When Belinda Andrews-Jones developed back pain so severe it triggered memories of childbirth, she counted on help from Britain’s taxpayer-funded NHS.
But the 47-year-old was told that it would take months to see a specialist and even then she might not qualify for surgery since her bladder was unaffected. She turned to the private sector, paying about £12,000 to have an operation at the Spire Southampton hospital to correct a severely protruding spinal disc.
She is not alone. The NHS, which marks its 75th anniversary in July, has long been seen by Britons as a repository of cherished national values. But with the queue for planned surgery at record levels and long waits for a GP appointment, millions are setting that fealty aside to buy care in the private sector.
Justin Ash, chief executive of Spire, the only listed UK private healthcare group, said the company’s hospital business was experiencing “unprecedented demand”. He added: “Obviously the waiting lists are part of the backdrop.”
Spire said 60 per cent of its target audience was now more likely to consider using a private hospital than before as a result of growing NHS waiting lists.
Going private was not easy for Andrews-Jones. She had to take out a loan and dip into savings from an earlier redundancy payout that she had earmarked for home improvements.
But the business consultant said she had undertaken a “cost-benefit analysis”. Without the operation, she could not work. Within weeks of the surgery she had secured and started a new job. She still values the NHS and believes the UK is lucky to have a system of free healthcare. But her faith in it has been shaken.
“I just find it very, very frustrating . . . I was in horrific pain and the NHS wasn’t there for me,” she said.
One in 10 Britons made use of private healthcare before the pandemic, according to figures from the OECD. But more recent surveys show that NHS shortcomings are pushing more people to pay for treatment.
In the winter of 2021, the IPPR and YouGov found that 12 per cent of the population used some form of paid-for alternative care, with the proportion rising to 16 per cent for wealthier groups. A survey carried out by the Office for National Statistics in December 2022 puts that figure at 13 per cent.
With both nurses and ambulance drivers holding strikes this month, Google searches for “private healthcare” and “private GP” in the UK have been trending upwards and reached a peak, far exceeding highs during the pandemic, when access to public healthcare was extremely limited.
David Furness, director of policy at the Independent Healthcare Providers Network, which represents private health companies, said recent IHPN polling showed that more than 1 in 5 people expected to use private healthcare in the next 12 months and almost half of the public would consider private healthcare if they needed treatment. The historically high level of waiting lists was driving even those who had never previously considered it to seek out private treatment, he added.
A separate survey of more than 1,000 small, medium and large UK businesses carried out for the IHPN pointed to a growing concern about the impact of long waiting lists on productivity and a willingness to consider private medical insurance for employees.
More than half of organisations were “concerned that the current rising NHS waiting times may result in employees taking long absences or permanently leaving work due to sickness”, Furness said. This rose to more than two-thirds of medium or large businesses and almost three quarters of those which had more than 1,000 employees.
Almost one in five employers were considering offering private medical insurance to their staff in the coming year — rising to almost four in ten (37 per cent) of businesses with more than 1,000 employees, he said.
Spire’s Ash confirmed the trend: “It looks to us like the underlying market for insurance is growing . . . so it’s not just self-pay which has been growing. It looks like employers are absolutely leaning into providing more insurance for their employees.”
Large insurers have seen a rise in demand. Aviva said the number of people covered by its private medical insurance had increased from 0.9mn in 2020 to 1.1mn in 2022.
Meanwhile provider HCA Healthcare UK said it had seen a “steady growth in demand for private healthcare across the board both in terms of volume and new patients”. The number of new self-pay patients had increased by almost 20 per cent, it said.
Dr Keith Klintworth, managing director of insurer VitalityHealth, said the reasons more people were choosing to buy health insurance “are more complex than NHS waits alone”.
People wanted to be confident of securing timely, high quality treatment, he argued, adding that the use of self-pay for individual procedures over the past year had heightened awareness of the costs and driven home the relative affordability of private insurance.
However, he acknowledged that the pandemic and NHS pressure had led people to look for “wider health support”.
A particular area of growth has been primary care. It accounted for more than half of all claims in the year to September 2022, increasing from just 10 per cent in 2015.
However, some policy experts worry about the long-term implications of this trend, fearing a two-tier system may develop, leaving better-off Britons who have the resources to go private less willing to pay the levels of taxation required to sustain the NHS.
Nigel Edwards, chief executive of the Nuffield Trust, said the UK was still some way off that “tipping point” in relation to elective surgery, with a substantial majority still carried out in the NHS. But in a “dystopian” sign of the potential shape of things to come, about 50 per cent of dentistry by value was now carried out in the private sector.
Should the wealthier feel that they had less of a stake in the universal state-funded system, the result could be declining quality, Edwards suggested. He cited the social researcher, Richard Titmuss, who in 1967 warned that “separate discriminatory services for poor people have always tended to be poor quality services”.
