Public or Private Care?

LegacyUser

Went private recently, consultant gave a 90% chance of him being there. But guaranteed a consultant would be there.

He missed it but an other consultant was there. Midwife does all the work for delivery but consultant was there holding a leg and ready to aid if necessary.

Post delivery there was some significant bleeding and consultant jumped straight in to lead the care/treatment. She was excellent.

Would you want a junior doc on a 6 month rotation there to stitch up etc. Or a 20+ year expert specialist ?

Toastytoes

Pistachios & cream wrote: »

I’m not sure if semi private is available in all hospitals. I never heard it mentioned as an option for me when my gp discussed public v private. I’m based in limerick

No semi private option in Galway either.

lazygal

Imo semi p in Dublin doesn't give a huge amount extra.

kandr10

I went public on my first and was very happy with the level of care. I’m going semi private now and so far the main benefits are shorter waiting times for appointments and a nicer environment to do your waiting in. I’m under one consultant but tend to see a different doctor at each appointment. This doesn’t bother me as I have no underlying medical conditions. I find the doctors have a bit more time to answer questions at appointments as they don’t seem quite so under pressure to see the next person. The only reason I chose it this time is because I have health insurance and didn’t before. I’m hoping the ward might be smaller after delivery but it will be what it will be.

Moonbeam

if you can afford private then go private,if not go with a midwife led clinic.

Thumpette

If you can afford it go private. I went public on my first. Low risk, all good. I felt rushed through all of the scans but took it as a good sign that there was no concerns. Unfortunately my son was unexpectedly stillborn at 41+4. I always wonder if I'd gone private might they have followed up on some little signs (slowed growth, unexplained itch) Maybe not but I'll always wonder what if. Went private with my second little boy and to be fair was obviously treated as high risk but the continuity of care was so reassuring. Thankfully he's a happy healthy 2 year d now.

ShaShaBear

Thumpette wrote: »

If you can afford it go private. I went public on my first. Low risk, all good. I felt rushed through all of the scans but took it as a good sign that there was no concerns. Unfortunately my son was unexpectedly stillborn at 41+4. I always wonder if I'd gone private might they have followed up on some little signs (slowed growth, unexplained itch) Maybe not but I'll always wonder what if. Went private with my second little boy and to be fair was obviously treated as high risk but the continuity of care was so reassuring. Thankfully he's a happy healthy 2 year d now.

While I am obviously so sorry for your loss, I dont think it's fair to suggest that your public care was the cause of it. Many people rely on public maternity care and many private patients also have stillborn babies. It's a risk we all must take when carrying children, but it's not fair on the women who have to go public to be afraid that their consultant is going to let something like that happen.

awny

ShashaBear, in fairness I don’t think Your response is fair. Trumpette is the only person who can comment on her experience. She believes that her scans were rushed and something may have been missed. She may well be right but she’ll never know. How can you conclude that it was nothing to do with Her care? None of us here can comment on her experience. It’s hers.

While your experiences of the public system are good, not everyone has had the same positive experience and they are entitled to their opinion, whether you agree with it or not.

Trumpette I’m very sorry for your loss.

Clashmore

If you are within a catchment area and are low risk. I would recommend Domino or Midwife led care. Includes combined care with GP.
No hanging around for hours at appointments, most I waited was about 20 minutes. Received great care from midwifes.

Sprites

Thumpette wrote: »

If you can afford it go private. I went public on my first. Low risk, all good. I felt rushed through all of the scans but took it as a good sign that there was no concerns. Unfortunately my son was unexpectedly stillborn at 41+4. I always wonder if I'd gone private might they have followed up on some little signs (slowed growth, unexplained itch) Maybe not but I'll always wonder what if. Went private with my second little boy and to be fair was obviously treated as high risk but the continuity of care was so reassuring. Thankfully he's a happy healthy 2 year d now.

So sorry for your loss Trumpette. I hope if the terrible tragedy you suffered was in anyway due to a deficiency in care you have been offered answers and explanations.

I have to say in my experience of public care any concerns I had (unexplained itchy skin, spotting, shortness of breath) were thoroughly examined and I don't believe I was discriminated against in terms of quality of care for being in the public system.

ShaShaBear

awny wrote: »

ShashaBear, in fairness I don’t think Your response is fair. Trumpette is the only person who can comment on her experience. She believes that her scans were rushed and something may have been missed. She may well be right but she’ll never know. How can you conclude that it was nothing to do with Her care? None of us here can comment on her experience. It’s hers.

While your experiences of the public system are good, not everyone has had the same positive experience and they are entitled to their opinion, whether you agree with it or not.

Trumpette I’m very sorry for your loss.

I most certainly did not conclude anything of the sort. I simply stated I don't believe it fair that she suggest it was the cause. Many women in Ireland have no other choice but to avail of free public care and likewise many women pay for private care to suffer a devastating loss. I feel strongly for any woman who has to go through something like that, but by and large I don't think it fair to suggest that a public consultant would ignore signs like this, but a private one would not. It puts unnecessary strain and anxiety on other mums, like myself, who have no other choice but to put their faith in the public healthcare system.

witchgirl26

Tim76 wrote: »

Hi guys,

Thanks for all the feedback. Your advice has really helped us in making up or mind.

We have decided to go private for a number of reasons but lo and behold there are now another two options, semi private or full!

Again, does anyone of any advice on which one to go for, the main differences etc?

So my experience was semi-private in the Coombe. Like I said, couldn't fault it. Between the scans & the initial payment I think it cost me about EUR600. I claimed the majority of that back from my VHI (haven't done my med1 for last year yet).
I also did the combined care so I saw my GP every second visit. This worked for me as I had some medical issues that shouldn't impact a pregnancy (as in the baby itself) but could affect me during pregnancy. I was lucky again in the my GP actually trained in the Coombe for 6 months to provide the best combined care.
Honestly I saw no need to go fully private at that point for me. Only downside was I developed gestational diabetes and if I'd had to go on meds as opposed to staying diet controlled, I would have been switched to the public system with no refund depending on how many visits I'd been to. If I'd been private it wouldn't have changed my care level.

awny

ShaShaBear wrote: »

I most certainly did not conclude anything of the sort. I simply stated I don't believe it fair that she suggest it was the cause. Many women in Ireland have no other choice but to avail of free public care and likewise many women pay for private care to suffer a devastating loss. I feel strongly for any woman who has to go through something like that, but by and large I don't think it fair to suggest that a public consultant would ignore signs like this, but a private one would not. It puts unnecessary strain and anxiety on other mums, like myself, who have no other choice but to put their faith in the public healthcare system.

But why wouldn’t she say it if she believes that her care failed her? It’s her opinion and she’s entitled to say it.

lazygal

I got better care in the private system and I make no apology for saying so. I found public adequate at best and chaotic at worst, in the few times I had appointments in the public clinic or was on the public wards. I had to ask for things rather than feeling like the staff were being proactive, I can't imagine what happens if you're not assertive or have communication issues. I couldn't put a price on continuity of care, especially when I needed things like c sections and amniocentesis.

Princess Calla

I went public, my sister in law went private. We both had the same consultant.

There was a private patient in my public ward as the private room was full.

I had gestational diabetes on both my pregnancies , no problem with the care I received.

The birth of my first I had 6 midwives and a Dr, there was also the paediatric team of about 6 or 7 waiting for the baby (I didn't know this wasn't normal at the time, which is testament to their professionalism)

On my second I was concerned at one point as my fingers continued to bleed after diabetes testing in the morning. I was afraid there was something wrong with my blood clotting... A massive concern for birth. I went to the hospital, checked into their casualty got full work up done no problem, bloods, urine, scans monitored for a few hours. Everything fine. Sent home.

38 weeks pregnant felt the baby wasn't as active as before, back into casualty again full work up all fine.

The wait into casualty was the length it took me to produce an urine sample.

The midwives and Dr's were fantastic.

So while the wait for routine visits is ridiculously long, I really couldn't fault the level of care.

Personally I wouldn't let level of care be a factor (but then I'm dublin based so have 3 maternity hospitals to choose from) as I think the care you get as a public patient is fantastic.

I had private insurance, so I could have gone private, but I used the money saved to take extra maternity leave.

honerbright

I went public. I did not have a good experience, I'm uunsure if private would have made a difference to the end result.

I was meant to be high risk because I have autoimmune issues and lost a twin at 9 weeks. There were 3 requests that were sent off and were pushed aside. 20 week appointment and my blood pressure was high, they kept taking it until it was an OK level. Mentioned to the doctor then about high risk, she asked another doctor (who people I know have had for their private care and swear by him) if I should be high risk, he said no and they sent me off. Come my anatomy scan at 23 weeks baby was having growth issues so I was referred on to a growth consultant who advised not to continue standard appointments because I was seeing him now. I went to my standard 28 week appointment anyway because I hadn't had my BP checked in a while or peed in a cup lately and next thing you know I'm admitted, diagnosed with pre-eclampsia and had a baby 2 days later. Baby spent 3 months in the NICU and were both perfectly fine now.

The standard of care once I was admitted and post birth was fantastic, but leading up to that stage was fairly traumatic. I had a semi private room post birth, but no roommate and they were kind enough to put me on a floor where i wouldn't hear other babies crying because mine was a few floors below in the nicu.

kandr10

witchgirl26 wrote: »

So my experience was semi-private in the Coombe. Like I said, couldn't fault it. Between the scans & the initial payment I think it cost me about EUR600. I claimed the majority of that back from my VHI (haven't done my med1 for last year yet).
I also did the combined care so I saw my GP every second visit. This worked for me as I had some medical issues that shouldn't impact a pregnancy (as in the baby itself) but could affect me during pregnancy. I was lucky again in the my GP actually trained in the Coombe for 6 months to provide the best combined care.
Honestly I saw no need to go fully private at that point for me. Only downside was I developed gestational diabetes and if I'd had to go on meds as opposed to staying diet controlled, I would have been switched to the public system with no refund depending on how many visits I'd been to. If I'd been private it wouldn't have changed my care level.

In the Rotunda with gestational diabetes, you attend the diabetes clinic but also have your regular appointments with the doctor/consultant through your semi private or private care. You see the diabetic team in addition to your appointments in other words.

Millem

I will not be attending any public clinic if I develop GD and I will be telling my consultant that!!
I am actually getting the test at 28 weeks in the private clinic. I am meeting my own consultant after it.

Last baby I did the same (different issue).
I was sent to the other consultant once who did a special scan in the private clinic and then back to my own consultant for all my appointments.
I do not have time to wait around nor do I have any desire to meet Tom, Dick or Harry and explain my situation on a number of occasions.

mvl

just thought I'd ask, for this decision, would it make a difference if the mother is in her 20s or 40s ?
e.g. I'd imagine for majority it is easier giving birth when mother is in her 20s than 40s ...

lazygal

I don't think age comes into it. It depends on your financial situation, priorities, medical history. You can have an easy pregnancy and straightforward delivery at 45 or a complex pregnancy and delivery at 20.

SixtaWalthers

Tim76 wrote: »

Hi all,

My wife and I are expecting our first child and are trying to determine whether to go public or private.

Anybody out there have any advice on which way to go? What are the main differences between the two, apart from the extra expense?

We could get the funds together for private if we do decide to go that way but would rather put the money into the baby’s future if there’s not much difference between the two.

Thanks in advance for any advice!

I agree with members who are saying if you have private healthcare insurance then go with it. Otherwise, public could be an option and you can use your funds for baby's future.

On the other hand, medical condition of your wife also matters. If her case is normal then public is ok but in case of complex situation, you should also think about private. Listen all of us but take your best decision.

kandr10

Millem wrote: »

I will not be attending any public clinic if I develop GD and I will be telling my consultant that!!
I am actually getting the test at 28 weeks in the private clinic. I am meeting my own consultant after it.

Last baby I did the same (different issue).
I was sent to the other consultant once who did a special scan in the private clinic and then back to my own consultant for all my appointments.
I do not have time to wait around nor do I have any desire to meet Tom, Dick or Harry and explain my situation on a number of occasions.

If you get a choice, well and good. I won’t get a choice if I end up on medication for gd again. That’s the hospital protocol. The midwives who are in the diabetes clinic are so knowledgeable about it and you need to see an endocrinologist at those appointments too. I would see it as a good thing that you’re getting to tap into someone else’s specialist knowledge in addition to the care given privately/ semi privately.

Millem

kandr10 wrote: »

If you get a choice, well and good. I won’t get a choice if I end up on medication for gd again. That’s the hospital protocol. The midwives who are in the diabetes clinic are so knowledgeable about it and you need to see an endocrinologist at those appointments too. I would see it as a good thing that you’re getting to tap into someone else’s specialist knowledge in addition to the care given privately/ semi privately.

I know my friend had a heart condition and she used to see them in mater while she was pregnant.

Anyway I was sent to the main hospital for my panorama test and honestly I told him never again.
It was the stuff nightmares were made of. Garda, prisons guards etc. Told reception I was leaving after 30 mins and rebooking in the beacon. Anyway they put in a separate room straight away.

The following week I told my consultant never again I really don’t care if I have to pay more it is not happening! Apparently it was a particularly bad day! At one stage I thought maybe I should just wait beside the Garda!!!!!

Princess Calla

mvl wrote: »

just thought I'd ask, for this decision, would it make a difference if the mother is in her 20s or 40s ?
e.g. I'd imagine for majority it is easier giving birth when mother is in her 20s than 40s ...

I was a "geriatric pregnancy" both times. I'm relatively healthy, conceived both times on first attempt. So I didn't see the point, in my case, of paying extra, I went public.

I've no idea how I developed gestational diabetes as I'm in no way overweight, my age was the only red flag there.

shesty

Millem wrote: »

I know my friend had a heart condition and she used to see them in mater while she was pregnant.

Anyway I was sent to the main hospital for my panorama test and honestly I told him never again.
It was the stuff nightmares were made of. Garda, prisons guards etc. Told reception I was leaving after 30 mins and rebooking in the beacon. Anyway they put in a separate room straight away.

The following week I told my consultant never again I really don’t care if I have to pay more it is not happening! Apparently it was a particularly bad day! At one stage I thought maybe I should just wait beside the Garda!!!!!

Well to be fair, despite being semi private I still had a few A&E admissions on all 3 early on due to bleeds.Still had to go through the same system, it works fine.Had to attend the Rotunda EPU on all three, care was excellent.

If you go in at the start of labour and are kept, or are being induced, then you are in the same labour ward as everyone else, no matter what your insurance is.

Everyone has different comfort levels....if someone feels they want one doctor all through, and they can afford it, then go for it, I suppose.

Antares35

Am 28 weeks and have opted for public care in Holles Street. I couldn't say a bad word about them based on our experience. The booking appointment at 12 weeks was very thorough. Even got tested for toxoplasmosis when I mentioned I had cats at home. Check later on for GD because there is diabetes on my Dad's side. The anomaly scan at 22 weeks was amazing and the sonographer spent so much time with us pointing everything out. Recently, ended up at A&E with (unknown to me at the time) "lightening crotch" pains. I thought I was having contractions or something. Again, in straight away and they checked BP and baby's heart. Once that was all ok, we waited maybe an hour to see a doctor and have a scan.

We couldn't really afford private, and the only benefits I could see from semi-private was reduced waiting times. Since our work policy provides for reasonable paid time off for ante-natal visits, it didn't make sense to me to fork out a couple of thousand to save my employer some time on the clock. Perhaps there are other benefits too that I was not aware of. IMO it is one of the few areas where we actually reap some kind of generous benefit in exchange for all that tax!

I am so apprehensive about labour and delivery that I really don't think privacy will be top of my agenda at that time - however I will probably eat those words!

crisco10

We had health insurance, but elected to go "public" with the Domino scheme based out of Holles St and had a hugely positive experience. Via the Midwife clinics and GP all the checkups were easy and quick (and local, as opposed to in the hospital), then it was great having the midwives out to the house for a week after the birth. Great for all the little first time parent questions!

Obviously, as others have said, domino/midwife lead only works if everything is uncomplicated.

witchgirl26

kandr10 wrote: »

In the Rotunda with gestational diabetes, you attend the diabetes clinic but also have your regular appointments with the doctor/consultant through your semi private or private care. You see the diabetic team in addition to your appointments in other words.

The way it works in the Coombe for semi-private is that you continue your normal schedule with calls to the diabetic nurses for blood sugar levels unless you are put on medication. If you are diet controlled (like I was) there is no change. If medication, then your care switches to the diabetic team which is in the public set-up. You see the diabetic nurses and the endo there as opposed to your normal consultant. You can still continue the combined care with your gp though.

Millem wrote: »

I will not be attending any public clinic if I develop GD and I will be telling my consultant that!!
I am actually getting the test at 28 weeks in the private clinic. I am meeting my own consultant after it.

Last baby I did the same (different issue).
I was sent to the other consultant once who did a special scan in the private clinic and then back to my own consultant for all my appointments.
I do not have time to wait around nor do I have any desire to meet Tom, Dick or Harry and explain my situation on a number of occasions.

If you're private in the Coombe, I believe you remain in the private part with additional appointments with the endo. It's only on semi-private that you might have to transfer.

And lets face it, most of us don't have the time to wait around but some us don't have a choice.

kandr10 wrote: »

If you get a choice, well and good. I won’t get a choice if I end up on medication for gd again. That’s the hospital protocol. The midwives who are in the diabetes clinic are so knowledgeable about it and you need to see an endocrinologist at those appointments too. I would see it as a good thing that you’re getting to tap into someone else’s specialist knowledge in addition to the care given privately/ semi privately.

This is so true. I didn't want to switch in for a number of reasons but none of them down to thinking I was getting a lesser standard of care. Instead it was more around not wanting to be on the meds etc. I found the diabetic nurses really great to deal with anytime I rang in my numbers, had to do a visit with them or just needed to ask them anything.

Millem wrote: »

I know my friend had a heart condition and she used to see them in mater while she was pregnant.

Anyway I was sent to the main hospital for my panorama test and honestly I told him never again.
It was the stuff nightmares were made of. Garda, prisons guards etc. Told reception I was leaving after 30 mins and rebooking in the beacon. Anyway they put in a separate room straight away.

The following week I told my consultant never again I really don’t care if I have to pay more it is not happening! Apparently it was a particularly bad day! At one stage I thought maybe I should just wait beside the Garda!!!!!

Oh come on! I've been in the Coombe loads and never seen that! Sorry I lie - I saw a couple of Garda a few times but mainly in the little cafe grabbing a cuppa.
Maybe you're better off staying in the private if waiting 30 mins with others around is too much for you. :rolleyes:

jlm29

Antares35 wrote: »

I am so apprehensive about labour and delivery that I really don't think privacy will be top of my agenda at that time - however I will probably eat those words!

Whether you’re public or private, you would leave your dignity on the front step when you go in to give birth, and if you’re lucky, collect it on the way out. There’s no extra privacy for being a private patient, when it comes down to getting baby out, and you’re right, you won’t care! For one of mine, there was such a collection of people in the room checking out proceedings that I couldn’t keep track!
And try not to worry about it, your body will do what it’s built for!

lazygal

jlm29 wrote: »

Whether you’re public or private, you would leave your dignity on the front step when you go in to give birth, and if you’re lucky, collect it on the way out. There’s no extra privacy for being a private patient, when it comes down to getting baby out, and you’re right, you won’t care! For one of mine, there was such a collection of people in the room checking out proceedings that I couldn’t keep track!
And try not to worry about it, your body will do what it’s built for!

Sorry might be off topic but this is such a damaging attitude, right up there with the idea that we can't complain once a live delivery happens. There's no reason whatsover to accept that you lose dignity because you're giving birth. We don't tell any other patients or those using health services to park their dignity at the door, and indeed I can only imagine the outcry if we did. I absolutely did care about my privacy, and that's why I went for private care because I know me and I need a room to myself and my own bathroom. I loathed being on a shared ward and couldn't get to the private room fast enough.

Dignity in labour and birth is something we have a right to, and any medical professional or person who says otherwise needs their attitude adjusted.