You would think nothing of dropping into a cobblers to get your shoes patched, or pitching up at the tailor to mend a sagging suit. But how about dropping into your local private GP centre or hospital whenever you want to mend or alter yourself?
Strange as the concept may seem, turn-up and pay medicine is now the fastest-growing sector in British healthcare. From dropping into a private GP on a station concourse to booking major heart surgery, pay-as-you-go healthcare is become a popular alternative to waiting for the NHS.
Several factors have combined to make pay-as-go, also known as self-pay, more attractive. Private hospitals have made the process of arranging surgery much easier and more transparent. Hospital groups such as Bupa and Nuffield have established fixed price treatment schemes, with care arranged through centralised telephone call centres.
And new intermediaries have sprung up, such as Go Private, part of health insurer Exeter Friendly Society. These intermediaries will shop around several different private hospitals and doctors on your behalf to arrange treatment, and package the service for you.
Geoff Benn, a spokesman for Nuffield Hospitals, says: ‘We’d like to think services such as Nuffield Direct have helped to drop the veil and take some of the mystique out of private medicine. ‘Consumers can see it as another service, which they buy when, where and how they need it.’
At the same time, rising insurance premiums have helped increase the reluctance of consumers to pay for medical insurance they hope they never use.
Changes in medical technology, such as keyhole surgery, have made some procedures less invasive. This means quicker recovery times and shorter, so cheaper, stays in hospital. With a private bed more expensive than the finest London hotels, at around £400-500 a day, this has dramatically reduced the costs of some private treatment.
A decade ago, a cataract operation cost roughly the same as buying a mid-range car. Now, new techniques, including laser treatment, have brought the average cost down to that of a decent holiday.
And even those who have health insurance through their employer are using self-pay when they need treatment the insurance will not cover, such as illnesses which pre-date the insurance or for cosmetic surgery, now highly fashionable.
Neil Armitage, marketing manager of Go Private, says: ‘Self-pay has grown very significantly in popularity because consumers want more choice. The old expectations of how you get private healthcare have changed and not everyone is willing or able to go on paying higher premiums. I talk to people who have consciously decided to stop buying insurance and take their chance that they will be able to afford to pay for the treatment if they need it.’
Go Private says the three most common surgical procedures it arranges on a self-pay basis are cataract operations, hip replacements and hernia treatments.
It is no coincidence that these procedures have some of the longest waits on the NHS. Benn says: ‘It would be false to assume that NHS waiting lists are not a factor in the growth of pay-as-you-go.’
Typically, the self-pay process works as follows. Once your condition is diagnosed, call one of the hospital or intermediary hotlines. Callers talk to medically-trained staff who will answers questions and give a guide price as to the cost of treatment. A final price is fixed only after a consultant has examined the patient.
If required, the staff will assist with arranging consultant appointments.
Once a consultant has seen the patient, a time is booked for treatment.
Callers go to whichever private hospital suits them from the provider’s network.
At the same time a price is finalised. This covers all costs, including surgeon’s fees, accommodation, drugs and nursing care. The price will not vary, even if the patient takes longer than expected to recover.
From first call to treatment usually takes between two and four weeks, depending on how quickly the patient can see the consultant and the complexity of the case.
Self-pay is even an option for those whose savings might not quite stretch to the bill. All the providers can arrange loans or credit plans to cover the cost of treatment. Nuffield Hospitals, for example, has links with Barclays, while Go Private can offer preferential rate loans from Lloyds TSB. Hospital group BMI has its own credit card scheme.
Armitage says that some customers prefer to arrange finance through the healthcare provider because it keeps details of their treatment confidential.
He says: ‘People may feel sensitive or embarrassed about some of the treatments. The option of finance from us saves them having to fib when the bank manager asks why they want a loan.’
Contact details: Bupa Hospitals 0845 6008822 or www.bupahospitals.co.uk; Nuffield Direct 0800 688699 or www.nuffieldhospitals.org.uk; Go Private 0845 604 0333 or www.goprivatehealth.co.uk
Cataract removal: £1,500 – £2,740
Heart bypass: £10,600 – £13,500
Hernia treatment: £1,000 – £1,500
Hip replacement: £5,300 – £8,250
Prostate treatment: £2,200 – £3,800
Vasectomy*: £250 – £850
Breast augmentation*: £3,200 – £5,000
Face-lift*: £2,700 – £6,500.
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