Long NHS waiting lists fuel rise in number of patients paying for private care

Health experts warned that increased demand could ‘exacerbate inequalities’ between those who can afford to pay and those who cannot.

The number of people in England waiting to start routine hospital treatment climbed to a new record high of 6.6 million people at the end of May (Rui Vieira/PA) (PA Archive)

Long NHS waiting lists are causing patients to “opt out” of NHS treatment and pay for healthcare from their own pockets, experts have said.

New figures show that patients paid for 69,045 private treatments themselves between October and December 2021, up 39% on the equivalent period in the pre-pandemic year of 2019.

The data from the the Private Healthcare Information Network (Phin), published on Friday, also shows there were 258,445 self-pay admissions at private providers in 2021, up 29% from the 199,675 in 2019.

Health experts said the record NHS backlog could be fuelling the demand for private care and warned that this could “exacerbate inequalities” between people who can afford to pay and those who cannot.

The number of people in England waiting to start routine hospital treatment climbed to a new record high of 6.6 million at the end of May.

Phin said that certain common procedures such as hip and knee replacements and cataract surgery are the primary drivers of the growth in the self-pay market.

Hip replacements were up 141% from 2,085 between October and December 2019 to 5,015 during the same period last year, knee replacements rose 111% from 1,240 to 2,620, and cataract surgery was up 56% from 8,145 to 12,700.

Jonathon Holmes, policy adviser at think tank The King’s Fund, told the PA news agency that if the NHS was providing the access to services that people wanted then they would not be paying for their own care.

He added: “I think, overall, support for the model of an universal healthcare system funded via tax still is what the public largely supports and wants.

People are opting out of the NHS, not opting into the private sector

Jonathon Holmes, The King's Fund

“So, if the NHS were providing the access and immediacy of services that people want and need, I am quite sure that people would select the free-at-the-point-of-use NHS rather than spend their own resources.

“People are opting out of the NHS, not opting into the private sector.”

Louise Ansari, national director at Healthwatch England, said that, due to the cost-of-living crisis, the gap between those who can pay for private care and those who cannot is likely to grow.

She added: “We know that some people who would previously have gone down an NHS pathway have already had treatment privately during the pandemic, and almost one in seven of those on waiting lists say they can afford to go private and are considering it.

“Yet, for more than two-thirds of people going private simply isn’t an option and, with the rising cost-of-living crisis, the gap between these groups is only likely to grow.

“Our evidence also shows that people on the lowest incomes are the most likely to wait the longest for NHS treatment and will have a more negative experience of waiting.

Tackling the NHS backlog is a huge challenge but decision-makers must find a way to do so without exacerbating health inequalities

Louise Ansari, Healthwatch England

“In turn, this leads to a worse impact on their physical health, mental health and their ability to work and care for loved ones.

“Tackling the NHS backlog is a huge challenge but decision-makers must find a way to do so without exacerbating health inequalities, the extent of which has been laid bare by the pandemic.”

The Phin data also shows that there are wide regional differences in the growth in people paying for independent healthcare themselves.

Wales had the largest growth, with 3,575 self-pay admissions between October and December last year, up 90% from the 1,885 in the same three months of 2019.

This was followed by Scotland at 84%, and the East Midlands at 75%.

Meanwhile, self-pay admissions rose by 20% in London from 11,580 between October and December 2019 to 13,875 in those three months in 2021, followed by a 25% rise in south-west England and a 32% rise in the south-east of England.

David Hare, chief executive of the Independent Healthcare Providers Network, said that, with NHS waiting lists growing, it is not surprising more people are choosing to go private.

“With NHS waiting lists at record levels and likely to continue to grow, it is not surprising that more people are paying for private treatment, including those who have never previously considered it,” he said.

“Recent IHPN polling found nearly half of the public would consider private healthcare and, with almost 700 independent healthcare sites across England delivering a wide range of services from consultations, tests and scans to surgery, there is significant capacity available for those that wish to fund their own care.”

An NHS spokesman said: “NHS staff have been working flat out to carry out as many elective procedures as possible, and over the past six months since our Covid Recovery Plan was launched the number of people waiting more than two years has dropped by more than 80%.

“There is no doubt the NHS still faces pressures – including an increase in Covid patients in hospitals and demand for emergency care – but we are committed to carrying out as much elective treatment as possible for patients, and one of the benefits of the NHS is that hospitals can work together, and so, if people can and want to be treated elsewhere in the country more quickly, NHS staff are ensuring that it can happen.”