Private healthcare provision has increased by 30% across UK

Record waiting lists have led to a 30% increase in the number of people paying for private healthcare provision across the UK’s four countries, according to new research from the Nuffield Trust.

The new briefing used Private Healthcare Information Network data for admissions and found that the number of self-funded healthcare provision rose 218% from 800 to 2,560 per quarter in Northern Ireland. It also doubled in Wales (up 124% from 1,865 to 4,100), increased by 80% from 2,835 to 5,165 in Scotland, and rose by 20% from 45,000 to 54,000 in England.

Private healthcare insurance admissions has also grown since the pandemic (up 5%), although this growth is more recent towards the end of 2023. Proportionally, Northern Ireland again sees the biggest increase in hospital care covered by private healthcare plans (a rise of 250% during the same period).

Mark Dayan, Nuffield Trust’s Policy Analyst and Head of Public Affairs, said: “While the vast majority of care remains NHS funded and delivered, there has been a definitive shift in all four UK countries towards private healthcare either funded out of pocket or to a lesser extent through private healthcare plans.

“Scotland, Wales, and Northern Ireland have seen the starkest rises in those turning to private healthcare provision. In Northern Ireland this more than tripled and could reflect patients grappling with the longest waiting times in any UK countries. At the same time, the English health service is once again starting to make more use of private providers itself, insofar as its budget can stretch.”

Private healthcare risks entrenching health inequalities

The report says that much of this increase is likely driven by record waiting lists, which deteriorated further during the pandemic. However, the authors warn that the rise in private sector provision risks entrenching health inequalities by determining the availability of care based on financial resource rather than need in a context of general scarcity.

It adds that since the pandemic there has been substantial growth in spending by NHS trusts in England on private care. Spending has nearly doubled (an 88% increase) between 2019/20 and 2022/23 and the proportion of patients in private hospitals in England has risen from 5.6% before the pandemic to 7.5% in 2022/23.

Data also suggests that, on average, 30,000 more patients a week are being treated privately within the NHS in England.

Mark Dayan added: “The private sector offers people more treatment at a time when many are in need and the health service is struggling to respond. But this shift raises difficult questions. The NHS could come to be reliant on private capacity without increasing what it can deliver. That capacity won’t always be in the right places, and at times there will be bidding against the health service. As more people shuttle from private care to NHS care and back, there is a risk that they will jump the queue, or fall through the cracks of disjointed information systems.

“The fact that more people are paying out of pocket at a time when the economy is tight and difficult, not a time of plenty, suggests they are turning to the private sector out of desperation as NHS provision flatlines. That means that the balance of care is very slowly shifting from care based on need, to care based on willingness and ability to pay.”