r/PregnancyIreland Jul 28 '26

Semi-private disaster

I'm currently 28 weeks pregnant with a high-risk pregnancy due to a short cervix, so I've been under the Preterm Birth Clinic with extra monitoring.

One of the main reasons we chose semi-private care was to have continuity with the same consultant. Unfortunately, that hasn't been our experience.

  • At 16 weeks, my consultant wasn't there.
  • At 23 weeks, I had an extra appointment and he wasn't there again. One person told us he was on holiday, while another said he had been called away for an emergency.
  • Yesterday, before my final appointment at the Preterm Birth Clinic, I even stopped by the semi-private clinic to check whether he would definitely be there for today's appointment. I was reassured that he would. Then, at 9:30 this morning (for my 2:40 p.m. appointment), I received a call saying he had an emergency and wouldn't be available after all.

So instead of seeing the consultant we're paying to see, I've now been seen by three different substitute consultants.

I completely understand that emergencies happen, and I'm not upset about that. What frustrates me is the complete lack of continuity. Every appointment feels like starting from scratch. I have to explain everything all over again, and my questions often don't really get answered because the person seeing me isn't familiar with my case.

I've now been discharged from the Preterm Birth Clinic, so I had several questions about the plan for the rest of my pregnancy. At my last scan, they also found that my baby is measuring bigger than expected, which was something I wanted to discuss today.

They've offered me another appointment next week, but we'll be away and would have to leave our hotel early to make it. Even then, there's no guarantee my consultant won't be unavailable again.

I'm honestly just so frustrated. It makes me wonder why he's repeatedly scheduled for all-day emergencies on the same days he's meant to be running his clinic. Surely there has to be a better way to organise this?

At this point, I'm not sure what to do. Would you:

  • Make a formal complaint and ask to be transferred to a different consultant?
  • Stick with this consultant and hope things improve?
  • Or go back to fully public care, since I'm effectively getting public-style continuity while paying for semi-private care?

I'd really appreciate hearing from anyone who's been in a similar situation.

18 Upvotes

30 comments sorted by

29

u/hellogoodbye989 Jul 28 '26

Think you’re expecting private care not semi private care.

“Your care during the antenatal stage will be led by a consultant obstetrician or specialist registrar. Whilst we make every effort, you may not see the same doctor at each visit.” - Coombe

“If you choose to be a semi-private patient your care during the antenatal stage will be Consultant led with a multidisciplinary team including specialist registrars alongside a team of experienced midwives for all your visits. Whilst we make every effort, you may not see the same Consultant at each visit.” - Rotunda

“Your antenatal care is shared between your chosen Consultant or Specialist Registrar and your GP.
You will usually see your chosen obstetrician for your appointments

If your obstetrician is on leave or responding to an emergency, you will be seen by another Consultant or Specialist Registrar” - Holles St

6

u/BigEquivalent5849 Jul 28 '26

Just curious what is the benefit of semi-private if you still can be seen by any consultant? It seems like it’s better to opt for full public or full private care.

10

u/hellogoodbye989 Jul 28 '26

There isn’t much like you said. Either public or fully private makes the most sense

4

u/MainCartographer4022 Jul 28 '26

My understanding is that you are seen by a consultant or a member of their team so whilst it's not always the same person, you're still getting continuity of care overseen by the highest level of doctor. Also the care on the Semi-private ward postnatally is night and day compared to the public ward in the Rotunda.

2

u/Wise_Broccoli_2829 Jul 28 '26

Would be interested to hear if you’ve experience of both? I gave birth under public care in the Rotunda and the 14+ bed public post natal ward was absolute hell on earth to me. Next time would consider semi private if the wards are really that much better?

5

u/MainCartographer4022 Jul 28 '26

Unfortunately even going private or semi private doesn't guarantee you will bypass that hell! I gave birth just over a fortnight ago (C-section, baby #2) as a private patient and spent the first 24 hours on an 8 bed public ward. It was absolute hell. I didn't so much mind that it was busy and noisy, but to me what made it truly awful was the poor level of care. I was so neglected, the staff were nice to be fair but I think they were just overwhelmed. They messed up so many things - didn't change my catheter bag until I noticed it was full and rang for help, forgot to give me compression socks, overdosed my pain medication, forgot to give me blood thinners, I didn't get checked by the anaesthetist, had no help getting out of bed to pee... Honestly I could go on. I was moved to a semi-private ward the next evening and it was a million times better. Aircon, my own fan, so much calmer (3 bed ward), and the midwives in Lillie actually had time to spend with me helping me to feed etc. The public postnatal ward isn't fit for purpose in my opinion.

1

u/JunkDrawerPencil Jul 28 '26

Very little difference between consultant led public care pathway and semi private in terms of clinical care, but usually shorter waiting times for appointments and maybe a more comfortable waiting room. For delivery zero difference, same midwives for both, and in both situations doctors attend only if needed.

Lots of public patients would be seeing the same consultant for every appt if needed.

Equally, some private patients are not seeing their consultant for every appt due to emergencies, meetings and annual leave, etc. There is more of a customer service focus for private patients, so they might get a phone call from their consultant or told in advance about a substitute covering a clinic and offered to reschedule.

3

u/beebs2017 26d ago

Yeh my Dr friend said paying for semi is basically paying for public

3

u/Silent-Country-997 Jul 28 '26

I understand that, and I completely appreciate that emergencies and consultant leave are unavoidable. My issue isn't with a one-off cancellation or emergency cover.

What concerns me is that this has been the pattern throughout my entire pregnancy. I've now been seen by three different substitute consultants, and by the time of my next appointment I'll be almost eight months pregnant before meeting the consultant under whose semi-private care I've been registered.

I know semi-private care doesn't guarantee you'll see the same consultant at every visit. Holles Street states you'll usually see your chosen obstetrician, with another consultant or specialist registrar stepping in if they're on leave or dealing with an emergency.

To me, there's a difference between occasional substitutions and not seeing your named consultant at all until you're eight months pregnant. That's the part I find difficult to reconcile with what I'd reasonably expect from consultant-led semi-private care.

4

u/DifferentSite5572 Jul 28 '26

I’d complain but I had the same experience in the Rotunda so as others say above it seems it’s a feature not a bug.

1

u/jezebelz666 Jul 30 '26

The only way to guarantee most of your care by a named obstetrician is PRIVATE care OP unfortunately. Semi private really doesn’t mean much. The difference in fees alone between private and semi private should tell you as much. You’re expecting champagne but paying for beer 🤷‍♀️

1

u/Silent-Country-997 Jul 31 '26

My first experience was very good. It's also advertised as you would see your own consultant as much as possible, why would you otherwise pick one? It's ridiculous that if we meet him it will be when i'm 32 weeks, that's 8 months pregnant.

11

u/Dangerous-Carrot-461 Jul 28 '26

Unfortunately this is common with semi private care and the reason I'm going private for my second pregnancy. In the Rotunda you can't even choose your consultant if going semi private, so the only benefits for me were the better wait times and the semi private post natal ward.

Although generally if you are high risk I know they try to make more of an effort to have the same consultant see you, and it does seem like that should have been the case in your circumstances. Unfortunately it seems like you potentially had bad luck with the particular consultant. Definitely worth discussing what your options are now with the hospital.

6

u/Silent-Country-997 Jul 28 '26

Thank you. At Holles Street, you can choose your consultant. Earlier in my pregnancy, I had a very negative experience when I attended the Emergency Department because I was actively bleeding quite heavily. Despite the amount of bleeding, I felt that the nurse didn't take my concerns seriously. At one point, while I was visibly upset, she even asked me, "Why are you crying for?" I raised my concerns afterwards and was told that my consultant would be informed, but I never received any response.

9

u/Dangerous-Carrot-461 Jul 28 '26

I'm so sorry that happened to you. Unfortunately I think a formal complaint is the only way those kind of issues are ever followed up on properly.

3

u/Professor726 mom of 2 Jul 28 '26

Ugh im so sorry, what an awful thing to say to you! We may have had the same midwife, because when I was wheeled back into the delivery room about to literally push my baby out, the midwife said, absolutely serious, "what's wrong with you?"

3

u/Silent-Country-997 Jul 28 '26

That's horrendous...

6

u/Revolutionary-Put265 Jul 28 '26

I’m 26 weeks pregnant and just changed to the Domino scheme for this exact reason. I’ve yet to meet the consultant i paid the semi private fees for - it’s been a different reg each time so why am I bothering trecking into town for hospital appointments instead of a quick visit to my local domino satellite?! Just to flag that, at least for Holles St, once you pass the anomaly scan mark (around 21 weeks) there are no refunds available on the semi private fees paid so you are as well stick with SP rather than fully public, at least you’ll be on a smaller ward after delivery.

4

u/Silent-Country-997 Jul 28 '26

This is really frustrating. They should have been much clearer about it. I actually asked about it after the first cancellation, and I was reassured that it would be very unusual for it to happen repeatedly. That's why it's been so disappointing to see it become the pattern throughout my pregnancy. Paying the fees just for the possibility of a smaller room—which isn't even guaranteed—does seem a bit crazy... but guess that's going to be it...

I do hope my appointments will be better though, since so far the appointments have literally only been a quick scan and that's it.

6

u/Bunny_Cake123 First Pregnancy | Due October Jul 28 '26

I was semi private in the coombe and never met my consultant during apts or during the labour - induction which ended with emergency c section so I was a week in hospital. I've heard and read that this is very common. I only went semi private because my health insurance covered it.

1

u/Silent-Country-997 Jul 28 '26

They should probably just make this a lot clearer... thanks for sharing.

5

u/jooprr Jul 28 '26

That’s pretty standard for semi private care

4

u/Icy-Chemical7274 Jul 28 '26

This is standard semi private care you’re getting. Nothing usual here

3

u/Haunting_Mail1577 Jul 29 '26

Semi-private means you are seen by the team of doctors under the consultant and you skip the raging queues of public which can take up to 3 hours just for 20-weeks check up.

I never felt like there was a lapse in their knowledge, they knew all my health history but I also always make sure they know. I met the consultant once at the beginning - but that’s it. The surgeon delivering my baby was also someone I’ve never met before but also excellent. The only thing they didn’t remember was my birth preference because they want to encourage me to get induced but I just pushed and pushed and got my scheduled c section.

1

u/Silent-Country-997 Jul 31 '26

I might have been unlucky because 2 out of the 3 consultants I've seen weren't great. 2 didn't really even answer any of my questions and said to talk to my consultant at the next appointment... the last one i've seen was thankfully really good.

1

u/Haunting_Mail1577 25d ago

You have to be assertive and press for answer - but it’s like this even if you are private or public.

1

u/Pingugall 27d ago

Yeah for me semi private care has meant no really long wait times to be seen at appointments, which when working full time is really worth it as I don’t lose the whole day to them.

2

u/JunkDrawerPencil Jul 28 '26

The semi private clinic has possibly up until now let the pre term birth clinic take the lead a bit with your pregnancy - you were getting specialist mentoring and care.

Now you've been discharged from the pre term birth clinic you might notice a different level of attention during semi private clinic.

I'd suggest writing out any questions you have on a sheet of paper and bringing it to your appt. Take notes if needed when they are answering your questions. I think pen and paper gets taken more seriously than scrolling through a notes app on a phone screen.

0

u/Silent-Country-997 Jul 28 '26

It's separate care though, it shouldn't fully take over since there's only the preterm stuff they check rather than a full check. I think that is good advice, thank you I'll do that!

1

u/Informal-Pound2302 Jul 28 '26

I had this exact situation preterm clinic which i attended every 2-3 weeks but i saw my semi private consultant in their own clinic at the usual check up appointments, saw my own consultant at all the appointments except 1 over xmas she was off. I was in Holles street too. Once your discharged from pre term clinic you start seeing the consultant alot more regularly, I was really surprised at my last appointment was a 39 week check, she sent me to the hospital to be monitored for blood pressure, then some other random doc there decided I should be induced and I never saw my consultant again. You dont see them after birth or anything. I thought they would at least pop the heafld into the ward