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Qualitative Methods

3. Observation

This sub-sample of cases revealed that the difference in length between NHS and private consultations was now reduced to an average of under 3 minutes. This was still statistically significant, although the significance was reduced.

Finally, if a comparison was made of only new patients seen by the same doctor, NHS patients got 4 minutes more on average - 34 minutes as against 30 minutes in the private clinic. This last finding was not suspected and had interesting implications for the overall assessment of the individual's costs and benefits from 'going private.' It is possible, for instance, that the tighter scheduling of appointments at the private clinic may limit the amount of time that can be given to new patients.

As a further aid to comparative analysis, patient participation was measured in the form of questions and unelicited statements. Once again, a highly significant difference was found: on this measure, private patients participated much more in the consultation.

However, once more taking only patients seen by the same doctor, the difference between the clinics became very small and was not significant. Finally, no significant difference was found in the degree to which non-medical matters (e.g. patient's work or home circumstances) were discussed in the clinics.

These quantitative data were a useful check on over-enthusiastic claims about the degree of difference between the NHS and private clinics. As Table 3 shows, both these quantitative measures revealed significant differences, in the expected direction, according to the mode of payment.

Table 3

Private and NHS Clinics: Ceremonial Orders

  Private Clinic (n=42) NHS Clinics (n=104)
Treatment or attendance fixed at patients' convenience 15 (36%) 10 (10%)
Social elicitation 25 (60%) 31 (30%)