Phil Hammond MD

You can tell a male paediatrician by the pattern of his tie. No self-respecting child expert would dare to be seen without Winnie the Pooh dangling down his front. Or perhaps Squirrel Nutkin. Recently, I ate out with three Yogi Bears and a Fred Flintstone (they even wear them off duty), yet despite their sartorial jocularity, the mood was anything but. They had been ordered to start treating children privately in their NHS hospital or else - the else being that without a large dollop of private cash, the trust could not afford to treat many patients for free.

None of the four had ever practised private medicine, not even in a private hospital, and the idea was abhorrent. As Yogi One put it, "Private patients are treated differently. They're more demanding, they get more attention and they get a better service. I just couldn't operate on two levels."

"But we already do," protested Yogi Two. "Patients of GP fundholders jump the queue every day."

"You're right," said Fred. "But at least they get treated the same as everyone else when they arrive. They don't expect a Jacuzzi and a view of the rose garden."

"Precisely," said Yogi Three. "I'm buggered if I'm sitting on a pay bed for two hours talking about gymkhanas when I could be seeing 20 kids in outpatients."

The notion that sick kids with parental clout get preferential treatment in NHS hospitals may make you gag, but it happens. Indeed, one children's hospital is as fond of welcoming private patients as TV cameras and yet, as was recently revealed, it's top of the pops for turning away NHS patients owing to a lack of intensive care beds. Of course, it might have to turn away many more without the money from private treatment, but in the race to the ventilator, you can't help thinking that some patients are more equal than others. Even in the less emotive world of routine care, private patients are treated more humanely. Every year, the NHS ombudsman gives woeful accounts of patients being ignored, patronised, stripped naked and yelled at from the end of the bed. Try that in your private rooms and see what happens to the bank balance.

But despite bad manners, you still get a pretty good service from the NHS, don't you? Let's see. You turn up on the ward for your op and nobody's got a clue who you are. So you lie on a trolley in the corridor for three days while the porters come to remove the corpse from your bed on the mixed geriatric ward. And when you do get a bed, there's no pillow and even if there were one you can't get any sleep thanks to the confused colonel crawling under your covers and peeing on your Maltesers. Yes, the NHS at its worst is the advert private hospitals dream of.

But before you rush off your premiums, a small caveat; private hospitals are not the best places to be in an emergency. OK, so you get your own pillow and the quail's eggs, but do you get a defibrillator? Not always. In my youth, I worked in one private hospital where the cardiac arrest trolley consisted of a bottle of port and the death certificate book. The lack of emergency equipment was so scary it put me off my foot massage and I've never been back. Many private hospitals do now have complicated machines that go ping but not always the staff to use them. Also, surgeons will insist on doing major operations in isolated Georgian buildings and then going home for dinner, leaving a single inexperienced junior doctor and three floppy nurses to cover the entire hospital. I met that doctor and was horrified to find that when one patient started to choke after a neck operation, no one knew how to intubate her. She died well before her consultant was out of his jim-jams.

Such horror stories are equally commonplace in the NHS, but the con of private hospitals is that patients believe the consultant is always there for you. Sometimes it isn't even the consultant doing the operation junior doctors and even nurses have long been allowed to dabble with the instruments for extra cash - and I know very few consultants who sleep over to be with their customers. The best you can hope for if disaster strikes is that they transfer you to the NHS as quickly as possible, and that you win the race to the ventilator. If you're really lucky, the taxpayer will pay. So much for ploughing back money into the NHS.