Private healthcare for urogynaecological conditions

Some of the people we spoke to had opted to have private healthcare instead of, or on top of care from the NHS.

This section covers:

  • Reasons for opting for private healthcare
  • Experiences of private healthcare
  • Paying for private healthcare

Reasons for opting for private healthcare

One of the main reasons we heard for ‘going private’ was to see a specialist sooner. Jan, Kerry, Elizabeth, and others said they had experienced long waiting times to see a healthcare professional in the NHS, made worse by the Covid-19 pandemic. Clare and Phoebe had seen a GP privately. Phoebe found using the private health insurance (provided through her workplace) quicker and easier than trying to get an NHS appointment. Elly, who has prolapse, saw a specialist privately after having appointments cancelled because of Covid-19.

Jan chose to go privately for help with prolapse and urinary incontinence because she “wasn’t really getting anywhere” with the NHS route.

Well I’ve not, I’ve not had any, this is the reality that in the four years, I didn’t get offered by my doctor to be referred to any hospital. They said it wasn’t severe enough and another friend has said the waiting list to get in is over a year to get any sort of test for the referral for stress and urge incontinence, it’s so common with women and the NHS has offered me to go back to the pelvic floor lady but she says it’s an over six month waiting list to get to see that nurse again and so it’s only through the private health now that they’ve phoned me and I’m having urodynamic tests done in three weeks’ time. I’m seeing the private pelvic floor lady in two weeks’ time and this is what I’ve been waiting for somebody actually to do some tests to see how severe it is, what they can do. The consultant mentioned a whole list of lots of things they can do apart from major surgery includes, including Botox injections at the neck of the bladder and so it’s, it’s given me lots of sort of positive feeling that ‘Yes, I’m gonna, I’m gonna try and do my best to sort this out without major surgery and try all these different avenues first and hopefully I won’t need surgery.’

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However, even in private healthcare, it could take a while to see a specialist. Laura described “feeling immensely ill and you’re having to try and find your own treatment and your own people to treat you and then dealing with the worst thing you can be told when you’re in that much pain is, “We can see you, but it’s three, four months’ time”.

Beth, Elly, Kezia, Amy, and others chose private health care when they felt they were not getting a diagnosis or effective treatment in the NHS. Beth said, “I’m really tired and exhausted and frustrated therefore I’m gonna go down this route instead”. Elly had also felt “I’ve had enough, I need some clear answers”. Phyliss had lost trust in NHS services. She went privately and was eventually seen at a tertiary clinic. Amy felt the NHS specialist wasn’t listening to her and went for private healthcare. Mehar and others felt they could only get the tests and treatments they needed privately.

Mehar was able to get more tests when she had private care. She thinks that NHS doctors would do more tests if they were not underfunded.

Sometimes doctors will look at you and say, “Oh there’s nothing actually wrong with you, you can just be on your way.” Even after all the diagnoses you have and then there’s some who just say, you know, “I don’t wanna deal with this, you’re too complicated.” I’ve actually had doctors, NHS doctors say that to me, they’re like, “It’s too complicated, I’m not dealing with it.” So, I don’t know if that’s just NHS and private or a general thing like I don’t know what’s that about but yeah like I also have noticed that then relating to that, they’re not willing to go above and beyond, they’re not willing to look into things. Like I went to this gastro doctor and she was really dismissive, like I went to her after my private doctor said, like he doesn’t specialise in gastro but he pointed that, you know, this and this might be the issue and you need to get a gastro to check and so I went to the NHS and I got an appointment and I said this and this is what my consultants think, “Can we test?” and she just laughed at me, she just, “Nope, other people have this problem and I don’t wanna test for it.” I was just like “Oh okay,” then I went back to my private, and he goes, “No we’re running these tests because that’s wrong because your symptoms aren’t normal,” you know, I don’t know. I feel it does come down to lack of funding because they can afford to do these things and the NHS can’t afford to run tests. They also can’t, they don’t test for a lot of things. They give a blood to a pri-, if you go to your GP and say, “I need a blood test because I have these symptoms,” NHS blood tests are quite basic compared to private blood tests, sorry, private will look into everything deeply where the NHS doesn’t, they don’t look into anything and that’s also what causes a delay in diagnosis because they don’t have the resources. Some aren’t, some willing to do it and then because they don’t find anything their initial report it’s like, “Oh well you can go away now.”
 
Mm and do you think that it that it comes down to finance and resource?
 
Yeah definitely, definitely if the NHS had more money, I do believe they would do more than they’re currently doing. 
 
So, I don’t think it’s entirely the NHS’s fault. I think the main problem is that they’re underfunded, you know, they don’t have money like private practice does to throw around on tests and things, they have to be really careful on what test they do, on what person and how much it costs and is it worth it? I think they really have to sit there and think. Whereas, private practice, you have a problem and they’ll be like, “Oh we can do this test easily,” because they can afford to do it. Whereas because the NHS is one big, obviously one big bubble of and there’s so much going on in there, one doctor can’t sit there and say, “I’m gonna do the test” because he doesn’t have the power to do that. It depends on the hospital, it depends on funding, it depends on other, if there’s other patients who need it more and things and private practice, if I go to one doctor and say, “Let’s do this test?” They’ll be like, “Okay, come tomorrow and we can do it.” 

 

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Private healthcare could also be used for a second opinion and/or access to treatments that weren’t available on the NHS. Megan got a second opinion in private healthcare when she was told by her NHS specialists that she might need to have her bladder removed if other treatments didn’t work. Some people we talked to had paid to see osteopaths and chiropractors.

We were told that some private UTI clinics had a different approach to diagnosis and treatment compared to NHS services. Laura didn’t think her GP would prescribe antibiotics for her chronic UTI: she paid for a one-off private prescription for a short course of antibiotics when she was due to go on holiday, in case she had a UTI. Elizabeth and Megan were both admitted to hospital because of complications from UTIs, which left them feeling they had exhausted the help available on the NHS so they decided to go private.

Experiences of private healthcare

One of the biggest draws to private healthcare for the people we spoke to was having more time in appointments to discuss their concerns, get information and ask questions. Jane said she has often gone private for urogynaecology issues because “I know it’s the only way I can get someone who will give me the time”. Mehar said that that private healthcare felt more “like teamwork” between healthcare professionals and patients. Sharon felt that private care was more thorough and that health problems were approached holistically, compared to quick appointments and minimal information in the NHS. Leah appreciates that the private clinic she attends is very responsive, for example if she contacts them with concerns about medication side-effects. Penny asks, “why do you have to pay to get someone [a healthcare professional] to listen to what you have to say and spend time with you?”

Although Jane feels a bit uncomfortable about going private, it has been important to build trust and have time to talk about her concerns.

I have to say I’ve got some very, very good NHS practitioners in my arsenal as well, my current practice nurse, one of them any way and the, the current, the GP who I’ve mentioned, I’ve got a decent enough relationship to be able to speak very frankly to them, and that, that helps. But I feel that having to go private, and I feel like it’s a having to go, and I hate it, because I feel it’s really hypocritical of me to go private when many people can’t afford it, and I believe strongly that this should, this kind of service should be available on the NHS, it’s really difficult to talk about your bladder and your vagina and your sex life, and your cleanliness down there, with people you don’t know and you don’t trust. And it’s really difficult to talk about those things with people who don’t give you enough time, like I have had today, you know to kind of burble on and finally get to the point.

 

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There were sometimes other benefits of private healthcare too. Sarah likes that she has more choice about who she sees and when. Amy and Mehar saw specialists with particular interests in prolapse, and hypermobility conditions, for more specific advice and treatment. Penny said the private clinic she went to had “state of the art” equipment, compared to the “creaky, dinky old stuff” in the NHS. Helen liked that there were more treatment options available to her privately, including complementary and alternative medicine.

Not everyone had a positive experience of the care received privately for urogynaecological problems. Janet felt disappointed and “very miserable” after having treatment at a private appointment when her symptoms got worse. Phoebe told us that the urogynaecologist she saw was rude and flippant about surgery, which left her feeling uncared for: “the cynical side of me wonders whether it was because I was a private patient, but I mean he gets more money from first surgery approach. I don’t want to think like that but it’s hard not to. I felt very [much] like a number”. Phoebe had also seen two different private physiotherapists and was shocked at how different their diagnoses, advice and approach to physiotherapy treatment had been.

Helen chose to see a private urogynaecologist but found her experience no better than the NHS.

I had a really bad experience with one GP. You know, I mean, I was desperately upset over the phone ‘cos I was still in y'know a lot of discomfort, you know really not kind of getting out of bed a lot of days. 
 
So I kind of got a bit fed up with being told that they weren’t gonna do any more for me and of course, it was in the beginning of the pandemic, so I mean the chances of being seen by anyone else were really slim. But at that point, I had some health insurance, so I went privately to see a urogynae but to be honest it wasn’t much better. I got put through every single test. 
 
I had cystoscopies. I had internal and external scans. I had MRIs. I had urodynamics. I had, you know, they tried to give me drugs for overactive bladder, which I don’t have. They gave me like bladder installations which did absolutely nothing. But you know, the response was well, you can’t have an infection ‘cos you had quite a few antibiotics, so it must have gone, no like actual ability to test anything further. And although it was private, it was the consultants that are with the NHS ones. So, it was the same protocol, you know, that they were following. 
 
So, very dismissive and it, it felt like they were just rolling out different, y'know, just to try just to see what happened without necessarily any real logic to it

 

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Laura felt the duty of care from her private specialist was lacking and she struggled to get a follow-up appointment because the service was so overstretched.

I kind of felt lost because I was under his care at this point but he, you know, I get it, he’s a very busy doctor. There’s a lot of, there’s a huge demand for urogynae appointments and care, and the NHS I don’t think is serving it. So people are forced to go privately and then the private ones that are addressing the issue are in huge demand. So I just couldn’t get hold of him.
 
And so, I, you know, it’s embarrassing to say it because it’s not-, you know, I’m not someone who begs for things. I’m, you know, it’s just not, I’m not a dramatic person. But I was literally sending emails because it was the only way I could hold of-, his secretary was saying, you know, essentially, “He’s busy, you know, you can get an appointment in three months”. I was literally, I was emailing saying, “To be honest, I’m suicidal. Like I can’t, I wake up, I dread waking up in the morning because I can’t face another day of every minute of that day being desperate for a wee”. It just feels like being tortured all day every day and, you know, you’re only sleeping, you know, getting sort of snapshots of sleep here and there as well.

 

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Paying for private healthcare

Being able to afford private healthcare was possible for some, but it was a challenge for others. Some had access to private healthcare through their own or their partner’s workplace schemes. Others had arranged a private healthcare plan themselves.

Mehar said private healthcare was not something she could easily afford but felt she had no choice. Penny had a mesh removal operation privately because the waiting list of the nearest NHS centre had closed; she took out interest-free credit and is paying off the loan. Parminder took out private health insurance during the Covid-19 pandemic, but this became too expensive so she asked to be transferred over to the NHS; this was possible because the specialist she saw worked in both settings. Felicity feels angry that she has paid thousands of pounds for care which she felt should have been able to receive on the NHS.

Kerry says she is fortunate to have been able to afford private physiotherapy, but knows that this isn’t an option for others.

I think we’re fortunate in that we’re well off and that I am able to go out and do these things. I think if we’d been, if I was [sigh]…if I was on a much lower income, if I was on the minimum wage, if I was on Universal Credit, if I was on any of those things, there would be no spare money and I would be sitting here with this thing going on in my body that I might be able to, I might have a phone that lets me access the internet, I might have enough data to get on, on the internet and have a look at stuff but actually I probably wouldn’t, I would be dependent on my absolutely rubbish GP giving me support and advice and waiting, still waiting for that referral to the hospital. 11 months and in that time because I don’t know what I’m doing, things would have got much worse and I would be a lot more miserable than I am, you know, it’s, it’s not right really.

 

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It was sometimes stressful negotiating with health insurance companies about coverage. Rose has private healthcare but found that it didn’t include any appointments or treatments for her prolapses, because they were classed as a pre-existing condition. Leeanne found that her private healthcare insurance had restrictions on where she could have mesh removal and by which surgeons. Phoebe’s healthcare insurance company had a maximum of six pelvic floor physiotherapy sessions and would not cover the physiotherapist she had found herself.

You can read more about experiences of using and navigating healthcare services here.