Private care - is this normal?

lazygal

It definitely sounds like a cosy arrangement.
A friend of mine used the same consultant as I did but chose to attend the gp instead of some appointments with the consultant. I'd be asking why I was being charged almost the same as I was in Holles St. for a lesser service.

cookiecakes

I'm private in the Rotunda and the consultant asked if it was handier for me to do some GP appointments in relation to work. I work in town so I told her it was easier to come into town and she said grand and never mentioned it again. I'd be super peed off if I had no choice!

tobdom

Toastytoes wrote: »

Phoned the secretary again this morning and she confirmed that shared care with the gp is the model they offer. I said I wasn’t happy with this as I’m going private because I’m high risk and I want to see consultant each visit when I’m paying full private fees. She said she’d highlight what I’m looking for to him and it’d be up to him. So have to wait for a response from him. It seem they’re really creaming it in Galway, there’s no semi private option and you pay €3,400 for shared care with the gp.

To be fair, for the sake of balance (and I'm not trying to defend the consultants - I'm kind of taking an attitude of "it is what it is" to this), we don't know yet if this is refused in Galway if explicitly requested - will be interesting to hear how it goes Toastytoes.

For ourselves, we know that if we wnat an appointment with the consultant at any time (for any concerns or whatever) all we have to do is ask and we'll be booked in.

If the consultants in Galway are "getting away with this" model, then it's likely because it doesn't get questioned much. For all we know, those that do question it get to see the consultant for all of their appointments..... Not for a second saying it's right, but as I said above, it is what it is (if it's generally accepted as such by the majority)

Toastytoes

tobdom wrote: »

To be fair, for the sake of balance (and I'm not trying to defend the consultants - I'm kind of taking an attitude of "it is what it is" to this), we don't know yet if this is refused in Galway if explicitly requested - will be interesting to hear how it goes Toastytoes.

For ourselves, we know that if we wnat an appointment with the consultant at any time (for any concerns or whatever) all we have to do is ask and we'll be booked in.

If the consultants in Galway are "getting away with this" model, then it's likely because it doesn't get questioned much. For all we know, those that do question it get to see the consultant for all of their appointments..... Not for a second saying it's right, but as I said above, it is what it is (if it's generally accepted as such by the majority)

I don’t know yet if he’s going to oblige me by agreeing to my request, I wouldn’t be betting my house on it at this stage. I was informed in no uncertain terms that it wasn’t the morn for him. People don’t really have a choice other than to accept it if they don’t want to go public. We don’t know that it doesn’t get questioned but people have no choice. Accept it or go public. Plus I’m sure lots of first time parents may not know that this is unusual, I wasn’t sure myself until I asked.

I can’t see any reasonable excuse for charging patients in Galway the same or more, than fees charged in other cities and offering them a lesser service for their money.

And there’s v clearly a cosy setup amongst them to maintain the status quo.

€3,400 is an outrageous amount of money to pay and have half your appointments under the free maternity scheme.

shesty

Toastytoes wrote: »

I don’t know yet if he’s going to oblige me by agreeing to my request, I wouldn’t be betting my house on it at this stage. I was informed in no uncertain terms that it wasn’t the morn for him. People don’t really have a choice other than to accept it if they don’t want to go public. We don’t know that it doesn’t get questioned but people have no choice. Accept it or go public. Plus I’m sure lots of first time parents may not know that this is unusual, I wasn’t sure myself until I asked.

I can’t see any reasonable excuse for charging patients in Galway the same or more, than fees charged in other cities and offering them a lesser service for their money.

And there’s v clearly a cosy setup amongst them to maintain the status quo.

€3,400 is an outrageous amount of money to pay and have half your appointments under the free maternity scheme.

I 100% agree with you, but I think it's just something they have been getting away with because of how our health service is set up.
I think you would be right to go to the HSE, although I wouldn't be surprised if you were told something like private consultants aren't their problem (although I'd argue that it is their problem if they are involving the free GP scheme, and using public hospital facility)
The whole thing makes me very cross.

tobdom

Toastytoes wrote: »

I don’t know yet if he’s going to oblige me by agreeing to my request, I wouldn’t be betting my house on it at this stage. I was informed in no uncertain terms that it wasn’t the morn for him. People don’t really have a choice other than to accept it if they don’t want to go public. We don’t know that it doesn’t get questioned but people have no choice. Accept it or go public. Plus I’m sure lots of first time parents may not know that this is unusual, I wasn’t sure myself until I asked.

I can’t see any reasonable excuse for charging patients in Galway the same or more, than fees charged in other cities and offering them a lesser service for their money.

And there’s v clearly a cosy setup amongst them to maintain the status quo.

€3,400 is an outrageous amount of money to pay and have half your appointments under the free maternity scheme.

Wait & see, hopefully he does agree to it.... I'll say again, I'm not defending them, but it comes down to supply & demand - there's obviously still plenty demand for their Private services at these fees.

There is a choice, as you say yourself, and that's to go Public. If you don't want to go public for whatever reason, then you are at the whim of the private consultants in your area, comparing to Dublin will only really serve to frustrate you due to the apparent differences in what is provided for the money.

Realistically, it won't be half your appointments - you will see the consultant a lot more in the weeks leading up to your due date, and then you have the 'comfort' of knowing that you will have a consultant there for the birth as well.

There are differences in the Public system too depending on where you are located, so it's not that odd. For example the Glucose Tolerance Test (for gestational diabetes) as far as I know is standard/mandatory in Galway for anyone over 30 (or something around that), where as it's different in Dublin - at least it was in the last couple of years.

Try not to let it get to you too much if you can (or else go Public) as you have enough to be doing now minding yourself & your bump!

tobdom

shesty wrote: »

I 100% agree with you, but I think it's just something they have been getting away with because of how our health service is set up.
I think you would be right to go to the HSE, although I wouldn't be surprised if you were told something like private consultants aren't their problem (although I'd argue that it is their problem if they are involving the free GP scheme, and using public hospital facility)
The whole thing makes me very cross.

I appreciate the frustrations of everyone expressing this opinion, but going to the HSE will get you nowhere (except possibly into hospital with high blood pressure due to letting these frustrations get the better of you).

No one is being forced to go private and engage the services of these consultants, it's a choice. Will we go to the national consumer agency if we can buy better quality tyres cheaper in Dublin, compared to lower quality tyres that cost more in Galway?

It's far from ideal, but it is what it is unfortunately.

Toastytoes

tobdom wrote: »

I appreciate the frustrations of everyone expressing this opinion, but going to the HSE will get you nowhere (except possibly into hospital with high blood pressure due to letting these frustrations get the better of you).

No one is being forced to go private and engage the services of these consultants, it's a choice. Will we go to the national consumer agency if we can buy better quality tyres cheaper in Dublin, compared to lower quality tyres that cost more in Galway?

It's far from ideal, but it is what it is unfortunately.

I dont think you can compare health care to tyres. There’s no option to shop around when there’s only one maternity hospital in the city and all the consultants are offering the same level of service, which is hardly a coincidence. I phoned the HSE and they have put in a query to the director of maternity services in Galway and have asked them to call me back to advise.

mrsmags16

That's crazy. In the Rotunda private I got a scan every month and weekly towards the end included in consultants' fees. I also got his mobile number and could come in for an appointment/scan any time if I was worried.
I signed up with GP too in case I got a UTI or anything but never needed to go.
Is there somewhere else you can go that the consultants haven't got this monopoly going on - what about Limerick? I know it would be nice to be nearer to home but I knew people who drove from other counties to the Rotunda, for example.
As someone who works in the HSE, and a doctor, I doubt they will be of any use. Some sort of consumer forum would be a better bet.

I would add if I was in this position, I'd go public and pay for private scans and any tests e.g. chromosomal etc extra if I wanted them.

Neyite

Toastytoes wrote: »

Phoned the secretary again this morning and she confirmed that shared care with the gp is the model they offer. I said I wasn’t happy with this as I’m going private because I’m high risk and I want to see consultant each visit when I’m paying full private fees. She said she’d highlight what I’m looking for to him and it’d be up to him. So have to wait for a response from him. It seem they’re really creaming it in Galway, there’s no semi private option and you pay €3,400 for shared care with the gp.

If you are high risk then you'd get a consultant on the public system anyway. I did and my risk wasn't even all that risky. I had a handful of GP appointments but the majority of them were in the clinic at the hospital. If you have to be under Morrison for his speciality then you'd probably be under his care on the public system as well. The only difference to you then is likely to be a private room or ward for your post natal stay. And if you are city based and have no complications you can avail of same-day discharge with the PHN following up on checks at home.

tobdom

Toastytoes wrote: »

I dont think you can compare health care to tyres. There’s no option to shop around when there’s only one maternity hospital in the city and all the consultants are offering the same level of service, which is hardly a coincidence. I phoned the HSE and they have put in a query to the director of maternity services in Galway and have asked them to call me back to advise.

Sorry, I wasn't trying to compare buying tyres with buying (that's essentailly what you are doing going private) maternity care, obviously that would be silly. I was just trying to use an example. Great if the HSE can do something, but I very much doubt it, and if they can, it would very likely take years.

If I set up a business in the morning, I decide what to charge. If I charge an outrageous price, I won't have many customers. The consultants in Galway clearly have plenty of private business operating as they currently do, so people are willing to pay their fees - the only thing that would likely change that is more competition or the majority of their 'customers' vigorously questioning their model/fees. You're probably 1-in-10 (if even) that will question this with them directly..... (many more of the remaining 9-in-10 will grumble at the cost but decide to pay it anyway, as their choice)

I'm only trying to play devils advocate - keep up the crusade if you think it might lead to a positive outcome. But there's really only one 'positive outcome' that you should be focusing all of your energy on (your baby), and all of the negative energy you are fostering with this frustration isn't going to help your pregnancy.

I'm not trying to argue, and I'm obviously not helping you, so I'll leave it at this.....

Best of luck again!

shortstuff!

That's standard for private in Mullingar for what it's worth! No option for semi private. It's not as expensive though. I'm sure if there were risk factors or concerns throughout the pregnancy the consultant would opt to see you more regularly, the same would happen if you were public, they don't necessarily stick to a schedule. For instance I had concerns around 18weeks and anatomy scan wasn't until 23weeks so I phone to request an appointment so went to him instead of GP so I could have a quick scan for reassurance.

Toastytoes

Just to update on this, Prof Morrison declined to take me on as a private patient, apparently he is too busy/will be away around my expected due date. I’ve drawn my own conclusion as to whether me requesting he see me for all my antenatal appointments had anything to do with that decision. The prospect of attending the maternity in Galway is frightening. I’ve heard so many bad stories about it. Really makes me want to attend Limerick instead but I’ll also be getting monitored by a different clinic in UHG throughout the pregnancy so I don’t think that would be allowed due to issues with accessing records between different hospitals plus the extra time I would need away from work for appointments.

tobdom

Toastytoes wrote: »

Just to update on this, Prof Morrison declined to take me on as a private patient, apparently he is too busy/will be away around my expected due date. I’ve drawn my own conclusion as to whether me requesting he see me for all my antenatal appointments had anything to do with that decision. The prospect of attending the maternity in Galway is frightening. I’ve heard so many bad stories about it. Really makes me want to attend Limerick instead but I’ll also be getting monitored by a different clinic in UHG throughout the pregnancy so I don’t think that would be allowed due to issues with accessing records between different hospitals plus the extra time I would need away from work for appointments.

Why not try Private with one of the other consultants in Galway? I'm sure Prof Morrison isn't the be all & end all.......

This is an anxious & stressful enough time without adding to that by travelling long distances for your appointments. But then you feel an injustice with the private model in Galway, so that's stressing for you as well, so maybe private in Galway is not the answer.

With regards to public in Galway, everyone will focus in on & remmeber the bad/tragic cases (which shouldn't happen), but there must be 100s & 1000s of unenvetful stories where everything goes fine. Regardless of being private or not, when you go in to have your baby, you'll be utilising a lot of the public system, outside of the kind of room you get and the fact that if private a/your consultant will deliver you. We found the care from the midwives in Galway fantastic - the consultant just showed up at the right time to deliver as was expected.

Toastytoes

tobdom wrote: »

Why not try Private with one of the other consultants in Galway? I'm sure Prof Morrison isn't the be all & end all.......

This is an anxious & stressful enough time without adding to that by travelling long distances for your appointments. But then you feel an injustice with the private model in Galway, so that's stressing for you as well, so maybe private in Galway is not the answer.

With regards to public in Galway, everyone will focus in on & remmeber the bad/tragic cases (which shouldn't happen), but there must be 100s & 1000s of unenvetful stories where everything goes fine. Regardless of being private or not, when you go in to have your baby, you'll be utilising a lot of the public system, outside of the kind of room you get and the fact that if private a/your consultant will deliver you. We found the care from the midwives in Galway fantastic - the consultant just showed up at the right time to deliver as was expected.

All the consultants in Galway offer the same package, ie. shared care. I had this confirmed by the hospital.

I’m not just talking about the high profile cases of things going wrong in Galway, shocking as those are, but I’m aware of many more of sub standard care and negative outcomes for patients as a result. I’m from the area and virtually everyone I know from the region who has had a baby uses the UHG maternity including family and friends, so while I’m sure there are many uneventful deliveries, there are also many eventful ones. And they are not all unavoidable.

shesty

But what are your options?

Toastytoes

shesty wrote: »

But what are your options?

Options are public for free, or shared care for €3,200 - €3,400 depending on consultant.

There’s no SP or fully private.

There’s only one maternity hospital in the city so there’s no other options in that regard.

shesty

Sorry, I probably sound really stupid here but if you really have an issue with the private set up (and I do understand where you are coming from on that), then your only other option is public care.

Do you have a pregnancy that's high risk or something and needs particular monitoring that you think would be better in private care?In which case I guess you have to deal with it and pay the money privately.

It doesn't matter that there's no semi-private option really because it's not like that's 'better' in any way.I know it probably makes the cost and combined bit a bit more palatable but at the end of the day if your pregnancy is high risk and you think you'll need the monitoring that you think you will get in private care, then.....private it is.

I have gone semi-private myself but really I am paying for the room afterwards.Both my babies were born in general hospital delivery suites under the care of a midwife on duty.The care was excellent.And I know plenty of people in the public system who have done fine too.

As I said in previous posts, I do agree that the set-up is a rip off and I can see why you are annoyed.But at the end of the day if you feel you would be happier with private care then that's it.The baby is going to be born no matter what.

Toastytoes

shesty wrote: »

Sorry, I probably sound really stupid here but if you really have an issue with the private set up (and I do understand where you are coming from on that), then your only other option is public care.

Do you have a pregnancy that's high risk or something and needs particular monitoring that you think would be better in private care?In which case I guess you have to deal with it and pay the money privately.

It doesn't matter that there's no semi-private option really because it's not like that's 'better' in any way.I know it probably makes the cost and combined bit a bit more palatable but at the end of the day if your pregnancy is high risk and you think you'll need the monitoring that you think you will get in private care, then.....private it is.

I have gone semi-private myself but really I am paying for the room afterwards.Both my babies were born in general hospital delivery suites under the care of a midwife on duty.The care was excellent.And I know plenty of people in the public system who have done fine too.

As I said in previous posts, I do agree that the set-up is a rip off and I can see why you are annoyed.But at the end of the day if you feel you would be happier with private care then that's it.The baby is going to be born no matter what.

My issue is that I don’t think that I’ll get the monitoring that I want (yes, high risk) by going private, because half my appointments would be with the gp.

My issue is there is in effect no actual full private option in Galway. I’m not happier as a high risk patient attending the gp for half my visits. My gp doesn’t even have a scanner.

Neyite

Toastytoes wrote: »

My issue is that I don’t think that I’ll get the monitoring that I want (yes, high risk) by going private, because half my appointments would be with the gp.

My issue is there is in effect no actual full private option in Galway. I’m not happier as a high risk patient attending the gp for half my visits. My gp doesn’t even have a scanner.

If you aren't in the system yet then that's the standard line that gets trotted out. In reality, your appointments are based on the care that you need. So if you need regular monitoring for X and a GP is unable to do it, your appointment that should be with the GP would be taken over by the hospital.

I was shared care & public in UHG. They told me that I'd have half GP half hospital visits and that my first appointment would be at 21 weeks. In reality, once I got the referral, the consultant called me in at 11 weeks and looked after me for all appointments thereafter (bar one I think, where my GP referred me back to them) I was at the absolute threshold for risk - likely slightly higher than a bog-standard pregnancy and I was given very good care in UHG under Gaffney and another professor who's name I cant recall right now. It was probably better care than private patients because I was in that category I was always seen by a doctor on the professors service.

If you are calling the secretary, they'll give you the standard spiel - they have to - they aren't doctors and would get into serious trouble if they tried to advise you otherwise. If you are high risk, then your GP can't take over half your appointments if you have certain things you need checking that they cannot cater for. They'll just refer you back. But they are not going to tell you that until you are in the system. And there is no way that you'll be left without monitoring of risk factors. Mine was a very minor endocrine issue and the amount of extra checks I got because of it was a bit daft really. But it was my first pregnancy so I was happy with all the extra checks.

Why not get into the system first and talk to the consultant to discuss the plan for your ante-natal first hand - you could go public initially, you can always switch over to private and you can also switch hospitals too if you like. I know a few women that swapped from UHG to limerick or another hospital.

shesty

Semi-private is combined care with GP too by the way.My GP doesn't have a scanner either, doppler only.

I don't know what else to say to you toastytoes, I understand why you are annoyed but the baby is coming either way. I don't know what your issue is but if you are being monitored by another clinic too, then perhaps the consultant/GP is sufficient.You will be assigned a consultant in a public hospital for the risk. They aren't miracle workers unfortunately, they cannot guarantee that everything will go well regardless of what way you go. I cannot imagine that your consultant would refuse you extra visits if needed, along with the GP particularly once you pass 24 weeks.Your best bet may be to find a consultant, have the conversation with him face to face in the context of your risks, and accept that the GP is there as an extra if you need them.The timetable issued by the secretary is a generic guideline for every pregnancy,same as the one I got.If you have higher risks, you will have extra visits, public or private.

I don't really see any other way for you to approach it.

mrsmags16

Wait - if you are high risk, do you not get seen in the public high risk clinic by a Consultant anyway?

Neyite

mrsmags16 wrote: »

Wait - if you are high risk, do you not get seen in the public high risk clinic by a Consultant anyway?

Yes you do. The care is identical in high risk cases between private and public. The only difference is the room you get after labour. If you are public you get a ward bed. If you are private you may get a private room if available.

There's no guarantee that going private means that Consultant will deliver your baby either. They could be already delivering another at the same time or on leave or on a day off or whatever. I know someone who went private on all three kids and the consultant only made it to the birth of the middle one - after the child was just delivered.

Lucyfur

If your pregnancy is high risk then your consultant will see you more regularly. I had a high risk pregnancy. I only saw my GP twice as I was with my consultant frequently. I was a public patient. I had 28 scans throughout my pregnancy.

smaoifs

Neyite wrote:

Yes you do. The care is identical in high risk cases between private and public. The only difference is the room you get after labour. If you are public you get a ward bed. If you are private you may get a private room if available.

Exactly, my sister and I both went public. She was high risk and saw the consultant every time she was in the hospital as well as seeing her GP throughout the pregnancy.
My friend is 14 weeks into her high risk and gets scanned weekly and sees the consultant and she's in the public system.
The only benefit I can see to going private is the private room after the birth, which may not even be available the days you're there.

Meeeee79

Toastytoes wrote: »

Options are public for free, or shared care for €3,200 - €3,400 depending on consultant.

There’s no SP or fully private.

There’s only one maternity hospital in the city so there’s no other options in that regard.

Another "I might sound stupid here question" but, I am new to all of this and wondering if you have private health insurance do you have to pay the €3200 - €3400 on top of what you're paying on a monthly basis?

lazygal

Meeeee79 wrote: »

Another "I might sound stupid here question" but, I am new to all of this and wondering if you have private health insurance do you have to pay the €3200 - €3400 on top of what you're paying on a monthly basis?

Yes. Consultant fees are not covered. You pay upfront and can claim some back depending on your insurance policy and then after on the med one form or whatever it is.

Meeeee79

lazygal wrote: »

Yes. Consultant fees are not covered. You pay upfront and can claim some back depending on your insurance policy and then after on the med one form or whatever it is.

Dear god! I have alot to learn :D:D

jlm29

Neyite wrote: »

Yes you do. The care is identical in high risk cases between private and public. The only difference is the room you get after labour. If you are public you get a ward bed. If you are private you may get a private room if available.

There's no guarantee that going private means that Consultant will deliver your baby either. They could be already delivering another at the same time or on leave or on a day off or whatever. I know someone who went private on all three kids and the consultant only made it to the birth of the middle one - after the child was just delivered.

It might not be guaranteed, but if you're unlucky enough to have a third or forth degree tear, or some other complications, if you're private, a consultant will be called to do the repair in theatre. I'd much rather have a consultant do that particular job, than to be a bit of practice for someone else who hasn't done too many...

Unfortunately toasty toes, it seems you don't really have any choice. If you won't be allowed go to limerick, you have to go to Galway. You could ask some of the other consultants if they will take you on privately, and opt to see you exclusively rather than going for combined care. It seems like a total racket, in that it's not generally how it's done around the country, but they do have exclusivity, so you need to make your decision and try not to stress about it. As others (who have local knowledge) have pointed out, you'll probably be seen almost exclusively in the hospital anyhow. You could start as a public patient and switch to private at a later date if you're unhappy.

shesty

Ugh *shudder*....hate that bit.
Oddly I'd consider the doctor on duty to probably be more in practice than the private consultant at that stuff, but I guess it would depend on the size of the hospital.
No point arguing over that but you've just given me shivers down my spine!!!!