Private practice

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7069.1401 (Published 30 November 1996) Cite this as: BMJ 1996;313:1401

Offering preferential NHS treatment to doctors is embarrassing

  1. Mary G Barrington
  1. Consultant physician in medicine for the elderly Airedale General Hospital, Keighley BD20 6TD

    EDITOR,—I entirely agree with David Currie's personal view about private health insurance: I would not allow myself or my family to be treated anywhere other than in NHS hospitals, because for all its difficulties the NHS provides a full range of health care in an accountable manner.1 But I have had private insurance since I was a senior house officer. Why? Because I am embarrassed by the preferential treatment and queue jumping that my colleagues (and I myself) offer to doctors and their families. By taking myself and my family into the private sector I am not pushing someone else down the list; I am not making staff equally uncomfortable about treating us differently or treating us the same.

    What I would not contemplate is treatment in a private hospital—without access to full medical records, dedicated nursing staff led by people interested in quality and progress, highly selected junior doctors with structured supervision of their postgraduate education, and a range of consultants to consult if all is not simple and straightforward. Readers may laugh at that description of an NHS hospital: I would have to agree that it is not quite like that, but it is our aim.

    Do I engage in private practice? Yes, occasionally, if people are insured and are also eligible for NHS treatment so that I never have to give a lesser service. And only in the private ward of an NHS hospital. What do I think patients get out of “going private”? Self esteem, their own bathroom, and quiet nights. What do they lose? The context in which to judge the severity of their condition and progress, camaraderie with staff and patients engaged in making the NHS work, and the privilege of training the new generation of professionals.

    People should not give up on an organisation that is imperfect: only from the inside— whether it be as a BMA member, an NHS consultant, a recognised BUPA specialist, or a patient— can they influence it.


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