Public vs Private

speckledhen

Hi,
Pregnant with my first and trying to decide what the best option is. Is there a big difference in public vs private care? From research so far it seems that you get a lot more visits and scans privately but not sure if that's necessary. Thanks for your help

Penny Dreadful

I too had to make this decision quite recently and opted for semi private at the Coombe. It was always going to be the Coombe so the cover didn't affect that decision.

When you go public everything is free you don't pay a penny but you will have to see whatever doctor is available when you present for your appointment and/ or delivery.
When you go private you see the same consultant all during your care unless they are on holidays or caught up with an emergency case when you present for your appointments/ delivery. You are however left with a short fall of several thousand euro that you have to pay yourself as your insurance carrier will not cover the full cost.
You are also entitled to a private room should one be available when you deliver. There is no guarantee of this though and you could easily end up in a public ward.
You also get to select your consultant.
You will also have to pay a fee for the scans some of which you can claim back on your Med 1 and insurance claim at year end. There is also a booing fee of €550 you have to pay.

With semi private you still pay the booking fee and for the scans but no more. You are entiteld to a semi private room when you deliver should one be available.
You are also put into a pool of doctors (consultant or Reg) who will see you for your appointments. This pool is smaller than the public pool of medical staff.

There are some other add ons that your own particular insurance carrier or plan will provide for. I called both the Coombe and the insurance people (Laya in my case) to double check the information and figures I got from each before making my decision.
Ultimately you are delivering your baby in the same hospital with the same staff whether you are public or private. I opted for semi private because I might get a semi private room but the appointments will (hopefully) be a little less chaotic in the lead up to the baby arriving. Also I'd rather have the few thousand euro to spend on stuff for the baby than hand over to the doctor/hospital.

John Mason

i am going public, 8 months gone.

i got to choose my consultant in Holles, i have seen the same consultant for all my appointments so far.

i received a scan on all of my appointments. i am also receiving physiotherapy and attending the pain clinic, all for free

i decided the additional cost of 4k for the possibility of private room, was not worth it.

lazygal

I would go public or private. A lot of people find semi private isn't much different to public. If you go private you'll pay the consultant fees and maybe anomaly scan fees or bloods. Accommodation is covered, as is epidural or c section, and other such things. I was happy with private, I wanted a particular consultant and continuity of care. I was glad of the private rooms as I had sections so I needed peace. I loved getting lots of scans and having consultant led care. Well worth the money if you can afford it.
I also know people who were more than happy with public care.

speckledhen

Thanks Penny, that's helped! Lot to think about. Here in CUH the only option is Semi Private or Public - Semi private is €3000 with Health Cover

lazygal

speckledhen wrote: »

Thanks Penny, that's helped! Lot to think about. Here in CUH the only option is Semi Private or Public - Semi private is €3000 with Health Cover

That is very expensive for semi private. I paid not much more to go fully private in Holles St. Semi private cost far less.

speckledhen

Sorry combined care, GP and obstetrician (is that semi private?) seems to be the only option. Rang a few and there's no variation in cost

lazygal

speckledhen wrote: »

Sorry combined care, GP and obstetrician (is that semi private?) seems to be the only option. Rang a few and there's no variation in cost

I had all appointments with my consultant, not half with a GP. I was paying for consultant services, not the GP. Sounds more like semi private care but that costs about two thirds less than your quoted price in Dublin hospitals.

p4ddyh1

Not sure if available in cork, but my wife and I went through the domino scheme. It's run by midwives and is a fantastic service. Completely free and they visit you at home

Penny Dreadful

speckledhen wrote: »

Thanks Penny, that's helped! Lot to think about. Here in CUH the only option is Semi Private or Public - Semi private is €3000 with Health Cover

That is a little less than the price I was quoted for fully private at the Coombe. Are they by any chance giving you the total cost of the care rather than just the amount you'd have to pay?

speckledhen wrote: »

Sorry combined care, GP and obstetrician (is that semi private?) seems to be the only option. Rang a few and there's no variation in cost

I'm doing combined care. I'm very happy with my GP and think its handy to not have to trek into the hospital all of the time. Also he has some clinics on a Saturday so my husband could come with me too then with ease if we want.

speckledhen

Penny Dreadful wrote: »

That is a little less than the price I was quoted for fully private at the Coombe. Are they by any chance giving you the total cost of the care rather than just the amount you'd have to pay?


Total Cost

Roesy

Speckledhen, its 3,000 for private care in Cork. It is combined care with your gp usually though.

lazygal

If you're happy with GP/combined care that's fair enough. I know some people who opted for that type of appointment system when going private. However, my GP, while good, doesn't have a scanner in the surgery and I felt I was paying the fees to get consultant obstetric care for the duration of my pregnancy. This was especially important to me on my first pregnancy, and I ended up with some complications I wanted a consultant not a GP to be in charge of. Has anyone asked the consultants in CUH why they outsource care to GPs while charging fees not much less than their Dublin counterparts who provide all antenatal appointments unless its the patient's choice to attend a GP?

Penny Dreadful

speckledhen wrote: »

Penny Dreadful wrote: »

That is a little less than the price I was quoted for fully private at the Coombe. Are they by any chance giving you the total cost of the care rather than just the amount you'd have to pay?


Total Cost

That is remarkably high.
I've checked over the notes that I took when I was on the phone to the Coombe and the following was the break down of costs I was given:
€750 to attend the semi private clinic. I have to pay this out when I go to my first appointment but can claim it back on my Med 1/ Laya at year end.
€160 for the scans (3). Again claim back as above.
€3200 covers 3 nights semi private cover for a regular delivery. If I have to have a section then I get covered for 6 nights. This bill is paid directly by Laya.
So I'll have to hand over apprix €1000 myself and can claim some of that back.

If I was going public I wouldn't have to pay a penny.

If I was going private I'd have to pay anywhere from €3500-5000 myself. Laya would only give back €298 of this for a vaginal delivery and €445 for a section.
I'd have to pay the same as above for the scans.

lazygal

p4ddyh1 wrote: »

Not sure if available in cork, but my wife and I went through the domino scheme. It's run by midwives and is a fantastic service. Completely free and they visit you at home

Not everyone is eligible for midwife led care.

Sligo1

Penny Dreadful wrote: »

speckledhen wrote: »

That is remarkably high.
I've checked over the notes that I took when I was on the phone to the Coombe and the following was the break down of costs I was given:
€750 to attend the semi private clinic. I have to pay this out when I go to my first appointment but can claim it back on my Med 1/ Laya at year end.
€160 for the scans (3). Again claim back as above.
€3200 covers 3 nights semi private cover for a regular delivery. If I have to have a section then I get covered for 6 nights. This bill is paid directly by Laya.
So I'll have to hand over apprix €1000 myself and can claim some of that back.

If I was going public I wouldn't have to pay a penny.

If I was going private I'd have to pay anywhere from €3500-5000 myself. Laya would only give back €298 of this for a vaginal delivery and €445 for a section.
I'd have to pay the same as above for the scans.

Don't forget you can also claim back I think around (20-25%) of your fees from revenue! I went private last year (I'm going private again this year) and I didn't realise you could claim back for all your scans and consultants fees and bloods etc.

Only claimed a couple months ago as I was informed by a friend to do this and I got a lovely cheque of around €800 in the post just before Xmas . Nice surprise!

Penny Dreadful

Sligo1 wrote: »

Penny Dreadful wrote: »

Don't forget you can also claim back I think around (20-25%) of your fees from revenue! I went private last year (I'm going private again this year) and I didn't realise you could claim back for all your scans and consultants fees and bloods etc.

Only claimed a couple months ago as I was informed by a friend to do this and I got a lovely cheque of around €800 in the post just before Xmas . Nice surprise![/quote]


Ohh nice.

The revenue fees are now based on the lower rate of tax (22% I think) but something is better than nothing.

Do you mind my asking what made you opt for private? I've made my decision now and I'm happy enough with it but as this is my first time on the pregnancy merry go round I'm always interested in why other people decide for something different.

speckledhen

Have double checked, only options in Cork are public or private. Private option is done only as combined care, the cost for antenatal care is €3000 - health care picks up the costs from the delivery on. With public everything is free.

Sounds like there's better options elsewhere

lazygal

speckledhen wrote: »

Have double checked, only options in Cork are public or private. Private option is done only as combined care, the cost for antenatal care is €3000 - health care picks up the costs from the delivery on. With public everything is free.

Sounds like there's better options elsewhere

I think you need to ask the consultants why they charge similar fees to those in Dublin yet outsource care to GPS. And please tell us what they say to justify it!

Penny Dreadful

lazygal wrote: »

I think you need to ask the consultants why they charge similar fees to those in Dublin yet outsource care to GPS. And please tell us what they say to justify it!

The consultants can set their fees at whatever they want and if people are willing to pay it then there is nothing stopping them. Dublin or Cork based shouldn't make a difference to that I'd imagine.

I agree that it should however be queried as to why their fees are as they are if a certain amount of the work is being outsourced. Do they charge more if every appointment is with them rather than the GP or is the fee simply a set fee.

With regard to a lack of semi private - I suppose if the hospitals in question don't have semi private rooms then there is no point in the consultants offering semi private care.

Sligo1

Penny, I spose I chose Private because I'd be a bit of a worrier. I work in healthcare and although I know midwives, docs and regs are extremely capable and competent I wanted the certainly of being under direct care of a consultant obstetrician and consultant anaesthetist. My consultant is lovely and I wanted the choice of having her at every appointment as I prefer continuity of care. I also didnt want to be waiting around for hours at public antenatal appointments which I know is what can happen. Especially as I now have a 1 year old in tow aswell.

A lot of midwives will say giving birth is a natural and normal time and consultants etc aren't needed. I do agree with this sentiment but as we have the option of having midwives and doctors there i would prefer both . I can afford to go private so it was my first option. However, I also think public, semi private is fine aswell. And the domino scheme is meant to be great!

A big thing for me would be having a private room aswell if I'm perfectly honest.

Penny Dreadful

Sligo1 wrote: »

Penny, I spose I chose Private because I'd be a bit of a worrier. I work in healthcare and although I know midwives, docs and regs are extremely capable and competent I wanted the certainly of being under direct care of a consultant obstetrician and consultant anaesthetist. My consultant is lovely and I wanted the choice of having her at every appointment as I prefer continuity of care. I also didnt want to be waiting around for hours at public antenatal appointments which I know is what can happen. Especially as I now have a 1 year old in tow aswell.

A lot of midwives will say giving birth is a natural and normal time and consultants etc aren't needed. I do agree with this sentiment but as we have the option of having midwives and doctors there i would prefer both . I can afford to go private so it was my first option. However, I also think public, semi private is fine aswell. And the domino scheme is meant to be great!

A big thing for me would be having a private room aswell if I'm perfectly honest.

I work in healthcare too and sometimes really wish I didn't know quite as much as I do- if you don't know about things you can't worry about them. Two of my sisters are in the industry too and feel the same.
The way I looked at it was that if I was happy to do combined care with my GP then it would cut down on the endless waiting time when at the hospital clinics. Semi private should cut down on that somewhat anyway and I'm happy for the doctor I see on any given day to be a Reg (or consultant naturally).
What was really pushing me towards private healthcare was the thought of my own room post delivery but when its not guaranteed but you'll still get the bill I thought hard of it.
My older sister went private on her first two and got stuck in a public ward with the first - would have been fine save for one or two really thoughtless women who were snoozing away during the day and then up and chatting loudly with each other and on their phones during the night when everyone else was trying to sleep. The second time she did get a room of her own which was lovely but she just got lucky that time.

In the end I thought that my pregnancy is going fine, fingers crossed it will continue that way and if I end up in an emergency situation then I'm just going to have to deal with it as it comes. Semi private gives some of the comfort of private and won't cost me a fortune.
Also we're trying to move house in the near future and I'd rather put my additional euros off my mortgage.

ncmc

Hi Speckledhen, I am 27 weeks and decided to go Public in CUMH. As you say, the only options are public and private, there is no semi private or domino scheme. My first visit to the hospital was at 12 weeks when I had a scan and met with one of the midwives. I didn’t see a doctor at that stage. I then went to my GP at 16 weeks, and hospital at 20 weeks where I spoke to a doctor. I had a quick scan at this appointment. They tell you that there is no guarantee of a scan at 20 weeks but everyone I know has had one. My next hospital visit is at 32 weeks where I believe they do a scan to check growth/location of placenta, I see my GP at four weekly intervals in between that. I think the visits then fall every two weeks. I also am booked for a breastfeeding class and ante natal class in May.

I have to say I am quite satisfied with the level of care so far. It doesn’t really matter to me that I don’t see the consultant at every visit, the way I see it, it’s mainly the midwives that you are dealing with during labour, so I am happy seeing one of them rather than a consultant. I am lucky in that I have had a very straightforward pregnancy to date. If I had a history of difficult pregnancies either myself or in my family, I would probably have gone private for peace of mind but as it is I just can’t justify the €3000 when there are so many other things to spend that money on! You could always pay for extra scans privately if you wished, at €100-200 you could get a lot of them for €3000!

It’s an individual choice, but I have only heard good things about public in CUMH, so am happy in my decision so far. I’ll come back to you in 13 weeks and see if that’s still the case!

Roesy

I saw my consultant a lot. The trips to the gp seemed a bit much on top of it all. I was seen by the midwife in the consultants at 8.5 weeks for an early scan, by the consultant at 9.5 weeks when I had a bleed and saw him at 12 weeks and every 4 weeks from there to 31/32 weeks when a potential problem was picked up. I was then switched to fortnightly appointments seeing my gp in between. I was scanned at every visit. I also had the routine appointments with the gp. The fee included all bloods and scans. I saw him and was examined at 7am, he was back with me in the delivery suite from about 7.40, he delivered my baby at 8.30 in the morning and when I had unexpected problems with heavy bleeding during the day I saw him a couple of times until things were under control. He scanned me at my bedside at about 8.30 that evening too. To be honest I was very pleased with the care I received.

Sligo1

That's the thing... When you work in healthcare it really can alter your views on things that you really perhaps wouldn't normally think about. But they would be the exception and not the rule.

I know what you mean about the uncertainty of having a private room! I'm quite worried I won't get one and count myself very lucky getting one first time around. Id be raging tbh. If I was in a public room however and there were some inconsiderate people... I would have absolutely no problem talking to the midwives on duty and getting them o shut-up! Lol.

monflat

speckledhen wrote: »

Have double checked, only options in Cork are public or private. Private option is done only as combined care, the cost for antenatal care is €3000 - health care picks up the costs from the delivery on. With public everything is free.

Sounds like there's better options elsewhere

In kilkenny there is either public or private.

Penny Dreadful

Sligo1 wrote: »

That's the thing... When you work in healthcare it really can alter your views on things that you really perhaps wouldn't normally think about. But they would be the exception and not the rule.

I know what you mean about the uncertainty of having a private room! I'm quite worried I won't get one and count myself very lucky getting one first time around. Id be raging tbh. If I was in a public room however and there were some inconsiderate people... I would have absolutely no problem talking to the midwives on duty and getting them o shut-up! Lol.

Me neither. My sister was far too nice.

Penny Dreadful

Sligo1 wrote: »

That's the thing... When you work in healthcare it really can alter your views on things that you really perhaps wouldn't normally think about. But they would be the exception and not the rule.

I know what you mean about the uncertainty of having a private room! I'm quite worried I won't get one and count myself very lucky getting one first time around. Id be raging tbh. If I was in a public room however and there were some inconsiderate people... I would have absolutely no problem talking to the midwives on duty and getting them o shut-up! Lol.

Good move that could have been a bit too much for some people. :eek::p

monflat

Penny Dreadful wrote: »

Me neither. My sister was far too nice.

Dont forget NOT EVERYONE who goes public are " INCONSIDEDERATE"

I CERTAINLY WOULD Not like to be tarred with this brush

Sligo1

monflat wrote: »

Dont forget NOT EVERYONE who goes public are " INCONSIDEDERATE"

I CERTAINLY WOULD Not like to be tarred with this brush

Where was that said? I think this post is slightly defensive. If there are 6 people in a room there might be people taking in the middle of the night which I would definitely deem to be inconsiderate? As in Penny's sisters case. But in all likelihood there maybe quietness aswell??

I'm sure most people in a large room will always be considerate of others... But that's not to say everyone will be?...

Penny Dreadful

monflat wrote: »

Dont forget NOT EVERYONE who goes public are " INCONSIDEDERATE"

I CERTAINLY WOULD Not like to be tarred with this brush

I never ever said they were or even hinted at it. I merely reported that two women who were in her public ward were rude and inconsiderate. For all I know they too (like my sister) may have opted for private care and been placed in the public ward due to space constraints.