Women increasingly seek private gynaecological care amid growing NHS waiting lists

Following a BBC report indicating that gynaecology appointment waiting lists throughout the UK have more than doubled since February 2020, numerous women have recounted feeling compelled to access private healthcare. Women experiencing severe pain while awaiting essential gynaecological treatment are increasingly opting for private services, often with the aim of securing an expedited referral to the top of the NHS waiting list. The accounts provided by these individuals to the BBC align with observations from professionals within the healthcare sector. An open letter, signed by the leaders of 11 prominent women’s health organizations, calls upon both the public and healthcare professionals to engage in their “Change NHS” discussion. These organizations stated: “Women and girls have repeatedly been left to ‘fall through the gaps’ of fragmented government policy.” According to The Royal College of Obstetricians and Gynaecologists, the ongoing discourse surrounding the government’s 10-year health plan presents an opportunity to advocate for “much needed” funding and comprehensive system-wide support, which are crucial for improving women’s health services. An NHS spokesperson commented: “While latest data shows NHS staff are making progress to cut waiting lists and tackle the backlog, we know there is much more to do to bring down long waits for care, particularly for women who are waiting for crucial appointments and treatment.” The spokesperson added: “We welcome feedback from the public and those working in women’s health services via Change NHS to build on our work on improving services for women – which includes developing a network of women’s health champions in every local care system and expanding neighbourhood women’s health hubs across the country – giving thousands more women access to specialist women’s health teams in the community.” Claire, a 40-year-old mother, underwent a hysterectomy—the surgical removal of the womb—12 weeks prior. This mother-of-one required the procedure to alleviate her “debilitating” endometriosis and adenomyosis. The operation, performed by a private consultant, cost Claire over £10,000; notably, she is on a three-year NHS waiting list to see the same consultant. She stated: “This was the last option, it was desperation.” Claire, who works as a librarian, faced challenges in having her pain taken seriously throughout her teenage years. She was 22 before she received a diagnosis of severe endometriosis. This diagnosis offered hope to Claire, who had previously been informed that her pain stemmed from an irritable bowel. She remembers a doctor telling her mother: “I think it’s just IBS. Get her to suck on a Polo mint.” However, the endometriosis diagnosis marked only the start of an ongoing struggle to access prompt NHS care. She explained: “These [gynaecology] appointments are a lifeline for us. We are in so much pain but we know it’s okay because in a few months we’ll be seeing this consultant or doctor, and then when they cancel it is heart-breaking.” She further described: “Out of every month I was getting one good week and around that it was about managing the pain and the emotional effects of that.” Claire, who also experiences premenstrual dysphoric disorder (PMDD), a menstrual-related condition that causes severe distress, is now faced with the decision of how much to depend on expensive private care for her ongoing treatment. She remarked: “I know I’m in a privileged position to be able to have gone private.” She added: “The nurses were amazing, the aftercare was all followed up, they referred me to physio. But I need to continue with the NHS now because otherwise, where does the cost end?” Pippa, a retired cafe owner, stated: “I am not the type of person to kick up a fuss.” For several months, she endured “excruciating pain” in her abdomen. However, despite three consecutive visits to her GP, she repeatedly left with prescriptions for antibiotics, intended to treat a presumed infection. Ultimately, a friend urged her to “pester” her GP to request a scan. Consequently, Pippa was urgently admitted to the hospital for emergency surgery to extract an ovarian cyst weighing 8lb (3.6kg), which was comparable in size to a brick. The surgical team had to use a bucket instead of their standard container to accommodate it. She commented: “It is a bit of a blur because it was very traumatic.” She described her NHS aftercare as “disappointing,” noting that her hospital recovery period was shortened due to bed pressures. Pippa now experiences life-altering pain caused by the cyst’s effect on her organs, in addition to nerve damage in her leg, which necessitates daily treatment. She reflected: “Maybe if I pushed for the scan earlier it would never have got so bad and I wouldn’t have found myself in this situation.” Amy was initially misdiagnosed with Irritable Bowel Syndrome until a procedure performed when she was 26 years old uncovered that she had severe endometriosis. After her diagnosis, she received NHS support, which included access to a pain-management clinic and an endometriosis specialist. However, following the Covid pandemic, this support was “no longer there” as the NHS faced difficulties managing the increased demand for its services. Amy stated: “We have spent £2,000 having to see the same [gynaecology] consultant privately.” She utilized these private appointments to obtain an NHS referral for surgery. Amy added that her consultant “has my best interests at heart,” but cannot provide treatment until she reaches the top of the waiting list. She recounted: “Three years ago we lost our baby girl at six months old [in pregnancy]. I’m pretty sure it was down to complications with my endometriosis. I just think there are not enough specialists who are able to look at our scans.” Currently, Amy’s endometriosis has progressed to a stage necessitating a full hysterectomy, and she might also require the removal of portions of her bowel. She quoted her consultant: “My consultant told me the wait with the NHS is two-to-three years, so if I could afford to pay for it, then I should. So that is what I am going to do.” She expressed: “This will be my seventh surgery but I am still scared because I’m just not confident that I will be in a much better place afterwards. I don’t have another choice.” She lamented: “I’ve lost so much of my life to this. You just become used to having no energy and you can’t really do a lot. I feel like a 40-year-old in a 90-year-old’s body.” Bethany frequently faced disciplinary issues at school due to poor attendance, which was caused by period pains that began when she was only 12 years old. Upon starting her initial retail job, her co-workers perceived her as “lazy” or “couldn’t be bothered,” yet her fatigue prevented her from completing an entire workday on her feet. She recalled: “I would go down to my car at lunchtime and go to sleep because I was just so exhausted.” Her interests, including rock-climbing, horse-riding, and hiking, gradually diminished, and her daily activities became restricted by her pain. At the age of 20, Bethany received an endometriosis diagnosis, which presented her with a significant decision. She stated: “I was told a hysterectomy was the only option for me.” She reflected: “My friends were just leaving university and thinking about getting their first job and I’m there thinking, am I going to have children? Do I need to freeze my eggs or start saving for IVF?” She quoted the doctor: “The doctor told me, you either have no pain, or you have babies. Make a choice.” Following family advice, Bethany sought a second opinion through the NHS, but securing the appointment took two years, and an additional 18 months passed before another procedure could be performed. She remembered: “By this point I couldn’t move my legs without pain.” Bethany’s endometriosis had started impacting her bowel, leading to a recommendation that she consult a colorectal surgeon for additional examination. Bethany is still awaiting this referral. She is currently investigating treatment options via private health insurance. She expressed: “I can’t put into words how profound the grief is for the life that I could’ve and should’ve had.” Saschan began experiencing abdominal pain during her first year of university. Saschan, a consultant in the wellbeing and healthcare sector, observed rapid weight gain, which caused her such severe pain that she missed lectures. Initially, doctors suspected she had developed pelvic inflammatory disease due to a fitted contraceptive coil; however, a subsequent scan also identified a cyst on her ovaries. While her peers participated in social events, Saschan remained confined to her halls of residence, unable to move. Her friends provided her with food and companionship. However, requiring additional care, she was compelled to suspend her studies for a year and return to her family home. During her wait for an appointment, Saschan frequently visited A&E, attending as often as three times a week during her most severe periods. Ultimately, she chose to pay for a private consultation with a doctor who also worked within the NHS. The consultant then referred Saschan for NHS surgery, during which five litres were drained from the cyst, and her ovary and one fallopian tube were removed, following the fast-tracking of her NHS appointment. She stated: “I used my grant from my student finance to pay for that first private consultant appointment.” In total, Saschan has incurred approximately £2,000 in costs for private appointments. She recalled her mother telling her: “My mum said to me, if we have to remortgage the house to pay for the surgery, then that’s what we have to do because you can’t put a price on your life.” Following four subsequent operations, Saschan received an additional endometriosis diagnosis and underwent treatment for fibroids and a hiatus hernia, both of which were worsened by the delay in receiving NHS surgery. She concluded: “I don’t think that the medical system recognises that even though you can’t see your uterus or your ovaries, when you are in a position where you are having them removed, it brings up a lot of things about how you feel about your identity and what you perceive your own experience around womanhood to be.” Copyright 2024 BBC. All rights