Private Medical Insurance or NHS?

If you are considering taking out private medical insurance (PMI), there are a number of factors that you need to consider. In particular, you may wish to find out how private care compares with NHS services in the area that you live.

Waiting lists

ambulance in londonWaiting times are usually considerably shorter if you go private, and this tends to be the main incentive for people who chose to pay for their healthcare. However, if you wish to be seen by some popular private consultant specialists you should be aware that this can actually take longer than NHS waiting times.

Waiting lists on the NHS vary between regions, and also within hospital trusts if you are looking at treatment for different conditions. If you’d like to research waiting times for certain conditions in your area, visit the NHS site. Generally speaking, NHS waiting times are falling, and the maximum waiting time should now be 18 weeks, after which you can demand to be seen privately.

General standards of care

The Quality Care Commission regularly produce reports on standards of care in both the NHS and the independent health sector. When it comes to quality of care and meeting all the required standards, there is no significant overall difference between the public and paid systems. However, there may be differences within your local area, so you may wish to use their searchable database to see their findings.

Prescription costs

A standard NHS prescription costs £7.65 in England, unless you need elastic hosiery, which costs £15.30 per pair. Patients needing several prescriptions each month can bring their costs down by purchasing a Prescription Prepayment Certificate (PPC). For example, if you need four or more items within three months, a three-monthly PPC costs £29.10.

Many NHS patients also get free prescriptions, such as the over 60s, under 16s, hospital inpatients, pregnant women and others who hold the relevant exemption certificates. There are currently no prescription costs in Scotland, Ireland or Wales.

Some medicines are not widely available on the NHS, and many private prescriptions are for the following types of drugs: some treatments for sexual dysfunction, certain antimalarial medicines and other travel drugs, and some hair loss treatments and smoking-cessation drugs. The cost of any private medical prescription must be met wholly by the patient. The price can vary greatly, as there is usually a fee involved for writing the prescription. Different pharmacies may also charge different amounts of money for the same drugs, so patients may need to shop around to get the best deal.

The NHS ‘postcode lottery’

Since 2010, the NHS has made its Atlas of Variation in Healthcare data available to the general public. It is a complex document and the data should be interpreted carefully – some of it relates to patient behaviour and other demographics, as well as to local standards of healthcare.

The latest edition, the 2011 version, contains 71 variables that show differences between geographic areas. For example, it reveals a 25-fold variation in anti-dementia drugs prescribing rates across England, and shows that patients with Type 2 diabetes are twice as likely to receive the highest standard of care in some areas of England in comparison to others.

It has been dubbed the ‘postcode lottery’ by the popular press, and it’s clear that some areas fare better than others when specific health conditions are looked at. If you’d like to look at the 71 results for your region, you can download a copy of the atlas. Unfortunately there is no atlas for private healthcare to make a direct comparison with.

Appointment times / doctor availability

As a general rule of thumb, appointment times are more flexible in private healthcare. Some patients prefer this as it means they can be seen at early morning, late evening or weekend appointments.

Choice of consultants

If you go private, some insurance policies do guarantee that you’ll see the consultant of your choice, but not all. It is worth checking the small print before buying any policy.

Via the NHS, you may not always be able to see the exact consultant of your choice, and in some cases you may end up seeing a less senior doctor or surgeon. You are entitled to request to see a particular NHS specialist, which can be done via your GP and the ‘Choose and Book’ service.

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