it will be treated on the NHS. A typical example is varicose veins (which this particular trust says it has been charging for since 2013). If they are painful, they will be done on the NHS. If they are merely unsightly, they are unlikely to be offered on the NHS.

 

If something is essential, the NHS will pay.

 

Yes, but most people will take out more than they pay, and not recognise that they are receiving a subsidy.

Most people very quickly won't be paying a second time if they need any serious interventions.

 

I didn't want to write an essay, so I was probably unclear when I merely said psychological need. Because the OP only published the price list, it is very easy to misunderstand the idea of "My Choice". Take a look at the Trust's Criteria for Clinical Procedures:

https://www.whh.nhs.uk/application/files/1515/4177/7487/PLCP__2018-19_FINAL_Policy_Document.pdf

There (page 74) you will see that NHS funding is available for hip replacement if the patient is suffering from severe joint pain AND limitation of movement (amongst other criteria).

The 'My Choice' option to pay for the operation is there for people who are not yet suffering severe joint pain and limited movement, but who have been told that this is their outlook and have therefore decided they want the operation now, before the symptoms start.

 

Fine for that example - but the examples I gave (hip & knee replacements, cataracts, heavy menstrual bleeding, steroid injections for joints) are done because they ARE debilitating. There's nothing cosmetic about any of them. The only reason to pay is to have them done more quickly - queue-jumping. So why are they on this list?

 

Our posts overlapped!

So, yes, paying to have them done is to jump the queue.
Because if the operations are done by NHS doctors as part of their NHS contract, then those who 'choose' (i.e. are rich enough) to pay will be ahead of those who are in pain etc, and who will consequently will have to wait even longer.

 

The trust say that no queue jumping is involved as this elective service is only offered for conditions where they have spare capacity to carry out the procedures required:

"Patients are scheduled into available slots on existing theatre lists and, after being referred, are treated exactly the same as NHS Patients ... Patients will have to wait for their treatments just like an NHS patient, there is no ‘queue jumping’ or private rooms or services."

It is strange to think that hospitals have spare capacity, but it is in part the result of changes to procedures in recent years - I know from my own experience that colonoscopies that were once done by the senior consultant are now carried out by specialist nurse practioners, giving the big cheese much more time for operations, and I'm sure there are many similar cases of streamlining.

 

I posted this link on the Podcasts thread yesterday. The programme picks a random postcode and visits it to see if there are any interesting stories that don't make it into the news. In this episode, they visited a Chatham postcode where they unearthed the story that it's very difficult to get a GP appointment, but an enterprising pharmacist gained the qualification to be able to prescribe medications that it would normally be expected only a GP surgery could prescribe.

Apparently the law changed not long ago to allow pharmacists to do this. However the medications have to be paid for, even if the patient is exempt from having to pay. He says he is always busy, usually finding a queue of around twenty people each morning waiting for him to open the pharmacy up.

Do have a listen and ask whether this is what you expect of the NHS.