Worrisome Lessons from Britain

Paying for private consultation has cost Jenny Whitehead her place on the National Health Service (NHS) surgical waiting list. A NHS spokesman said that “Anyone who chooses to pay for a private outpatient consultation cannot receive NHS treatment unless they are then referred on to an NHS pathway by their consultant.”

In 2008, the NHS tried to deny all care to cancer patients who paid for drugs not offered by the health service. The government said that it had ordered the NHS to stop withdrawing care from people who paid privately for unobtainable drugs or treatments.

In March 2009 the NHS released soothing guidelines for the treatment of patients who paid for private hospital treatment. One part of the public explanation promises that “If you’ve had a private consultation for tests and diagnosis, you can still have treatment on the NHS. Your position on the NHS waiting list should be the same as if your original consultation was on the NHS.”

However the guidelines also say that “private hospital treatment must be given separately from…NHS treatment.” Separately means “at different times” and “in different places.”

In practice, this appears to clear the way for the novel use of clinical pathways to justify denying treatment. As Mrs. Whitehead paid privately for a consultation with the surgeon who would be removing the cyst on her spine, she was disqualified from getting treatment under the referral that her general practitioner originated because she had deviated from the government prescribed care pathway. She would have to go back to the start of the “care pathway,” originate a new request for surgery with her general practitioner, and wait another 18 weeks for an appointment with a specialist.

The health bureaucracy in the United States calls “pathways of care” “clinical practice guidelines.” Let’s hope the results are not the same.

Hat tip: Power Line

Comments (6)

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  1. Ken says:

    Showing the Obama Care folks how to ration health care the right way.

  2. Joe S. says:

    Sounds like they make the rules up as they go along.

  3. Virginia says:

    What a nightmare. Let me get this straight: A woman who acts in a way that she feels will best preserve her health and well-being (thereby preserving her ability to contribute to society) is punished because she doesn’t conform with the government protocol of “wait in this line so that you can evenutally wait in that other line.”

    How about just shooting her instead? Then the NHS could steal her retirement money and give it to “the people” instead. It’s obvious that administrative procedure is more important than actually preserving life for the NHS.

  4. Devon Herrick says:

    This already occurs in the United States to some extent. In 2002 my mother was diagnosed with breast cancer. She chose to see a doctor who was not participating in the Medicare program for treatments that were not covered by Medicare. She needed a chemotherapy port inserted underneath her skin – something Medicare would typically pay for. Medicare refused to pay the $2,500 cost, despite being inserted at a hospital that was a Medicare provider, because the doctor that ordered it was not a Medicare provider.

  5. monkeywrench says:

    According to the New York Times, in addition to a five-month wait necessary to see a general practitioner, the typical Britain in need of an operation might wait about 18 months for an appointment to be examined by a specialist — then another year until the actual operation:


    This is proof that anyone who promotes government health care is a gangster and should be treated as such. Their ideas should be ridiculed and they should not enjoy the company of decent people.

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