Britain’s NHS was once idolized. Today, the worst crisis in its history is fueling a boom in private health care


Tens of thousands of nurses and nearly 12,000 paramedics went on strike on Monday over wages and working conditions in the biggest strike in Britain’s National Health Service (NHS) 75-year history.

The escalating industrial action comes after years of falling wages, tight budgets and staff shortages that have left the NHS in a state of crisis, with wait times for treatment at an all-time high. At the same time, an aging population needs its services more than ever.

This unfortunate mix is ​​fueling a boom in demand for private healthcare from a much wider part of the UK population than ever before – a fundamental change for a nation with one of the world’s best known universal health systems.

“Our providers tell us that people are going private, many for the first time, and the key factor driving this is the challenge of accessing NHS care,” said David Furness, director of policy at Independent Healthcare Providers. Network, an industry body for private healthcare companies.

At the end of November, a record 7.2million patients in England were waiting for non-emergency medical treatment on the NHS, known as ‘elective’ care. This covers diagnostic tests and scans, procedures such as hip and knee replacements, but also heart surgery, cancer treatment and neurosurgery.

More than half of those on the list were waiting up to 18 weeks and around 400,000 patients had been waiting for more than a year, NHS England data shows.

To avoid being put on a waiting list, more and more people pay for their own private medical care or take out health insurance.

In the second quarter of 2022, the number of patients paying directly for private hospital care rose 34% from the same period in 2019 to 67,000, according to the Private Healthcare Information Network, which collects data on private healthcare. UK.

The figures revealed a 184% increase in the number of people paying for hip replacements during this period, a 153% increase in self-payment for knee replacements and a 42% increase in surgery deprived of cataracts.

To meet the growing demand for their services, private healthcare providers are growing at a rapid pace.

US group Cleveland Clinic plans to open its third UK facility in London later this year, adding to the 184-bed hospital and six-storey clinic it opened in the capital in 2021 and 2022 respectively .

Another US group, HCA Healthcare (HCA), which has more than 30 facilities in London and Manchester, will open a £100 million ($120 million) private hospital in Birmingham – the second largest city in the UK – later this year.

London Bridge Hospital, one of the largest private hospitals in the UK operated by HCA Healthcare.

And Spire Healthcare, one of the largest private hospital groups in the UK, is adding new clinics, theaters and beds across the country as it strives to meet demand.

CEO Justin Ash estimates the private healthcare market in the UK has doubled since before the pandemic to 15 million people.

“Our biggest challenge is how to deal with the number of patients who come to us,” he told CNN.

The group plans to develop two new clinics in 2023, which are faster to build than hospitals and designed for procedures that do not require overnight stays – for example, those in ophthalmology, gynecology and dermatology.

Spire is also pushing into primary care services, citing demand for face-to-face appointments with GPs. In December, it acquired The Doctors Clinic Group, a network of 22 private GP clinics with a strong presence in central London.

Ash said the appetite for private health care covers a much wider range of ages and incomes than in the past.

“It’s not the super-rich. It’s ordinary people choosing to go private, and that’s a change,” he said.

One such patient is Emma Freeth, a website administrator. She decided to take out private medical insurance after waiting nine months to see an NHS specialist.

“That’s what really triggered it: the idea that I just want to be able to get help when I need it, rather than having to wait and wait and wait,” she said. told CNN. “If I was in pain or uncomfortable, that would be a real problem,” she said of her thoughts at the time.

In November, Freeth, 58, and her 55-year-old husband, Peter, a photographer, purchased personal medical insurance for the first time in their lives.

Their story is reflected in data from health insurers. Bupa added 150,000 new UK health insurance customers in 2022, while rival VitalityHealth saw a 20% increase in customers over the past year to more than 900,000.

“We expect the growth we’ve seen in health insurance take-up to continue into 2023,” said Neville Koopowitz, CEO of Vitality UK.

“That’s because people are definitely turning to private health care to ensure they have access to high-quality care, quickly, if they get sick,” he added.

Nursing staff and supporters march from University College Hospital to Downing Street on January 18, 2023 in London, England.

The Freeths, who are self-employed, said minimizing time off for health issues was a major factor in their decision-making, especially given the long waiting times for NHS appointments .

Record numbers of Britons are leaving the labor market due to long-term illness, a problem it attributes in part to long waiting times for NHS treatment, according to the Office for National Statistics.

This is an issue of increasing concern to employers. A recent survey of more than 1,000 companies by Savanta on behalf of the Independent Healthcare Providers Network found that more than half fear rising NHS waiting times will lead to prolonged absences or permanent work stoppages due to illness.

And one in five said they plan to offer private medical insurance to their employees in the coming year.

With the NHS estimating it will take years for waiting times to come down, demand for private healthcare in Britain is set to continue to grow.

In the longer term, there are questions about whether the NHS is sustainable in its current form, providing free comprehensive healthcare to all funded solely by taxes, particularly in the context of an aging population and strained public finances.

The NHS is already the biggest single item of public spending in Britain, according to the Office for Budget Responsibility, with ONS figures showing healthcare spending accounts for around 12% of GDP.

Some experts fear that moving away from a universal NHS could lead to a two-tier healthcare system where people of means pay for private care, allowing them to return to work and resume normal life more quickly than those who are less well off and forced to rely on constrained public services.

“The risk is less sudden privatization than the emergence of something resembling the English education system – where the best education is so often conditional on the ability to pay,” wrote researchers from the Institute for Public Policy Research, a think tank. a report last year.

“If this were to become the new norm…it would worsen overall health and deepen inequalities,” they added.

But Ash of Spire Healthcare has a less dystopian view of the future. “We have clearly entered a world where we are all NHS patients but have episodes of private care,” he said.

It’s “a million miles from an American system,” he added. There is no universal health care in America and most people have private health insurance because health care is very expensive.

“There is a huge commitment to the NHS. You can’t underestimate that,” Ash said.


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