Any idea about private clinic vs. public clinic?

hopehope2019 · 17-12-2020 11:14am #1

Does anyone know about the difference between the private clinic vs. public clinic in the same hospital?

If one doctor in tallaght hospital has both public and private clinic, are they in fact the same? I mean the services and quality offered, because they are from the same person, right?

So am I right in understanding that, I just pay $$$ in order to avoid the long queue as a public patient?

First time visiting hospital here in Ireland...so a bit confused...

Thanks a mill in advance!

Gregor Samsa · 17-12-2020 11:30am

hopehope2019 wrote: »

So am I right in understanding that, I just pay $$$ in order to avoid the long queue as a public patient?

Bingo.

Private care can give you access to some hospitals and clinics that aren't on the public system at all, but if you're talking about a consultant/facility that does both, the only difference is waiting times, and maybe a little more face time with the Consultant themselves on Private. On Public, the Consultant will still be overseeing your treatment, but you might be dealing more with their staff rather than them directly. But there may be very little to no difference in that area.

The other difference is, if you have Private health insurance, the hospital gets to charge the insurance company a lot of money for your treatment, despite it being exactly the same as what you would have got on Public for a nominal amount (or free with a medical card).

seamus · 17-12-2020 11:37am

^^
This is it in a nutshell. When you pay for private treatment in a public hospital, you're basically paying to skip the queue. The treatment is the same, the staff are the same, sometimes you even get the same room. But you get access to it tomorow instead of in 2 years' time.

_Brian · 17-12-2020 11:51am

The big deal is shortening wait times or “skipping the queue”.

For specific illnesses this can be lifesaving, or it may just reduce the time spent suffering.

Accessing private hospitals however such as the Beacon is operating in a higher sphere of equipment and staffing quality.

We compromise on allot of lifestyle choices in order to keep up a half decent private policy. There have been years that €30k has been paid over on our behalf and it’s literally been lifesaving for us.

arctictree · 17-12-2020 11:52am

What really annoyed me when my wife was pregnant is that the consultants would arrange these 'appointments' for 20 women at the same time. Then you just had to wait until called, could be hours. Its like their time was much more important than the patients.

messrs · 17-12-2020 11:57am

Gregor Samsa wrote: »

Bingo.

Private care can give you access to some hospitals and clinics that aren't on the public system at all, but if you're talking about a consultant/facility that does both, the only difference is waiting times, and maybe a little more face time with the Consultant themselves on Private. On Public, the Consultant will still be overseeing your treatment, but you might be dealing more with their staff rather than them directly. But there may be very little to no difference in that area.

The other difference is, if you have Private health insurance, the hospital gets to charge the insurance company a lot of money for your treatment, despite it being exactly the same as what you would have got on Public for a nominal amount (or free with a medical card).

This!! I recently had to go for a biopsy so was going in as a day patient. Going to be using the bed for a couple of hours. Got my letter beforehand advising if I had health insurance the cost of the bed was €430. If I didnt have health insurance and was paying myself or if I had a medical card the cost was €80!

r93kaey5p2izun · 17-12-2020 12:49pm

In my experience you are unlikely to see the actual consultant in the public clinic, but instead will see one of his/her team, and likely you will see a different one each visit. In the private clinic you will see the actual consultant each time. If it is a life threatening urgent condition you may see the actual consultant consistently in public, though. Once, I chose public over private because the waiting list was longer private, believe it or not. Never again. A waste of time, nobody listened to me, they failed to diagnose the issue. Ended up waiting and going private anyway, where issue was diagnosed immediately.

Concretejungle · 12-01-2021 10:38am

Does anyone know if the private hospitals are still doing private outpatient procedures or have they been taken over by the HSE.

Jen Pigs Fly · 12-01-2021 12:18pm

Concretejungle wrote: »

Does anyone know if the private hospitals are still doing private outpatient procedures or have they been taken over by the HSE.

I can’t say for sure for all, but I got radiofrequency ablation injections done in St. Vincent’s private on the 3rd and 11th of December (referred the week prior to the 3rd by the national maternity hospital pain management consultant) and my ENT advised he is still doing day surgeries in the Hermitage, so I would assume yes!

Victor · 12-01-2021 1:00pm

Concretejungle wrote: »

Does anyone know if the private hospitals are still doing private outpatient procedures or have they been taken over by the HSE.

As I understand things, the HSE gave the private hospitals back to their normal operators during the summer. There was word over the last few days of the HSE preparing to send ICU patients to ICU facilities in private hospitals over the next while. Otherwise, services are likely to be operating mostly as normal.

dotsman · 12-01-2021 3:26pm

arctictree wrote: »

What really annoyed me when my wife was pregnant is that the consultants would arrange these 'appointments' for 20 women at the same time. Then you just had to wait until called, could be hours. Its like their time was much more important than the patients.

This as well.

From my limited experience, when going private, you arrive at the appointed time, and there may be one person ahead of you, so you will typically be seen within a few minutes. When going public, the HSE queuing system is extremely inefficient and they just seem to tell a huge bunch of people to come in at the same time and then make you queue for up to an hour or two before you will be seen often without even a chair to sit on!

riclad · 12-01-2021 4:05pm

private =you do not wait for years to see a consultant.
whatever the issue you will see a consultant in a few days .
the same doctor may work in a private hospital and a public hospital .
public you could be waiting 1-2 years to see a consultant .

r93kaey5p2izun · 12-01-2021 7:46pm

riclad wrote: »

private =you do not wait for years to see a consultant.
whatever the issue you will see a consultant in a few days .
the same doctor may work in a private hospital and a public hospital .
public you could be waiting 1-2 years to see a consultant .

Unfortunately, not a few days unless maybe you have access to the absolute top level insurance - I don't have cover for Mater Private, so maybe they're exceptionally quick. But I waited 4 months in 2018 to see my private cardiologist having been hospitalised through A&E with deterioration of long term condition. I was on waiting lists in Hermitage, Blackrock Clinic, SJH private and public. Back in 2008 the initial private referral took 6 months for the Hermitage.

Concretejungle · 12-01-2021 8:34pm

Trying to get a private appt. for the Mater Private for the last week and no joy so far, but just wondering if the Covid is responsible for that ?

Strumms · 12-01-2021 10:18pm

riclad wrote: »

private =you do not wait for years to see a consultant.
whatever the issue you will see a consultant in a few days .
the same doctor may work in a private hospital and a public hospital .
public you could be waiting 1-2 years to see a consultant .

My experience.. I let mine lapse and when I was in hospital I wouldn’t have minded a private ward, seeing firstly as some prick in our ward was going around helping himself to everything from peoples slippers, books, magazines socks, snacks and in my case a mobile phone that wasn’t recovered, no cctv in wards and it was an orthopedic ward.

The TV at the end of the ward was tiny, and the color out of sync, I think with the digital age it wouldn’t be impossible to give everybody in public a small monitor for say xx euro a week even to cover the costs. The WiFi was appalling too. Care very good but the facility lousy.

I’ve attended outpatient appointments for a scan in private hospital and have been amazed at the levels of absolute comfort, modernized facilities.

Cappagh is like someplace literally from the 1950’s... facility wise, an outright absolute and absurd disgrace.

Concretejungle · 13-01-2021 8:25am

Strumms wrote: »

My experience.. I let mine lapse and when I was in hospital I wouldn’t have minded a private ward, seeing firstly as some prick in our ward was going around helping himself to everything from peoples slippers, books, magazines socks, snacks and in my case a mobile phone that wasn’t recovered, no cctv in wards and it was an orthopedic ward.

The TV at the end of the ward was tiny, and the color out of sync, I think with the digital age it wouldn’t be impossible to give everybody in public a small monitor for say xx euro a week even to cover the costs. The WiFi was appalling too. Care very good but the facility lousy.

I’ve attended outpatient appointments for a scan in private hospital and have been amazed at the levels of absolute comfort, modernized facilities.

Cappagh is like someplace literally from the 1950’s... facility wise, an outright absolute and absurd disgrace.

A disgrace.

Corruptedmorals · 13-01-2021 8:44am

Well, speaking as someone who books public clinics - they are actually not all booked for the same time. For maternity they might be because they can't reduce their clinics or cancel patients.

Public clinics normally run for 2-3 hours. Patients are booked for 10, 15, 20, 30 minute intervals - whatever the consultant requests. If there is a consultant and 2 other doctors then 3 people will get the 9AM slot and so on. They will get delayed especially towards the end because appointments almost always overrun. Maybe there are some people due for a big surgery and they have a lot of questions. Maybe somebody is getting an awful diagnosis. Sometimes reports that should be available instantly take ages to come through so the patient can't be seen until it does.

A pre-Covid problem was patients arriving too early or late so that the 9.15, 9.30 and 9.45 all arrive at the exact same time at 9.30 and the doctor could have been free and waiting but now 2 of the patients will be left waiting. Now it's far more strict and patients aren't allowed in until their appointment time so we can control distancing.

The care is brilliant in the public service IF you can get in. Waiting lists are worse now than ever of course. Our sickest patients have to be treated here because there is no multi-disciplinary care in the private rooms.

fits · 13-01-2021 8:48am

I had an appointment last week ( not a clinic) in a public hospital and was seen immediately. I was actually a bit late which is unlike me and feel bad about. ( the screen wash had frozen so I had to stop a couple of times to clean windscreen on the way.)

mirrorwall14 · 13-01-2021 9:00am

Norah Fast Sheriff wrote: »

In my experience you are unlikely to see the actual consultant in the public clinic, but instead will see one of his/her team, and likely you will see a different one each visit. In the private clinic you will see the actual consultant each time. If it is a life threatening urgent condition you may see the actual consultant consistently in public, though. Once, I chose public over private because the waiting list was longer private, believe it or not. Never again. A waste of time, nobody listened to me, they failed to diagnose the issue. Ended up waiting and going private anyway, where issue was diagnosed immediately.

I found I was escalated up the team depending on how I was. Early appointments were all with the junior docs. As issues started to arise I tended to see the more senior docs on the team rather than them and once I hit blood pressure that wouldn’t come down and pre-eclampsia I was seeing the consultant (unless in surgery). One of the things I actually liked most about this as opposed to private was with all the appointments I saw every doc on the team and knew some of them by the end. And it ended up being one of them who delivered my first which was nice as they happened to be the one on call over night

Wait times could really be shocking though particularly as I waited for more senior docs

You also do have to be an advocate for yourself. Read your chart, ask questions, write them down in advance etc. I was more more able for that the second time around and fought with a junior doc towards the end until he went off to speak to the higher ups

Multipass · 13-01-2021 9:11am

Corruptedmorals wrote: »

Well, speaking as someone who books public clinics - they are actually not all booked for the same time. For maternity they might be because they can't reduce their clinics or cancel patients.

Public clinics normally run for 2-3 hours. Patients are booked for 10, 15, 20, 30 minute intervals - whatever the consultant requests. If there is a consultant and 2 other doctors then 3 people will get the 9AM slot and so on. They will get delayed especially towards the end because appointments almost always overrun. Maybe there are some people due for a big surgery and they have a lot of questions. Maybe somebody is getting an awful diagnosis. Sometimes reports that should be available instantly take ages to come through so the patient can't be seen until it does.

A pre-Covid problem was patients arriving too early or late so that the 9.15, 9.30 and 9.45 all arrive at the exact same time at 9.30 and the doctor could have been free and waiting but now 2 of the patients will be left waiting. Now it's far more strict and patients aren't allowed in until their appointment time so we can control distancing.

The care is brilliant in the public service IF you can get in. Waiting lists are worse now than ever of course. Our sickest patients have to be treated here because there is no multi-disciplinary care in the private rooms.

That’s not my experience at all - when did that start? Ive never waited less than a couple of hours, and everyone arrives at the same time. An elderly relative of mine broke his arm during covid, and still waited 2.5 hours at the follow up clinic. Everyone arrived at the same time.

Concretejungle · 13-01-2021 9:23am

This happens in the private sector too, i.e. all booked for the same time. I actually asked around a waiting room one time to see what time each patient was due in for, now in fairness there were only 3 patients in the waiting room at the time, and we were all booked for the same time. It didn't help that the Consultant was about 30 mins. late, so it was first come first served when the clinic started.

Corruptedmorals · 13-01-2021 9:42am

Multipass wrote: »

That’s not my experience at all - when did that start? Ive never waited less than a couple of hours, and everyone arrives at the same time. An elderly relative of mine broke his arm during covid, and still waited 2.5 hours at the follow up clinic. Everyone arrived at the same time.

Yes everyone arrives at the same time that doesn't mean they all HAVE the same appointment time. Not sure what you mean by when did that start...that's how the majority of public clinics are run. They're booked according to how many doctors there will be. More urgent types of clinics will have more last-minute overbookings. In some of our clinics people will be waiting no more than 10 minutes. In others they'd be lucky to be waiting less than 1.5 hours. It all depends on the nature of the appointment and if others are on time. Some appointments take less then 5 minutes and the patient is here every 6 weeks for the same thing. Others are very serious and the patient is new so it will take a lot longer. If a doctor is on leave, sick or has exams then the clinic will be reduced so that it isn't overburdened. There is a LOT of organisation that goes into everything when there are too many patients and not near enough slots available.

Fracture clinics are another exception. You can't cancel people with broken arms or who are pregnant. They will still be divided timewise but those clinics will be huge and chaotic. Nurses and doctors don't actually want everyone to arrive together. It makes their jobs more difficult.

Multipass · 13-01-2021 10:53am

Corruptedmorals wrote: »

Yes everyone arrives at the same time that doesn't mean they all HAVE the same appointment time. Not sure what you mean by when did that start...that's how the majority of public clinics are run. They're booked according to how many doctors there will be. More urgent types of clinics will have more last-minute overbookings. In some of our clinics people will be waiting no more than 10 minutes. In others they'd be lucky to be waiting less than 1.5 hours. It all depends on the nature of the appointment and if others are on time. Some appointments take less then 5 minutes and the patient is here every 6 weeks for the same thing. Others are very serious and the patient is new so it will take a lot longer. If a doctor is on leave, sick or has exams then the clinic will be reduced so that it isn't overburdened. There is a LOT of organisation that goes into everything when there are too many patients and not near enough slots available.

Fracture clinics are another exception. You can't cancel people with broken arms or who are pregnant. They will still be divided timewise but those clinics will be huge and chaotic. Nurses and doctors don't actually want everyone to arrive together. It makes their jobs more difficult.

That doesn’t make sense though - if everyone has an appointment time how is it possible to be waiting the extreme times that seem to be the norm. I left an eye clinic without being seen after waiting 3 hours - there weren’t enough chairs.

Rodin · 13-01-2021 10:59am

Multipass wrote: »

That doesn’t make sense though - if everyone has an appointment time how is it possible to be waiting the extreme times that seem to be the norm. I left an eye clinic without being seen after waiting 3 hours - there weren’t enough chairs.

Galway or Eye and Ear?

Corruptedmorals · 13-01-2021 12:45pm

Multipass wrote: »

That doesn’t make sense though - if everyone has an appointment time how is it possible to be waiting the extreme times that seem to be the norm. I left an eye clinic without being seen after waiting 3 hours - there weren’t enough chairs.

Because they overrun and it has a big knock-on effect. But not all clinics and specialities are the same. Plenty of clinics run roughly to schedule or only 20ish minutes behind. It depends on the nature of the appointment, if patients arrived on time, how serious the patients are, any emergencies booked in last minute, all technology behaving (HSE uses ancient software, big surprise)...

One week you can get a glorious clinic people called in early and the next they can be waiting hours because the consultant was urgently called up to theatre. I'm not suggesting there aren't massive delays...just that there is a logic to the booking and some do run as they should.

Geuze · 13-01-2021 12:48pm

messrs wrote: »

This!! I recently had to go for a biopsy so was going in as a day patient. Going to be using the bed for a couple of hours. Got my letter beforehand advising if I had health insurance the cost of the bed was €430. If I didnt have health insurance and was paying myself or if I had a medical card the cost was €80!

The 80 is not the true cost.

Most of the cost is financed by tax.

shesty · 13-01-2021 12:53pm

Well yes, but is it right that a doctor is getting paid hundreds by his private patients, who are also funding the tax costs that cover his public sector salary......

I can't understand why people don't seem to get that they are paying 2 or 3 times over for the same thing.

Geuze · 13-01-2021 2:29pm

The original argument, years ago, was that if we don't allow the consultant to have a private practice along with the public contract, then they won't work for the State.

I don't know how true that is.

The idea of Slaintecare is to disentangle public and private care by:

removing private practice from public hosps
having more consultant contracts that are public-only

Geuze · 13-01-2021 2:30pm

shesty wrote: »

Well yes, but is it right that a doctor is getting paid hundreds by his private patients, who are also funding the tax costs that cover his public sector salary......

I can't understand why people don't seem to get that they are paying 2 or 3 times over for the same thing.

Yes.

I pay tax to cover my healthcare
I pay tax to pay for other people's medical card
I pay health insurance.

Multipass · 13-01-2021 3:31pm

Rodin wrote: »

Galway or Eye and Ear?

Galway - is it known for crowding?

mfceiling · 13-01-2021 6:35pm

My example today.

Appointment with specialist in Santry sports clinic at 10.30 a.m

I get there at 9.50. I'm seen within 5 minutes of sitting down.

I'm out the door at 10.10 after paying €190 ( I can claim 80% back on my health insurance policy).

His secretary calls me 1 hour later with an appointment for surgery on the 28th of this month.

Health insurance covers the entire cost.

Rodin · 13-01-2021 7:07pm

Multipass wrote: »

Galway - is it known for crowding?

Hell yeah.

Rodin · 13-01-2021 7:08pm

mfceiling wrote: »

My example today.

Appointment with specialist in Santry sports clinic at 10.30 a.m

I get there at 9.50. I'm seen within 5 minutes of sitting down.

I'm out the door at 10.10 after paying €190 ( I can claim 80% back on my health insurance policy).

His secretary calls me 1 hour later with an appointment for surgery on the 28th of this month.

Health insurance covers the entire cost.

Did you already have your imaging with you?

13-01-2021 7:34pm

I know when I was seeing my GI surgeon in Beacon I could be delayed up to 2 hours, in fact was never seen on time. Didn't bother me, but going private certainly didn't mean "efficient"appointments. Simply put, that surgeon never knew how long he would be detained in theatre as he did very complex procedures. Just the nature of it. Planned orthopaedic procedures are generally quite predictable and surgeons doing elective private work can give more precise appointments.

mfceiling · 13-01-2021 8:15pm

Rodin wrote: »

Did you already have your imaging with you?

It was sent to him from the vhi swiftcare clinic a few weeks ago.

Rodin · 14-01-2021 12:55am

mfceiling wrote: »

It was sent to him from the vhi swiftcare clinic a few weeks ago.

That's why it only took 20 minutes. Add in imaging review and it'd be longer
Is it something straight forward like k-wiring a non-union of a fracture?

Capt'n Midnight · 14-01-2021 1:05am

If you need immediate emergency treatment it's going to be public. Always.

It's only if it can be deferred that it would ever go to private.

farmerval · 14-01-2021 1:32am

In my experience the public versus private is more complex. With health insurance the consultant is much more likely to refer you for tests and these will be carried out in a timely fashion. Waiting for these on the public system can be brutally slow.
Also on health insurance the consultant is probably much more likely to refer you for tests, rule out all the possibilities before committing to the diagnosis.

14-01-2021 7:43am

Capt'n Midnight wrote: »

If you need immediate emergency treatment it's going to be public. Always.

It's only if it can be deferred that it would ever go to private.

I've had emergency treatment several times in a private hospital, but I have been able to arrive in a taxi on those occasions, one being when I had a fairly critical cardiac issue and rightly ought to have gone to a public place although the cardiologist was able to do an immediate cath lab procedure. To be safe, in the event, I should have phoned for an ambulance with it's on-board paramedics. On one occasion when I had bowel obstruction with highly unpleasant form of vomiting I was in no position to arrive in a friend's car, so I had to call an ambulance and go public, which was fine except that the beds weren't electronically adjustable (as they are in the private) which is infinitely more comfortable after the mesh surgery (or indeed any surgery or illness) to repair the strangulated hernia. However I actually recovered quicker as I had to actually use muscles to get myself up and out of bed!

But it's overall better to be in a public hospital if you're pretty ill, as during unexpected complications in the course of your illness it can be difficult to get immediate ICU care if you are depending on the care of a single consultant in a private place. During my last admission in a private hospital a patient in my room developed sepsis and needed to be put on a ventilator (out of the blue) in the middle of the night, but her elderly medical consultant needed to be summonsed to authorise this and was not contactable for a few hours. A very distressing scenario to witness, took tons of staff trying to figure out how to keep them alive pending arrival of said consultant.

mfceiling · 14-01-2021 11:54am

Rodin wrote: »

That's why it only took 20 minutes. Add in imaging review and it'd be longer
Is it something straight forward like k-wiring a non-union of a fracture?

Damaged knee. Bone bruising, torn meniscus, damaged ligaments. Keyhole surgery and out the same day.

Rodin · 14-01-2021 1:51pm

mfceiling wrote: »

Damaged knee. Bone bruising, torn meniscus, damaged ligaments. Keyhole surgery and out the same day.

Case of they'll know what they're dealing with once in there...
Arthroscopy +/- proceed

Any idea about private clinic vs. public clinic?

Comments