I would love to hear from people who prefer PHI and not getting 'stuck' in the public system. As my current understanding is you are only paying for a faster service and choice of doctor.

Warning: poo related/TMI

I have a family history of bowel cancer and need screening colonoscopies every two years. I work in healthcare myself. I would never ever have a screening colonoscopy in the public sector because I want (1) on-time screening that meets the recommendations, (2) a full GA and not just "twilight" sedation which you occasionally get in public, (3) choice of doctor and most definitely a consultant and not a registrar (so that I can pick someone with a low complication rate, an excellent reputation, and good bedside manner in case we need to discuss poo/bowel habits/anything down there - it can be an embarrassing topic, I want someone I feel comfortable with!).

In the state I've predominantly worked in, SA (now based in Vic and it's heaps better, that stamp duty revenue!), I have never ever seen the public system achieve screening colonoscopy regimens that match the guidelines. At best, I've seen a few people who were supposed to be 2 yearly (eg. need another scope in 2 years after a polyp was found and removed) get 3 yearly. (I've never seen family history cases, with no polyps, be screened appropriately in the public sector. Ever.) That's the best I've ever seen. Mostly, they just get lost to follow up and it ends up being 5 yearly if at all. The emphasis in SA is on non-screening colonoscopies, ie. trying to at least achieve the targets for people who have symptoms or who have returned a positive FOBT (the test looking for blood in the poo that gets sent to 50+ year olds and you may have seen ads on tv). IMO the performance for this category is also appalling. Best I've seen is appointment in 2 months, colonoscopy in 3 months, from the time I refer to the hospital as the patient's doctor. Worst is > 6 months for people who I consider urgent or what we call "red flag" cases and where I've sent multiple referrals and phoned the hospital asking for them to be bumped up the list because they're urgent (eg. if patient has trifecta of weight loss, visible blood in poo, and iron deficiency anaemia, then there's a very high chance they have cancer, and they ought to be seen and scoped within 6 weeks max). I have personally seen a few cases over the years of patients whose cancer was metastatic at the time of diagnosis and we will never know if it was non-metastatic at the time of referral. Tragic.

I would be happy to use the public sector for some things. For certain things, I would always go private. Colonoscopies happens to be one of them.