Private medicine has no national price list. Each doctor or clinic sets its own fees, which is why the same consultation can differ several-fold across London.
The parts of the bill
The initial consultation. Usually the largest single item and usually quoted up front. Ask how long it is — the fee means little without the duration.
Follow-up appointments. Shorter and cheaper, but the number needed is what determines the total. For anything ongoing, ask how many are typical.
Investigations. Blood tests, imaging and other tests are charged separately and are frequently not quoted at the start, because nobody knows what will be needed until you have been seen. Ask for the price list.
Letters and reports. A clinic letter to your GP is often included. An insurance report, a letter for an employer, or anything medico-legal usually is not.
Prescriptions. The act of prescribing is commonly included in the consultation fee. The medicine is not. A private prescription is dispensed at the drug’s real cost plus the pharmacy’s fee, which may be well below the NHS prescription charge for cheap generics and far above it for expensive drugs.
Contact between appointments. Some clinics include it, some charge, and some do not offer it at all. Worth establishing before you need it.
Where people get caught out
The treatment needs continuing and the private route gets expensive. A one-off opinion has a fixed cost. Ongoing treatment does not, and the cost continues as long as the treatment does.
Shared care is declined. The common assumption is that a private doctor starts a medication and the NHS GP then takes over prescribing it. GPs are entitled to decline, and some practices decline all private shared care as policy. If that happens you continue paying private prescription costs indefinitely. Ask your own GP practice what their position is before you start, not afterwards.
Insurance shortfalls. Many policies reimburse up to a published rate. Doctors who charge above it are entitled to, and the difference is yours. Ask whether the doctor is recognised by your insurer and whether they charge within the reimbursement rate — those are two different questions.
The second opinion that becomes a second pathway. A private assessment does not move you up an NHS waiting list, and some NHS services will want to repeat an assessment themselves before taking over care.
Comparing against the NHS route
The NHS alternative is free at the point of use and may be slower. Whether paying is worth it depends on what the wait actually costs you — in symptoms, in work, in uncertainty — rather than on the wait existing.
It is worth asking what the realistic NHS wait is in your area for your problem before assuming it is unbearable. Sometimes it is months rather than years, and sometimes there is a route nobody has mentioned.
Questions that get useful answers
Questions to ask before booking covers the clinical side of the same conversation — who you will see, how often they treat your problem, and what happens if something goes wrong.